Driver's Medical Exam

Do you have to do it?

Across most of North America there’s some process for ensuring people are medically fit to drive. If you’ve been told to do a driver’s medical exam, chances are:

• You are a certain age - sometimes a medical report is required when a driver reaches a certain age,
• You have a medical condition - either diagnosed with or suspected to have a medical condition that could affect driving abilities, or,
• It's a lead from authorities - the driver licensing authority has received information from say, a health professional or police officer that needs to be followed up on

Whatever the reason, if you’ve been told to do a medical exam, do it. And within the time required. Otherwise you may have to give up driving.

How does a medical exam work?

The medical exam is done to report to the licensing body if you have any medical conditions that could impact your driving ability. Sometimes the diagnosis of a medical condition is enough to determine you can’t drive, even without doing a driving test. A good example of this is narcolepsy, which periodically and unpredictably causes problems with alertness. Obviously no one wants to have a driver on the road who could fall asleep or lose consciousness at any time.

There are some conditions that can cause temporary or limited impact on driving, for example a mild stroke or seizure disorder. These often require a driver be symptom free for a certain amount of time before they can drive again.

There are also conditions we know can affect driving but we don’t know to what extent. In these cases, it’s not the diagnosis of a condition that matters, it’s the impact the condition has on driving. That’s where a test comes in.

What can I expect?

All driver’s medical exams collect information on the functions important to driving. Usually a doctor or nurse will be ask if you have problems with your:

• Vision
• Heart or vascular system
• Brain or nervous system
• Physical abilities
• Lungs or breathing

They also ask if you have any psychiatric conditions, drug or alcohol dependencies or other conditions that could affect driving.

Tests can include a report on vital signs, like blood pressure and eyesight.

You may also be asked to do some further testing of your functional abilities. Some of these tests can be done in a doctor’s office, at a clinic or with a specialist. The testing will include screens and assessments.

What is the difference between a screen and an assessment?

Screens are used to see if you need a more in depth assessment or evaluation. A screen for driving determines if you are at risk for having a functional impairment - it doesn’t necessarily mean you have one. Screening can include being asked a few questions to completing a formal screening tool. Some common screening tools include:

• SIMARD-MD- this is the only evidence-based screen available specific to the cognitive or thinking abilities related to driving.
• Montreal Cognitive Assessment (MoCA)- an evidence-based screen for mild impairment. It is not specific to driving, but many doctors use it to determine if you could have mild impairment which indicates the need for more testing.
• Mini Mental Status Examination (MMSE)- this is another screen of cognitive abilities. It’s not as good for mild impairment and is not recommended to use for driving.

Assessments are tests that are more detailed and usually determine if you have an issue or not. For example, an x-ray, when a doctor thinks you might have a broken arm. The x-ray either confirms a break or rules it out.

Assessments are done at clinics or in a vehicle by specially trained professionals. Some common assessments related to driving include:

• DriveABLE- used to determine if a person has the cognitive abilities to drive.
• Functional Driving Assessment- looks at all your functional abilities: cognitive, motor and sensory.

Do I need to pay?

Unfortunately in many locations, routine examinations and testing related to driving are not covered by government programs. Sometimes testing is covered or partially covered, but usually you will have to pay for a medical exam and any further testing that isn’t run by the government. You will need to ask your doctor or nurse practitioner the fee they charge for driver’s medical examinations.

Going through a driver’s medical exam can be very stressful and it’s expected that you'll be nervous. But it’s an important part of making sure everyone on the road is fit to drive.