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CENTRE FOR ADVANCED ASSESSMENT

Fitness for Duty & Practice Assessment

Fitness for Duty
& Practice Assessment

These high stakes multidisciplinary evaluations include psychological, neuropsychological, psychiatric, and occupational medicine assessments. Fitness for Duty evaluations are called for in the context of challenging work readiness scenarios where risk to safety of self or others may be involved. They are specialized evaluations of professionals in safety sensitive occupations, such as physicians or airline pilots, to determine their cognitive, emotional, and behavioural ability to carry out the duties of their profession.

The CORTEX Centre’s advanced Fitness for Duty evaluation methodology assesses a range of cognitive, emotional, and behavioural difficulties that can adversely affect pertinent work functions. This is particularly helpful when assessing individuals such as physicians and surgeons, other healthcare professionals, or aviation personnel who are in decision-making positions that affect the health, safety, and lives of others.

The CORTEX Centre provides multidisciplinary Fitness for Duty evaluations; in addition to clinical psychologists and neuropsychologists, our experts also include highly qualified medical, occupational therapy, and vocational rehabilitation consultants. Our Fitness for Duty assessments are designed to meet both the highest professional standards in the field, as well as respective regulatory and legal requirements. In some cases, where mental ability to perform professional duties safely is a concern, the CORTEX Centre can provide cognitive screening evaluations pertinent to a given occupation.

The unique features of the CORTEX Centre’s Fitness for Duty Evaluations include:

  • Focus on psychological, cognitive, and mental health components of work capacity
  • Integrated clinical and occupational expertise
  • Evidence-informed, multimodal, and rigorous methodology
  • Provision of remediation and return to work plans, where applicable
  • High standards required by professional regulatory bodies, government agencies and employers
  • Sensitive to Canadian contexts, regulations, legislation, and resources

Physicians and Surgeons

The CORTEX Centre uses advanced assessments to help physicians and surgeons determine if they have the mental capacity to continue practicing medicine.

The CORTEX Centre’s Fitness for Duty Evaluations for Physicians focus on mental health, addictions, and cognitive issues interfering with the safe practice of medicine.  Our psychological, neuropsychological, medical, and occupational experts provide a diagnosis, clinical and vocational prognosis, treatment and work recommendations (including job accommodations and other workplace interventions), and evaluate the impact of impairment or difficulties on work capacity. The most common assessment issues involve early dementia, brain aging and injury, neurological conditions, serious mental health problems, substance abuse, distress and disruption in the workplace, misconduct and boundary violations, and other difficulties performing a professional role.

To precisely respond to referral questions, the CORTEX Centre’s multimodal Fitness for Duty Evaluations integrate clinical and vocational evidence collected from independent sources, focusing on the impact of specific psychological, neuropsychological, psychiatric, or addiction issues on work capacity and the safe practice of medicine. Specific job and occupational context is analyzed, including demands, supports, and control factors. If medical practice can be safely performed under specific conditions, our reports clearly identify them. Such conditions include recommended workplace environment characteristics, job accommodations, consideration of specific risk factors, as well as conditions of treatment and treatment monitoring, together with appropriate workplace and other interventions (see Guidelines for Psychiatric “Fitness of Duty” Evaluations of Physicians, 2004, American Psychiatric Association).

The CORTEX Centre’s Fitness for Duty Evaluations for Physicians endeavour to obtain a thorough history of clinical conditions and work issues, gathering collateral data from health care providers, spouses, peers, supervisory and supervisee sources, administrative and regulatory bodies and other sources, in addition to relevant psychological, neuropsychological, medical, and occupational testing. We also provide specialized cognitive screening.

The professional specialty composition of our multidisciplinary evaluation team is customized depending on the specific clinical and occupational issues involved. In addition to psychology and neuropsychology, we implement expertise in occupational medicine, psychiatry, neuropsychiatry, occupational therapy, and vocational rehabilitation. We offer both basic and expanded Fitness for Duty evaluations, in addition to neuropsychological screening, depending on the referral questions and specific needs.  The duration of assessment depends on the nature of referral.

To our knowledge, the CORTEX Centre’s Fitness for Duty Evaluation for Physicians is the only such integrated program in Canada, and therefore uniquely sensitive to Canadian health care, legislative, regulatory, employment, and resource contexts.

Nurses, Dentists, Pharmacists, and Other Healthcare Professionals

The CORTEX Centre uses advanced assessments to help nurses, dentists, pharmacists, and other licensed health professionals determine if they have developed emotional, cognitive, and behavioural difficulties that adversely affect their work capacity and fitness for duty.

The most common assessment issues involve early dementia, brain injury, neurological conditions, chronic pain, serious mental health problems, and addictions. The CORTEX Centre can provide a diagnosis, clinical and vocational prognosis, clinical and work recommendations (including return to work and job accommodations), and assess the impact of impairment on work capacity. Specific job demands, supports, and control factors, together with the work context, are analyzed in the process of assessment. In addition to psychological and neuropsychological assessments, multidisciplinary assessments tailored to individual referral circumstances are available.

Airline Pilots and Air Traffic Controllers

The CORTEX Centre uses advanced assessments for Fitness for Duty Evaluations for airline pilots and air traffic controllers in order to determine if they have developed emotional, cognitive, and behavioural difficulties that potentially adversely affect their fitness for duty and preclude safe completion of duties. These psychological, neuropsychological, psychiatric, and multidisciplinary assessments with an occupational health and vocational capacity focus are designed to meet required professional and regulatory standards in aviation.

The most common assessment issues involve early dementia, brain injury, neurological conditions, substance use and serious mental health problems. Some mental health and neurological conditions may be aeromedically significant if they occur unpredictably, cause sudden or subtle incapacitation, have no easily detectable signs, or require frequent or invasive treatments.  The CORTEX Centre can provide a diagnosis, determination of functional limitations, clinical and vocational prognosis, clinical and work recommendations (including return to work), and assess the impact of impairment on work capacity. Analysis of specific work demands and supports is included in the evaluation process.

Law Enforcement

The CORTEX Centre uses advanced assessments to help police officers and other law enforcement professionals determine if they have developed emotional, cognitive, and behavioural difficulties in the course of their employment that may negatively affect their fitness for duty.

The most common assessment issues involve early dementia, brain injury, neurological conditions, and serious mental health problems. The CORTEX Centre can provide a diagnosis, clinical and vocational prognosis, clinical and return to work recommendations (including job accommodations), and assess the impact of impairment on work capacity and related special functions (such as carrying firearms). Analysis of specific work demands, supports, control factors, and work environment issues is included in the assessment process.

Other Professionals

The CORTEX Centre also provides custom-designed Fitness for Duty evaluations for professionals in a variety of other safety sensitive occupations, such as transportation professionals, firefighters, teachers, or nuclear plant operators, to determine if they have developed mental health or cognitive difficulties that adversely affect their fitness for duty.

The most common assessment issues include serious mental health symptoms, addictions, chronic pain, early dementia, and neurological problems. We provide diagnosis, determination of functional limitations, prognosis, clinical and return to work recommendations (including job accommodations), and assess the impact of impairment on work capacity. Analysis of specific work demands and supports is included in the evaluation process.