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Have you ever wondered what exactly happens during a pre-employment physical? A pre-employment physical, also known as a pre-placement physical or pre-hire medical exam, is a medical check-up often required by employers before a job offer is finalized.

While the specifics of the exam may vary depending on the job and industry, some common components are typically included in a standard pre-employment physical.

Medical History and Physical Examination

One of the first parts of the pre-employment physical is providing your medical history. The medical professional will likely ask you about any pre-existing conditions, past injuries or surgeries, current medications, and your family history of medical issues.

They will then perform a basic physical examination. This usually involves checking your vital signs, like blood pressure, temperature, pulse, and respiratory rate. The doctor will listen to your heart and lungs with a stethoscope.

They may check things like your vision, hearing, reflexes, and range of motion and do a brief neurological examination as well. The physical exam helps determine if you have any physical limitations or restrictions.

Drug and Alcohol Screening

It is also very common for employers to require a drug and alcohol screening as part of the pre-employment physical. This usually involves providing a urine sample that is tested for the presence of illegal drugs or alcohol.

Employers are legally allowed to require drug screening for safety-sensitive jobs or positions where drug or alcohol use could impact job performance and safety.

Other Possible Tests

Depending on the job requirements and risks, some employers may request additional medical tests as part of the pre-employment physical.

Here are some other tests that may potentially be included:

  1. Respiratory Fitness Test: Required for jobs that involve strenuous physical activity or working in hazardous conditions.
  2. Audiogram: Measures hearing ability through earphones. For jobs with high noise exposure.
  3. Vision Test: Checks visual acuity, color vision, and other aspects of sight. Important for driving/operation jobs.
  4. Strength/Lifting Test: Determines ability to meet physical demands. Typical for construction, labor, and public safety roles.
  5. Back Evaluation: Assesses back health through movements/positions. Important for material handling jobs.
  6. TB Skin Test: Checks for exposure to tuberculosis bacteria. Often required in healthcare settings.
  7. Blood Tests: Can check for blood cell count, cholesterol, diabetes, etc. It may be needed based on job duties/risks.

Medical Evaluation and Clearance

Once all required tests are complete, the evaluating medical professional will review the results. They will determine if you meet the health and safety standards for the job in question. Any medical conditions or test abnormalities may require follow-up exams or documentation from your regular doctor before clearance.

The doctor will issue a fit-for-duty certification for medical recommendation documenting their evaluation results. This determination is then provided to the employer for final hiring decisions.

Employers must keep all medical information confidential under the Americans with Disabilities Act (ADA).

Purpose of Pre-Employment Screening

The goal of requiring pre-employment physicals is to help employers assess an individual’s medical fitness for the job and identify any limitations or restrictions early on. It protects both the employee and employer.

For the employee, it ensures they can safely perform the job duties without risking their health or safety. On the other hand, for the employer, it reduces the chances of hiring someone who may face a higher risk of work-related injury or illness, file a workers’ compensation claim, take unplanned medical leave, or be unable to meet essential job functions.

Pre-screening can help avoid unnecessary costs, workplace hazards, and potential legal liability issues.


While a pre-employment physical may feel invasive, undergoing the screening allows job-seekers to showcase their ability and health for the position. Focus on seeing it as an opportunity rather than an obstacle. Come prepared knowing the types of tests to expect so there are no surprises.

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