[Physical examination preceding entry into apprenticeship: preventive measure or administrative burden?]

The new Swiss federal legislation on vocational and trade training requires that all cantons organize a system of medical screening for young people entering an apprenticeship. This paper focuses on the principles and implementation of such an examination. It outlines the most frequent health problems young people may face upon leaving school and entering apprenticeship. It underlines the difficulties of this kind of examination, since absolute contra-indications to distinct professions are very rare. Indeed, the medical examination should not be a selection procedure but much more an occasion to facilitate the transition from school to workplace. With this objective, the canton of Vaud health authority has created an examination sheet that will be supplied each year to the physicians (private pediatricians, general practitioners and internists) examining about 5000 candidates. This instrument introduces a uniform history taking procedure oriented towards occupational medicine and focuses on a few important screening items. No laboratory tests are mandatory. The process does not use a contra-indication list, which most of the time appears fallacious. It insists on the importance of an assessment of each individual situation.