Empirical findings of fitness-for-duty evaluations

This article was migrated. The article was marked as recommended. Background:The ability of physicians to practice appropriately is often evaluated by a fitness for duty exam. This report reviews the empirical literature on fitness for duty evaluations. Methods: A literature review was performed on PubMed using the terms physician, impairment, burnout, fitness to practice and fitness for duty. Results: At least one percent of physicians are referred each year for possibly serious difficulties. Surgery and its subspecialties and psychiatry may be at higher risk. Variables associated with fitness for duty evaluations include educational, personality, culture and emotional illness. Conclusions: Risk factors appear to vary between modifiable (training, culture and treatable emotional illness), less modifiable (personality) and likely unmodifiable (specialty).  Fitness for duty should be part of the training of all psychiatrists.