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I took it the first year it was out and mine had a bunch of beta questions.

The scenarios weren’t realistic as I recall.

My cert is good till 2024 but I won’t ever do another DOT ever if I can help it.

Get thru the test but rely on common sense and current data to make decisions. 

Books by Natalie Hartenbaum are worth every penny.

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Basically memorize the blood pressure and vision standards. If you see the choice refer to PCP or specialist pick that one. My test really hammered home that you're just checking boxes, not actually treating people. I got a 90 on it and barely studied. I thought it was one of the easiest tests I've ever taken

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3 hours ago, Pac30 said:

Basically memorize the blood pressure and vision standards. If you see the choice refer to PCP or specialist pick that one. My test really hammered home that you're just checking boxes, not actually treating people. I got a 90 on it and barely studied. I thought it was one of the easiest tests I've ever taken

I seem to recall it was a bit more involved than that, but not by much.

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4 hours ago, rev ronin said:

I seem to recall it was a bit more involved than that, but not by much.

Yeah I just took it in January. I think that's enough to bring you most of the way home. I had a couple automatic disqualifier questions but most of them you can work your way through without memorizing.

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It is 1,000,000x easier than the Pance/Panre.  Most if it is common sense.  As someone previously mentioned know the "standards"

 

Otherwise questions similar to this:  You hear a heart murmur, what test would you order?  A)  Chest X-Ray  B)  MRI  C)  Echocardiogram  D)  EMG

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1 hour ago, ShakaHoo said:

It is 1,000,000x easier than the Pance/Panre.  Most if it is common sense.  As someone previously mentioned know the "standards"

 

Otherwise questions similar to this:  You hear a heart murmur, what test would you order?  A)  Chest X-Ray  B)  MRI  C)  Echocardiogram  D)  EMG

E) Refer to cardio for clearance. . . 

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2 hours ago, DizzyJ said:

E) Refer to cardio for clearance. . . 

And then in the real world the cardiologist says...

1.  "I cannot not clear them to drive that is your job." 

 

Or...

 

2.  "They are stable from a cardiovascular standpoint, but I cannot comment on their ability to operate a commercial motor vehicle."

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On 11/11/2020 at 2:14 PM, ShakaHoo said:

And then in the real world the cardiologist says...

1.  "I cannot not clear them to drive that is your job." 

 

Or...

 

2.  "They are stable from a cardiovascular standpoint, but I cannot comment on their ability to operate a commercial motor vehicle."

In my "real world" of doing DOT exams, I never had 1 or 2 be the answer returned to me.  They came back with clearance or they didn't drive.  

I never ordered tests. That wasn't my job to workup anything.  So, no CXR, EKG, ECHO...refer to cardio. 

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1 hour ago, DizzyJ said:

In my "real world" of doing DOT exams, I never had 1 or 2 be the answer returned to me.  They came back with clearance or they didn't drive.  

I never ordered tests. That wasn't my job to workup anything.  So, no CXR, EKG, ECHO...refer to cardio. 

I agree as well.  I never order any tests either.

I literally got a note from a cardiologist early this week.  CAD stable, patient doing well with no reported chest pain or SOB.  echo shows.......  "As for the patient's ability to safely operate a commercial motor vehicle, I leave that in your perfectly capable hands."

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Those that do DOT 

create a hand out that tells the CARS provider(or any other specialist) what you need from them. Exactly.  Spell it out and after they get it for the fifth sixth and seventh time from you they will start to realize what they need to do.  
 

they really have no idea about cdl refs so make their job easier by informing them what you need. 

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free to copy paste and re-use - just write patient name in, and then check off boxes that apply

 

 

DATE ________________

RE:______________________

DOB______________________

 

Dear Healthcare Provider:

 

Today we had the pleasure of seeing your patient for their DOT physical exam.  The goal of the DOT physical exam is to determine an individual's “medical fitness for duty” in accordance with the Federal Motor Carrier Safety Administration's guidelines and regulations.  Fitness is based on the presence of “physical, mental or organic conditions of such character and extent as to affect the ability of the driver to operate a commercial vehicle safely.”  https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/mission/advisory-committees/mrb/83401/fmcsamedicalexaminerhandbook.pdf 

 

Despite our diligence, we are limited by an individual's self reporting of medical history both on DOT forms and via medical examiner questioning.  Oftentimes, the DOT exam is our first ever encounter with your patient.  Due to these limitations, we ask for your assistance.  We ask that you please provide us with the following information:

(this should be provided with a brief typed or handwritten note)

 

Cardiac History

▢  Document from you (or if you are not a cardiologist a consult from the patients cardiologist) clearing the patient from a cardiac standpoint to safely operate a vehicle/machinery with their cardiac history.

▢  A copy of the patients most recent       ▢ ECHO ▢ Stress Test 

STENT/PCI - Stress test must be < 2 years old, starting 3-6months after STENT  

CABG -  Annual Stress test starting 5 years after CABG 

▢  HTN - a statement from you stating that the patient is well controlled with BP’s consistently <140/90, compliant with medications and follow up.  

▢  Written note/document confirming this patient is stable on the medication and has not had any adverse events or side effects (daytime somnolence, slowed reaction time, altered mental status, hypoglycemia, syncopal episode, falls etc…..)

 

Diabetes (not on insulin)

▢ Document from you that you are the treating provider ) clearing the patient from an endocrine standpoint to safely operate a vehicle/machinery with their cardiac history.

▢ Most recent HgA1C, date and value (It must be within 60 days or it is invalid - please order a new HgA1C if > 60 days old)

▢  Written note/document confirming this patient is stable on the medication and has not had any adverse events or side effects (daytime somnolence, slowed reaction time, altered mental status, hypoglycemia,syncopal episode, falls etc…..)

▢  Patient is stable on their DM management, compliant with follow up with treating provider

 

Diabetes (Uses any type of insulin)

▢ Document from you that you are the treating provider, clearing the patient from an endocrine standpoint to safely operate a vehicle/machinery with their cardiac history.

This must be done on MCSA-5870, US Dept of Transportation, INSULIN-TREATED DIABETES MELLITUS ASSESSMENT FORM (available on web with simple google search) - please complete fully and forward to us

 

Neurologic Condition

▢  Document from you stating you are the treating provider for the neurologic condition, clearing the patient from a neurological standpoint to safely operate a vehicle/machinery with their history.

▢  A copy of the patients most recent    ________________________________________________________

▢   _____________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________

▢  Written note/document confirming this patient is stable on the medication and has not had any adverse events or side effects (daytime somnolence, slowed reaction time, altered mental status, hypoglycemia, syncopal episode, falls etc…..)

 

Sleep Apnea

▢  Document from you that you are the treating provider clearing the patient from an OSA standpoint to safely operate a vehicle/machinery with their cardiac history.

▢  A copy of the patients most recent CPAP compliance report (must be within 30 days and encompass at least 90 days use-unless brand new Dx then only 30 days compliance needed)

▢  Written note/document confirming this patient is stable on the treatment pan and has not had any adverse events or side effects (daytime somnolence, slowed reaction time, altered mental status, hypoglycemia, syncopal episode, falls etc…..)

 

OTHER: ____________________________________

▢  Document from you that you are the treating provider clearing the patient from an ________________ standpoint to safely operate a vehicle/machinery with their history.

▢   _____________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________

▢   _____________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________

▢   _____________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________

▢  Written note/document confirming this patient is stable on the treatment pan and has not had any adverse events or side effects (daytime somnolence, slowed reaction time, altered mental status, hypoglycemia, syncopal episode, falls etc…..)



 

We appreciate your assistance with completing this in a time sensitive manner as we have only 45 days to complete the entire process.  Please fax the requested notes to

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  • 4 weeks later...

I just took it in June 2020.  It wasn't hard but it wasn't easy, only because the questions are so weird.  As long as you know all about the HTN guidelines, sleep apnea requirements, vision, and hearing you will be fine.  Just make sure to study. 

For the record, I absolutely HATE doing DOT exams.  I wish I never had to another one.  But, my job requires it so I don't have a choice.

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