Advice for GPs

The medical assessment will be based on the following requirements.  Freedom from:

• Any abnormality, congenital or acquired; or
• Any active, latent, acute or chronic disability, disease or illness; or
• Any wound, injury or sequelae from an operation.

Such as may entail a degree of functional incapacity of the applicant to perform full Police duties throughout an expected career of up to 32 years.

Applicants with a history of frequent absences from work due to medical conditions may well be assessed as unfit. 

The applicant should not suffer from any disease or disability which may render him or her likely to become suddenly unable to perform any Police duty.  The functional job description of a Police Officer is attached (Appendix One).

The administration of therapeutic drugs for the treatment of any condition may produce side effects which are likely to interfere with the safe performance of duties.  An applicant taking regular medication causing such effects would be unlikely to be assessed as suitable for service in the Police.

Note:  Under an early retirement programme introduced in 1985, Police have to maintain standards of medical, physical and psychological health to perform the full range of Police duties, or they have to disengage or retire from the Police. This makes it uneconomic to recruit applicants who have the potential to develop conditions which would preclude a full career.

1. The applicant should not possess any abnormality of the heart, congenital or acquired, likely to interfere with the execution of Police duties.  A history of congenital heart disease or corrective surgery would have to be assessed in terms of likely prognosis.
2. Systolic and diastolic blood pressure should be within normal limits and therapy for hypertension would make an applicant unsuitable for service.  Blood pressure recordings which remain elevated, despite five minutes rest, above 140mm systolic and 90mm diastolic, would automatically downgrade applicants to a doubtful category (3) and they would normally require further investigation before acceptance.
3. Normal Blood Pressure with treatment (on medication) with no underlying medical condition is acceptable.

1. There should be no functional disability of the lungs or any active disease of the structures of the lungs, mediastinum, or pleura
2. Cases of active pulmonary tuberculosis will be assessed as unfit
3. Cases of asthma will generally be regarded as unfit for Police service due to its unpredictable outcome and the stressful and physical nature of policing.  Asthma can be acceptable if stable for prophylaxis treatment only and requiring no other treatment, and with normal results to a challenge test.  Doubtful cases will require specialist assessment
4. Recruit applicants will not routinely have a chest x-ray, but in cases of doubt, Police Medical Clearance Coordinator may recommend that applicants have a chest x-ray to exclude any abnormality prior to acceptance.

1. Problems which cause a functional incapacity will render applicants unfit for service, and applicants with evidence of past or chronic disease should be assessed carefully with regards to liability for future problems before acceptance
2. Chronic suppurative otitis media will render people unfit for service
3. A perforated tympanic membrane will render people unfit for service
4. Chronic sinusitis and severe allergic rhinitis, which cause functional incapacity or absence from work, would render applicants unsuitable for service.

It is not practicable to perform audiometric tests on all applicants to the Police, and the voice must continue to be used as the method of testing of hearing at recruit examinations.  If an applicant hears a forced whisper in each ear at three metres, this will be an acceptable standard.  Those who fail to hear a forced whisper at three metres in each ear will be required to undergo an audiogram. 

1. Method of Testing

The necessity for the quietest surroundings when testing hearing is emphasised.  The following points are to be observed:

1. Hearing tests are not to be performed under the following circumstances:

• If an uninterrupted view of each eardrum is not obtained, wax should be removed if need be.
• If a discharge is present, the applicant may require referral to a specialist in otolaryngology.
• The use of hearing aids, in-ear type, to achieve normal hearing to "forced whisper" test will be acceptable.

2. In performing a forced whisper, the examiner should first exhale to the extent of a normal exhalation and then perform the whispering.
3. In assessing hearing, the applicant should be placed sideways to the medical examiner with eyes closed so that there may be no lipreading.  The ear further away from the examiner should be occluded by an assistant’s middle finger which should be lightly shaken to produce masking effect in the ear which is not under test.    The procedure is reversed when the other ear is tested.
4. The applicant should be asked to repeat the words, phrases and numbers that are heard.  Numbers are more easily heard than words, and vowel sounds are more readily heard than consonants.  If the words to be repeated are chosen carefully, according to whether they are low pitched or high pitched, the examiner will be able to get some idea of the nature of any defect in hearing which may be present.
5. The following is a list of words which should be used in assessing hearing:

Low Tone

High Tone

2. Standards of Hearing

Acceptable

1. Hears a forced whisper at three metres in each ear, or better
2. Audiometric standard – no loss to exceed KH2 in each ear, audiometric results should be referred to the Manager: Recruiting and Appointments for a referral to the Medical Advisor.

In general, the following standards will be meet:

• 05, 1.00, 1.5, 2.0, and 3.0Hz, 20db or better
• 4 KHz; 30db or better
• 6 and 8 KHz, 40db or better

It will be acceptable for candidates to wear hearing aids, inner ear type (canal fitted), for either test.  Candidates who fail to meet these levels are unacceptable.

Visual Acuity

Minimum visual standards cover the following:

1. Ocular conditions (including laser surgery)
2. Uncorrected/corrected vision
3. Visual fields
4. Colour perception
5. Diplopia and strabismus
6. Low luminance

Tests are carried out by Police approved optometrists.

1. Cases of disabling disease with marked impairment of the function of the gastrointestinal tract or its adnexae will be assessed as unfit.  The applicant should be required to be free from hernias that might give rise to incapacitating symptoms
2. Any sequelae of disease or surgical intervention on any part of the digestive tract or adnexae, liable to cause incapacity, in particular, any obstruction due to stricture or compression, may be assessed as unfit
3. An applicant who has undergone a surgical operation on the biliary passages, the digestive tract or its adnexae, which has involved a major excision or a diversion of any of these organs, may be assessed as unfit until such time as the effects of the operation are not likely to cause incapacity, and the applicant is fit to perform full Police duties.

1. Cases or organic diseases of the kidney may be assessed as unfit.  The urine shall contain no abnormal element considered by the medical assessor to be of pathological significance.  Cases of infections of the urinary passages and of the genital organs may be assessed as unfit
2. Any sequelae of disease or surgical procedures on the kidneys or the urinary tracts liable to cause incapacity, in particular, any obstructions due to stone, structure or compression, may be assessed as unfit.  Compensated nephrectomy without hypertension or uraemia may be assessed as fit.

Metabolic, nutritional, or endocrine disorders likely to interfere with any Police duty will be assessed as unfit.

1. The applicant should have no established history or medical diagnosis of any of the following:

• A disease of the nervous system
• Epilepsy, unless unmedicated and seizure free for 5 years
• Any disturbance of consciousness due to a neurological condition without satisfactory medical explanation of the cause.

2. Cases of head injury, the effects of which are likely to interfere with the performance of any Police duty.

1. Spinal Disorders

1. Mild abnormalities of spinal curvature (mild kyphosis, lordosis or scoliosis) would not preclude service in the Police provided free and pain-free spinal movement exists
2. Any abnormalities which cause limitation in spinal movement should not be accepted
3. A history of a prolapsed intervertebral disc, sciatica, recurrent sacroiliac strain, recurrent lumbago or backache should not be accepted

2. Knee Problems

1. Major damage to the cruciate ligaments should preclude acceptance
2. Damage to the knee cartilages may preclude acceptance.  Removal of the complete cartilage would preclude acceptance, but the removal of a portion of the cartilage may be acceptable if the prognosis for the future has been assessed as good
3. Medial and lateral ligament damage will not preclude acceptance provided the injury has healed completely and there is no functional disability.

3. Other Joint Conditions

Acceptance will depend on the person’s functional ability to do Police work and the prognosis for the future.  Fracture through major joints will normally preclude acceptance because of the increased chance of osteoarthritis.

4. Musculoskeletal

The following movements should be performed to give the Police Medical Officer an opportunity of appraising general physical development and any abnormality of the bones and joints of the limbs and trunk, including spinal deformity.  It is important to note any abnormalities.

1. Neck movement

• Lateral rotation to the left and right
• Flexion and extension of the neck
• Rotation of the neck

2. Upper limbs

• Extend both arms forward with palms upward, open and close the hands, and move fingers and thumbs separately
• Turn the back of the hands upwards
• Bend the elbows and wrists freely
• Swing the arms around freely at the shoulder joint 

3. Lower limbs and spine

• Stand on the right foot, first on the sole, then on the ball of the foot, then on the toes.  Repeat on the left foot
• Stand on the right foot, extend the left leg and move the ankle and toes freely
• Repeat on the left foot
• Kneel on the right knee, rise to erect posture
• Repeat on the left knee
• Kneel on both knees, rising with a spring to erect posture
• Swing the right lower limb freely from the hip
• Repeat with the left lower limb
• Stand erect with feet slightly separated and with back turned to the examiner, stand on tip-toe and down again, then bend forward and touch the ground with the fingers
• The applicant should be directed to walk across the room smartly and to hop first on one foot and then on the other.

An applicant who is diagnosed as having had proven cancer may be assessed as fit only after receiving a report from a specialist physician or surgeon certifying that there is no active disease present, the prognosis for the future is good, and that the applicant would be able to perform full police duties.

Type 1

Diabetes Mellitus is likely to exclude an applicant and will require further assessment and report from an endocrinologist. 

Type 2

Diabetes Mellitus requiring oral hypoglycemic medication may exclude and is likely to exclude if requires insulin.  Further assessment will be requested. 

Obesity has been shown to be a significant health risk and also a good indication of problems in passing the Physical Competence Test, which is a requirement in recruit training.  The chart below shows that applicants with a BMI of 18.5-24.9 have a healthy weight and our successful applicants ideally should fall within this range.  People outside this range would only be acceptable with accompanying explanation of the rationale for acceptance.

Classification of Obesity (National Heart Foundation of New Zealand)

This requires Police Officers to be able to:

• Run quickly and on occasion for prolonged periods
• Jump and climb
• Be agile
• Grip and hold objects or people firmly.

This requires Police Officers to be able to:

• Carry and push heavy weights
• Hear effectively including in noisy situations in order to communicate
• Speak effectively and negotiate positive outcomes with minimal force
• Make competent and safe decisions often with inadequate information.

This requires Police Officers to be able to:

• Interact and communicate effectively with people
• React calmly and competently in such situations
• Make competent and safe decisions often with inadequate information
• Speak effectively and negotiate positive outcomes with minimal use of force
• Have the ability to identify and positively manage their stress arising from interpersonal, organisational and operational situations.

Police work is a 24 hour a day emergency service. This requires Police Officers to cope with rotational shift work and, on occasion, to cope with overtime work during emergencies or when the workload is heavy.

This requires Police Officers to have:

• Good hand and eye coordination
• Excellent vision and good peripheral vision both in day and night conditions and safe colour perception
• Logical and rational decision-making ability with safe options being taken.

Police Officers need to be able to competently and safely use a computer, keyboard, and mouse.

Police Officers need to be able to hear accurately in a variety of situations where there may be background noise. Good hearing is required for the following reasons:

• Evidence gathering
• Location of sounds in searches
• Safety of individuals
• Communication
• Everyday communication with the public and other police members
• Command and control situations where a misunderstanding could have serious consequences
• Communication Centre operations.

Communication is an every day part of community policing and becomes critical in operational and dangerous situations. This requires both good hearing (see above) and the ability to speak clearly and intelligibly.

Police Officers need to be able to see accurately (uncorrected and corrected vision) in a variety of situations primarily for safety and evidence gathering reasons. Possible situations include:

• High speed chases and driving both day and night
• Evidence gathering at scenes of crime
• Confrontational situations to constantly assess the threat the use of firearms.

Police Officers have to be able to use a variety of weapons and restraints and these include:

• Firearms – pistols and rifles
• Batons & handcuffs
• OC spray.

This requires Police Officers to have:

• Good hand-eye coordination
• Ability to hold objects and people firmly
• Good vision
• Agility.

Police Officers need to be able to swim, tread water, and dive under the surface. Swimming skills are required to enable Police Officers to:

• Rescue members of the public who get into difficulty in the water
• Rescue people from submerged vehicles.

• Work in hot/humid/cold/wet/snow conditions
• Work on water/in bush/undergrowth/confined conditions.

During the initial 18 weeks of Training at the Royal New Zealand Police College (RNZPC) the physical and academic demands on the Police Officer is intense in nature and therefore recruits should be free and fully cleared of any injury regardless of future prognosis.

Required medical, physical and psychological standards

1. The medical standard required of Police staff is set down in Police General Instructions (M271(5)). The standard is set out below.

Medical Standard (includes Psychological)

Freedom from any:

• Abnormality, congenital or acquired
• Active or latent or acute, or chronic disability
• Active or latent or acute or chronic disease or illness
• Wound or injury or sequelae from operation.

such as may entail a degree of functional incapacity to perform competently the duties of the member’s rank and any other duties that may reasonably be required of them from time to time.

2. The psychological standard prescribed for all sworn members requires members to demonstrate that they are fit to competently perform the duties of their rank and any other duties that may reasonably be required of them from time to time and includes:

• An absence of psychological conditions, disorders or symptoms
• Or, where such conditions, disorders or symptoms are noted, that they do not impair the functional or occupational ability of the member.

Psychological fitness can be formulated within this standard (taking into account clinical judgment), to include the absence of, or a minimal presence of, the following:

• Major psychological disorders
• Anxiety
• Depression
• Stress disorders
• Post-traumatic reactions
• Serious substance abuse
• Disordered interpersonal relationships
• Disorders of impulse control
• Excessive aggression
• Psychosomatic disorders.

The diagnosis and classification of any psychological condition or disorder should, wherever possible, be formulated with the terms of the Diagnostic and Statistical Manual (APA, 1994).