The purpose of this chapter is to review the various types of physical examinations and their requirements, provide a general understanding of how physical examination forms and reports are completed, and cover some of the testing procedures and equipment for which you may be responsible. In your capacity as a Hospital Corpsman, you will function as both clerical and medical assistant to the medical examiner. To do this properly, you should be familiar with administrative regulations that apply to physical examinations. You should also ensure the patient's health record is correct and complete, all tests and laboratory results are recorded, and the completed report of medical examination and history are properly filed in the member's health record.

TYPES OF PHYSICAL EXAMINATIONS

LEARNING OBJECTIVE: Differentiate between the types of physical examinations.

Physical examinations, whether routine or special duty, are mandatory for members at certain times during their military careers. The first of these examinations is the entrance (enlistment, appointment, or commissioning) physical examination, and the last is the physical examination that occurs upon separation from the service. In addition to these two, there may be several others, depending on the length of the member's service or special duty requirements.

Physical examinations of Marine Corps and Navy personnel, active and reserve, are performed by Navy medical officers or other credentialed providers. If a Navy medical officer or credentialed provider is not available, the medical examination may be performed by a Department of Defense (DoD) physician or credentialed civilian contracted physician. Dental examinations are normally performed by Navy dental officers. For further information on dental examinations for naval reserve personnel, refer to the Manual of the Medical Department (MANMED), NAVMED P-117.

Most physical examinations will require special studies (tests). Some of these special studies (which will be performed in advance of the physical examination by the medical examiner) may include laboratory tests to detect syphilis (RPR), HIV, and cholesterol levels; optometric evaluation to determine visual acuity; audiometric testing for hearing capabilities; and dental examination to determine dental fitness. For more information on special study requirements for each type of physical examination, refer to the MANMED and directives that address specific physical examinations.

ROUTINE PHYSICAL EXAMINATIONS
Essentially, there are four types of routine physical examinations you should know about. They are the entrance, periodic, reenlistment, and separation physicals. The MANMED provides specific instructions on how and when each type of physical is to be conducted.

Entrance (Enlistment, Appointment, and Commissioning) Physical Examination

The Department of Defense (DoD) establishes the standards for entry into military service (DoD Directive 6130.3). Entry physical standards for training programs leading to officer appointment are more stringent than the basic physical qualifications for enlistment or commissioning. This policy ensures qualification of the member at the time of his appointment.

Entrance physical examinations are normally performed at Military Entrance Processing Stations (MEPS). Entrance physical examination results are documented on the Report of Medical Examination (SF-88) and Report of Medical History (SF-93). The original completed physical examination forms are permanently filed in the member's health record. Copies of the completed examination forms are filed by the examining facility for a specified period of time. (See MANMED for current physical examination disposition requirements.) This policy applies to all of the physical examinations service members may have throughout their career. The forms used for the entrance physical (SF-88 and SF-93) are also used for many of the routine and special duty physical examinations that will be discussed in more detail later in this chapter.

Periodic Physical Examination
The purpose of the periodic examination is to determine physical qualification for retention on active duty and to maintain current medical data regarding physical qualification of personnel. Retention standards are not the same as entrance standards; the prime consideration for retention is the ability to continue active service. The periodic physical examination evaluates the member's current state of health. The examination also includes documentation of chronic or unresolved medical complaints from injuries or illnesses incurred during military service or complaints or injuries that may have existed before induction. The periodic physical examination is conducted at the intervals prescribed in the MANMED.

If the examining medical officer determines a defect exists that he cannot adequately evaluate, a consultation or referral for further evaluation may be initiated. If the defect is severe enough, the member may be referred to a medical board. Amedical board is convened to evaluate and report on the diagnosis; prognosis for return to full duty; plan for further treatment, rehabilitation, or convalescence; estimate the length of further disability; and provide medical recommendations for disposition of the service member being evaluated.

Amember may be considered physically qualified (PQ) despite the presence of certain medical conditions. However, if it is clearly determined that the condition interferes with the member's capability of functioning in the naval service effectively, the member may be processed for an administrative or medical discharge. Additional guidance is provided in the Military Personnel Manual (MILPERSMAN) and applicable Navy and Marine Corps directives.