MROCC Competency Statements, Topics on Examination and References

 

 CLINICAL ASPECTS

Approximately 10% of the exam items are within this competency area

Competency Statement

The MRO must be familiar with clinical issues related to drug and alcohol use and testing, including medical explanations for positive or indeterminate tests and medical qualifications for performance safety sensitive tasks.  Knowledge in these clinical areas will enable the MRO to:

  • recognize clinical evidence of drug use and impairment.

  • evaluate alternative medical explanations for laboratory drug test results (including positive, substituted, adulterated and invalid specimens).

  • evaluate the inability to produce urine specimens.

  • recognize and appropriately respond to conditions which may render an individual unfit and/or unqualified for duty, including:  (1) unauthorized drug use, (2) authorized prescription or over-the-counter drug use, (3) drug/alcohol addiction, and (4) illness.

Topics on Examination

  • Alternative medical explanations

  • Clinical assessment of drug use, abuse and impairment

  • Determination of fitness for duty

  • Inadequate urine volume

References

  • Swotinsky RB, Smith DR, The Medical Review Officer's Manual.  Beverly Farms, MA, OEM Press, 4th ed. 2010, pages 217-266.

  • Peterson KW, American College of Occupational and Environmental Medicine, Drug and Alcohol Testing Medical Review Officer Course Syllabus and Resource Manual, updated annually.  Sections on clinical aspects.

  • American Society of Addiction Medicine, Medical Review Officer Course Manual, updated annually.  Sections on clinical aspects.

  • Ropero-Miller JD, Goldberger BA, et al, Handbook of Workplace Drug Testing, AACC Press, 2nd ed. 2008.

  • U.S. DOT Office of Drug and Alcohol Policy and Compliance, “Substance Abuse Professional Guidelines”, Washington, DC. www.dot.gov/ost/dapc

GENERAL SUGGESTED REFERENCES & ON LINE RESOURCES