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Employment & Prof. Development

Physical Examination Record for Foreigner

Employment choices and professional development issues.

Physical Examination Record for Foreigner

Postby gregory » Thu Jun 17, 2010 9:04 am

Dr. Greg,

I recently accepted a job teaching English at a university in Zhejiang Province. Now I am supposed to be getting the physical form filled out and sent to the university so they can get the invitation letter authorized.

I have put a lot into finding this job, because I had some previous bad experiences with being ignored by recruiters because of my age, which is just over 60. So I went ahead and did it myself, and in the process managed to get myself quite worked up about going to China. Now it seems like maybe I have been worrying about this too much because my blood pressure is way up, as in 160 to 175 over 75 to 88.

This has happened to me before. I have never been too concerned about it since both of my parents are now in their 80s and have high blood pressure for years. I have always managed to get it to come down without medication by cutting out salt, drinking lot of water, walking a lot, and trying to deal with whatever it is I am worrying about.

But this takes time, and I am not sure if I have enough time for that now. Classes start Sept 15, and they want me there a week early. I have written to the very nice FAO lady, briefly explaining the situation, and asking her to give me a deadline for when they must have the completed form, but I have not sent it yet.

What I would like to ask you is how serious the Chinese government takes these physicals? I can understand their wanting to keep the flow of communicable diseases into the country at a minimum, but what is their attitude about non-communicable health issues such as blood pressure?

Any other comments or suggestions you might have about this situation would be very greatly appreciated.

Thank you,

Gregory
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Re: Physical Examination Record for Foreigner

Postby Dr. Greg » Thu Jun 17, 2010 10:32 am

Hi Gregory,

I personally don't believe that moderate to even severe hypertension, alone, would cause you to fail the physical exam.

Aside from ruling out communicable diseases, the physical exam record for foreigner is intended to determine "fitness for duty," i.e., the foreigner's physical ability to teach English for up to 22 periods per week. I know several insulin-dependent diabetics who have passed the physical exam year after year and I have topped a BP of 150/90 on more than one physical exam.

Are you against starting a minimal amount of antihypertensive medication? If you are able to reduce your blood pressure with diet and exercise alone, I imagine that even a small amount of a diuretic, such as hydrochlorothiazide (HCTZ), would do the trick. In addition, antihypertensive medications aren't what they used to be in our parents' time: many of the newer ones are not only highly effective but without noticeable side effects.

One sure way of resolving this favorably is to start an initial course of antihypertensive medication. Aside from the passing the physical exam, it's probably time given your age and family history. I've been on such medications since the age of 22.
Dr. Greg
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Re: Physical Examination Record for Foreigner

Postby gregory » Thu Jun 17, 2010 11:29 am

Thank you for the information, Dr. Greg, and the advice too. It probably is time for medication. That will be one less thing to worry about. What is different this time is that my salt intake has not been high.

Thanks very much for the quick response.
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Physical Examination Record for Foreigner

Postby Bryan » Tue Jun 29, 2010 3:24 pm

@Gregory,

I don't think you need to worry so much about your systolic (top number) as you do the bottom one. Your top number is pre-hypertensive but, at your age, not that bad.

My recent medical exam showed I had a calcified stone in one of my intrahepatic bile ducts (stone in my liver), and this had no effect on my employability. The only thing I've heard about at my school that caused problems were communicable diseases (STDs specifically). One good thing is, after a year living in China, my blood pressure has improved dramatically :) Good luck...
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Applying for a working visa with a heart condition

Postby Paddywaks1967 » Sun Dec 04, 2011 1:49 am

Hello,

I'm a 44-year-old man with who has just been offered a teaching job in Guangzhou. I have a long-standing heart condition that is likely to be spotted during the physical check (heart murmur and an enlarged heart).

The condition is not so bad that I need to take any medication at all and, generally, I am fit, well, and not overweight. I actually look fine and am more than presentable and very young looking for my age. I have no other issues or disease. The condition has never had an effect on my ability to work, sometimes in very physical jobs.

I have approximately eight years teaching experience and a CELTA qualification. I am seriously worried that I might fail the medical. Your opinion/viewpoint would be appreciated.
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Re: Physical Examination Record for Foreigner

Postby Dr. Greg » Sun Dec 04, 2011 12:39 pm

A benign heart condition, one that doesn't require treatment, is not a sufficient reason for being found unfit for duty.

The goal of this physical exam in China is to eliminate foreigners who have communicable diseases and those who are just too sick to teach 18 to 22 periods per week, e.g., those in the end stages of a fatal illness. I have known insulin-dependent diabetics and chronic alcoholics with cirrhotic livers who passed the physical examination record for foreigners year after year with flying colors.

Don't worry about this. If you can walk and talk without assistance and you don't have AIDS, you will pass the exam.
Dr. Greg
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Re: Physical Examination Record for Foreigner

Postby gregory » Sun Dec 04, 2011 9:19 pm

Well, I have just passed my third physical here in Zhejiang and at least at the provincial hospital in Hangzhou they do not take your blood pressure until after you have negotiated several flights of stairs, been subjected to a blood test and then walked down a long corridor. By the time I have done that, my heart rate is pretty high and my blood pressure is even higher, so I now have no trouble believing that they will pass almost anyone.

Welcome to China, it is a great place to learn to relax and stop worrying about details.

Gregory
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Re: Physical Examination Record for Foreigner

Postby Paddywaks1967 » Sun Dec 04, 2011 10:55 pm

Thanks for the prompt reply. It has reassured me to a large degree. My worry really is over the fact that the physical involves an ECG, which measures electrical activity in the heart. It's something I've had done many a time but the very fact that they perform this test indicates to me that they must consider heart disease, etc., in deciding whether to pass someone on the physical? Would be very happy to be proved wrong but it still remains a niggling worry for me.

Do you know of anyone that has been refused a work visa because of heart problems or other issues related to other organs...i.e., lungs, kidneys, liver, etc?
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Re: Physical Examination Record for Foreigner

Postby Dr. Greg » Mon Dec 05, 2011 1:32 am

When it comes to China, no one can guarantee anything because, often, what was true yesterday is no longer true today. Nevertheless, to the very best of my knowledge, the presence of abnormal findings on the physical exam does not necessarily lead to the determination that the applicant is "unfit for duty." You would have to be close to death or test positive for AIDS or hepatitis to be rejected.

For years they told me I had a fatty liver (and I do, thanks to having been overweight for years). For years they told me my blood pressure was high (it was). Guess what? I passed the physical exam every year without incident.

The realty is whatever type of heart condition you have, it obviously doesn't require treatment and they can and will understand that.

If you are still the least bit concerned, have the medical form completed by your doctor back home, send the employer the completed medical form, and ask him to pass it along to the docs at the local hospital where they give physical exams to foreigners. If they give the nod, then you really should have nothing to worry about.
Dr. Greg
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Re: Physical Examination Record for Foreigner

Postby gregory » Mon Dec 05, 2011 8:01 am

I did not mention that I also have sinus bradycardia with first degree blockage, which in spite of its rather ominous name is not at all serious, and they pass me with that too. The first time there was a lot of chattering and consulting between hospital staff, but the last 2 times there have none of that.There was also quite a bit of fuss about my color blindness the first time, but none the other times. It does make me wonder why some of those items are on there, but I have never heard of anyone failing the physical.
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