Why Medical Questions?

Why do I have to complete a medical questionnaire when applying for a job overseas?

Applying for jobs in the Middle East involves a lot of paperwork. One particular aspect of paperwork that some people question is the medical questionnaire that must be completed and submitted along with their initial application to the hospital.

In North America, employment legislation has meant that people are accustomed to any type of medical disclosure — should it be asked — happening after an offer of employment is made, except in exceptional circumstances where such disclosure is a bona fide requirement for a job. Not so for people seeking jobs in the Middle East.

Why do the employers in the Middle East want to know about one's weight and height or BMI; infectious disease status, such as Hepatitis or TB; chronic health concerns, such as diabetes or high blood pressure? And why are they allowed to refuse to consider applicants based on health? It's certainly not that there are no obese people or people with infectious diseases in the Middle East. Beyond the reality that different countries have different views of what is legally permissible to ask, and when it is legally permissible to ask certain things, the reason can be explained in one word: Money.

Depending on the source, stats say the cost of hiring and training a new employee in a typical North American employment setting ranges from 25% to 200% of their annual compensation, due to recruitment, selection, and orientation/training costs. Sometimes the cost-to-hire calculation also includes overtime that must be paid to existing employees until the hire arrives onsite.

But in the case of hiring healthcare professionals to staff hospitals overseas in the Middle East, there are added costs — return airfare; furnished, air-conditioned housing, with utilities included; healthcare (including prescription medications) when in the country. Thus the cost of an average hire is significantly higher than in a facility in North America.

The already significant expense means that employers want to minimize the risk of accruing even higher costs. And one risk factor is hiring someone — keeping in mind all that the process entails when shipping a person overseas, housing them, and covering their healthcare costs — who, typically, has several health concerns. This means added costs related to sick time or modified work, high-cost prescription medications, hospitalization, etc. Therefore, the staff in Employee Health/Family Medicine who go over the medical questionnaire which accompanies each person's application in advance of an offer to assess how much a financial risk the applicant would be based on the sum of their health issues, and make their decision. (And then the staff in Employee Health/Family Medicine go over everyone's official doctor-completed medicals again, before relocation, because, yes, an offer can be withdrawn due to the results.)

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