x to DGMS(Army)/DGMS-A ‘SN No 76060/DGMS-6A dt 07 Aug 19 1 MEDICAL STANDARDS AND PROCEDURE OF MEDICAL EXAMINATION FOR OFFICER ENTRIES INTO ARMY. Ain ‘Aim of this literature is to familiarize the general population on medical standards for enrolment of candidates into Army through various types of entries. This literature also serves the purpose of placing information in public domain as per the policy of Information Commission under RTI Act -2005 Introduction (@) The primary responsibilty of the Armed Forces is defending territorial integrity of the nation. For this purpose Armed Forces should always be prepared {or war. Armed Forces personnel undergo rigorous training in preparation for war. ‘Armed Forces also assist civil authorities if required whenever the need arises like in the case of disasters. To carry out such tasks Armed Forces requires candidates with robust mental and physical health. Such candidates should also be capable of withstanding rigorous stress and strain of service conditions to perform their military duties in adverse terrain and uncongenial climate incl sea and air, in remote areas, in austere conditions with no medical faciities. A medically unfit individual due to diseaseidisabilly can not only drain precious resources but can also jeopardize lives of other members of the team during operations, Therefore only medically fit ‘candidates are selected who emerge fit to be trained for war. (0) The Armed Forces Medical Services are responsible for ensuring selection of ‘Medically Fit’ individuais into the Amed Forces. (©) All Armed Forces personnel regardless of occupational specialty, unit assignment, age or gender should have a basic level of general ‘Medical fitness’ When inducted into service. This basic level of fimess can then be used as a benchmark to train personnel for further physically demanding occupational specialties or unit assignments. This will enhance deployable combat readiness, (@) Medical examinations are carried out meticulously by Armed Forces Medical Services Medical Officers. These Medical Officers are well oriented to specific ‘working conditions of Armed Forces after undergoing basic military training, Medical examinations are finalized by the Board of Medical Officers, The decision of the Medical Board is final. In case of any doubt about any diseaseldisabilityfinuryigenotic disorder etc noticed during enrolment! commissioning, the benefit of doubt will be given to State.Appx to DGMS(Army)/OGMS-A ‘SN No 76060/0GMS-5A dt 01 Aua 19 Medical Standards. 3, Medical standards described in the following paragraphs are general guidelines They are not exhaustive in view of the vast knowledge of disease. These standards are subject to change with advancament ia the ecienliic knowledge and change in working conditions of Armed Forcas due to introduction of new eqptirades. Such changes will be promulgated from time to time by policy laters by competent authorities. Medical Officers, Spl Medical Officers and Medical Boards will take appropriate decisions based on following guidelines and principle. 4. To be deemed ‘Medically fit, a candidate must be in good physical and ‘mental health and free from any disease/syndromeldisability likely to interfere with the efficient performance of military duties in any terrain, climate, season inc! soa and air, in remote areas, in austere conditions with no medical aid. Candidate also should be free of medical conditions which require frequent visit to medical facilities and use of any aid / drugs. (a) twill, however, be ensured that candidate is in good health. There should be no evidence of weak constitution, imperfect development of any system, any congerital deformities! diseases/syndrome or malformation. (©) No swelling/s including tumoursieystlswollen lymph nodefs anywhere on the ody. No sinus/es or fistula/e anywhere on the body. (6) No hyper or hypo pigmentation or any other disease/syndromeldisabilty of the skin, (4) No hernia anywhere on the body. (e) No scars which can impair the functioning and cause significant disfigurement, (No arterio-venous maiformation anywhere infon the body. (a) No malformation of the head and face including asymmetry, deformity from fracture or depression of the bones of the skull; or scars indicating old operative interference and malformation like sinuses and fistulae et. (h) No impairment of vision including colour perception and fleld of vision, @__Nohearing impairment, deformitiesidisabilties in ears vestibule-cochlear system, (&) No impediment of speech due to any aetiology. (0) No diseaseidisabiity’ congenital anomalyisyndrome of the bones or cartilages of the nose, or palate, nasal polyps or disease of the naso-Pharynx, tuvula and accessory sinuses. There should be no nasal deformity and no features ‘of chronic tonsils. See tnd Sa sam Faerie5. Appx to DGMS(ArmyJOGMS-A ‘SN No 76060/0GMS.5A dt 01 Aug 19 3 (0m) _ No disease /syndromelsisablty of the throat, palate tonss or gums or any disease or injury affecting the normal unetion of either mandibular joint. (n) No disease /syndrome/disabilty of the heart and blood vessels incl ‘congenital, genetic, organic inc! hypertension, and conduction disorders. (0) _ No evidence of pulmonary tuberculosis or previous history ofthis disease or any other disease /syndromefdisabilty chronic disease of the lungs and chest including allergies immunological conditions, connective tissue disorders, ‘musculoskeletal deformities of chest. (p) _ No disease ofthe digestive system including any abnormality ofthe liver, ‘Pancreas incl endocrinal, congenital, hereditary or genetic diseases ‘syndromes and disabilities, (@) No diseases/syndromeldisabilty of any endocrinal system, Feliculoendothelial system. (9 No. diseases/syndromeldisabilty of genito-urinary system including ‘malformations, atrophy/hypertrophy of any organ or gland, (8) No active, latent or congenital venereal disease. (9. No history or evidence of mental disease, epilepsy, incontinence of urine or enuresis. (u)__ No disease/deformity/syndrome of musculoskeletal system and joints incl ‘skull, spine and limbs. (¥) There is no congenital or hereditary disease! syndromeldisabily Psychological examinations will be carried out during SSB selection procedure. However, any abnormal traits noticed during medical examination will be a cause for Fejection, 6 Based on the above mentioned guidelines usual medical conditions wich lead to rejection are: (2) Musculo-skeletal deformities of spine, chest and pelvis, imbs e.g. scoliosis, torticolis, kyphosis, deformities of vertebrae, ribs, sternum, clavicle, other bones of skeleton, makunited fractures, deformed limbs, fingers, toes and congenital deformities of spine, (©) Deformities of Limbs: Deformed limbs, toos and fingers, deformed joints like Ccubitus valgus, cubitus varus, knock knees, bow legs, hyper mobile joints, ‘amputated toes or fingers and shortened limbs. (@)__ Vision and eye: Myopia, hypermetropia, astigmatism, lesions of cornea, lens, retina, squint and ptosis. (@)__ Hearing, ears, nose and throat: ‘Sub standard hearing capability, lesions of pinna, tympanic membranes, middle ear, deviated nasal septum, and congenital abnormalities of lips, palate, peri-auricular sinuses and Iymphadenitis/adenopathy of neck. Hearing capacity should be 610 cm for Conversational Voice and Forced Whispering for each ear. \ sie Bhan Sa geen) Maoh os key?Appx to DGMS(ArmyVDGMS-A SN No 76060/0GMS-5A dt 04 Aug 19 (e) Dental conditions:- (Incipient pathological conditions of the jaws, which are known to be Progressive or recurrent. () Significant jaw discrepancies between upper and lower jaw which may hamper efficient mastication and/or speech will be a cause for rejection (ii) Symptomatic Temporo-Mandibular Joint clicking and tendemess. A mouth opening of less than 30 mm measured at the incisal edges, Dislocation of the TMJ on wide opening. (iv) Allpotentialy cancerous conditions () Clinical diagnosis for sub mucous fibrosis with or without restriction of mouth opening, (vi) Poor oral health status in the form of gross visible calculus, periodontal pockets andior bleeding from gums. (vil) Loose teeth: More than two mobile teeth will render the candidate unit (vil) Cosmetic or post-traumatic maxillofacial surgeryftrauma will be UNFIT {or at least 24 weeks from the date of surgerylinjury whichever is later. (If malocclusion of teeth is hampering efficient mastication, ‘maintenance of oral hygiene or general nutrition or performance of duties efficiently, ()__ Chest: Tuberculosis, or evidence of tuberculos heart , musculo skeletal lesions of chest wall lesions of lungs, (@)__ Abdomen and genitor-urinary system: Hernia, un-descended testis, varicocele, organomegaly, solitary kidney, horseshoe kidney & cysts in the kidneyfiver, Gall bladder stones, renal and ureteric stones, lesions/defarmities of Urogenital organs, piles, sinuses and iymphadenitisipathy. (b) Nervous system: Tremors, speech impediment and imbalance. © Skin: Vitligo, haemangiomas, warts, coms, dermatitis, skin infections ‘growths and hyperhidrosis Sra RSPR Sates oo7. Height and Weight: ‘Appx to DGMS(Army/OGMS-A ‘SN No 76060/DGMS-5A dt 01 Aug 19, 5 Height requirement varies as per the stream of entry. Weight should be proportionate to height as per the chart given below:- 427 ‘Age | Minimum | Age: 17020 | Age: 20°07 [Age 30+ | Age: (r=) | weight for | yrs day-30y%5 | Ot day - | Above 40 il ages 4oys | ys Height | Weight | Weight (Ka) | Weight K@) | Weight [Weight fom) _| a) Kg) Kg) 140 [35.5 Bi ai 47.0 | 49.0 Tat [358 437 457 ar7__| 497, 142 [36.3 aa 464 484604 as 368 450) 144 [379 456 145 [378 46.3 38.4 460) 38.9 a7. 30.4 48.2 400) 405) 410) 16) [42.4 Cahir Shiny‘Appx to DGMS{Army)/OGMS-A SN No 76060/DGMS-5A dt 01 Aug 19 6 ‘Age | Minimum weight | Ager 771 [Age: [Agar 30+ | Age (ors) |foraiages | 20yrs | 20e01 day Jot day - | Above 40 =30 yrs 3 Height | Wein (Ray | Weight (RG) [Weeght | Weight | Weight [fem 6g) | 6g) 160 [583 ig [as T7708 81.0 11 [580 7 754 {7a aig 102 [59.8 Tas 762 [708 828 13 [603 Tar 70 [a0 83.7 ies [609 745779 fats 346 185 [61.6 [35.6 106} 62.3 6.5 ser e29 87.4 036 64 x [643 03 6 90.3 68.7 —fat2 684 922 67.0 [sat 77 eat) [684 95:1 6a [96.0 699 970 706 98.0 [a3 95.0 98.0 720 Ex 100.0 Br 97.0 401.0 Tad 379 7020 742 907, 948 [98.9 | 103.0 748) 518) 95.7 [89.9 104.0 756. [925 96.7 | 100.8 [105.1 764 934 97.5 [101.8 | 106.1 [77 943) 986 [4028 [107-1 208 [779-92 |995 | 1038 | 108.2 209 [786 86.1 100.5 |104.8 [409.2 210 [79.4 —t870 701.4 [105.8 [11033 (a) Weight for height charts given above is for all categories of personnel. This chart is prepared based on the BMI. The chart specifies the minimum acceptable Woight that candidates of a particular height must have. Weights below the minimum specified wil not be acceptable in any case. The maximum acceptable weight of height, hhas been specified in age wise categories, Weights higher than the acceptable limit will bbe acceptable only in the case of candidates with documented evidence of body building, wresting, and boxing at the National level. In such cases the following criteria, will have to be met, (Body Mass Index should be below 25. (i) Waist Hip ratio should be below 0.9 for males and 0.8 for females. (ii) Waist Circumference should be less than 80 em for males and 80 cm {or females, y niente Sain) 19 Men man pear ease Ne oma Shore.Appx to DGMS(Army/OGMS-A ‘SN No 76060/0GMS-5A dt 01 Aug 19 7 Note: The height and weight for candidates below 17 yrs will be followed as per guidelines by ‘indian Academy of Paediatiics growth charts for height, weight and BMI for (5 yrs to 16 yrs old children 8. Following investigations wil be carried out forall officer entries and for pre- commission raining academies. However examining medical officer! medical board may ask for any other investigation deemed fit (2) Complete haemogram (b) Urine RE (6) Chest X-ray (€) USG abdomen and Pelvis. 8. Certain standards vary depending on age and type entry viz stds for vision as follows:- Parameter Standards: 10+2 | Graduate & Post graduate & entries, NDA(Army), | equivalent entries: | equivalent entries: ‘TES and equivalent | CDSE, IMA, OTA, | JAG, AEC , APS, UES, NCC, TGC & | RVG.TA, AMC, equivalent ADC, SLB 8 equivalent Uncorrected 66 R BRE 6160 B6I6O 3160 & 360 vision(max allowed) | [BCVA RIGS R LT Rie BLS Myopia ‘=-25D Sph =-350DSph | =-5.50D Sph including max ‘including max | {including max astigmatism ¢+/-2.0 | astigmatism s+/- | astigmatism < +/- Dey) 20DCy)) 2.0 Dy), Fypemetropia | <+2.5 D Sph <#3.50 DSph_—_—-| <*3.50DSph__| (including max (including max | (inciyding max astigmatism s-+-2.0 | astigmatism s +/ | astigmatism s +/- Doy) 2.00 Gy) 2.0DCy)) Tasikfequvalent | Not permitted Permitted * Permitted™ [surgery _| Colour perception | CP=I CP —[ePar Bl LASIK or Equivalent kerato-refractive procedure (a) Any candidate who has undergone any kerato-tefractive procedure will have 2 certifcateloperative notes from the medical centre where helshe has undergone the procedure, specifying the date and type of surgery. Note: Absence of such a certificate will necessitate the Ophthalmologist to make a decision to reject the candidate with specific endorsement of “Unfit due to ‘undacumented Visual Acuity corrective procedure! (©) _ In order to be made FIT, the following criteria will have to be met: (0) Age more than 2 ys a the me of surgery A 5, SST?x to DGMS(Army)/DGMS-A, 'SN No 76060/DGMS-5A dt 01 Aug 19 8 (i) Minimum 12 months post LASIK (i) Central comeal thickness equal to or more than 450 j (iv) Axl length by 1OL Master equal oor less than 26 mm (W)__ Residual refraction of less than or equal to +/- 1.0 D inc cylinder, (provided acceptable in the category applied for). (v) Normal healthy retina, (vil) Corneal topography and ectasia markers can also be included as add criteria, Candidates who have undergone radial keratotomy are permanently unfit 10. Form to be used for med board proceedings is AFMSF-2A, 11. Procedure of Medical Examination Board: Medical Examination Board for selection {or officers and pre-commissioning training academies are convened at designated Armed Forces Medical Services Hospitals near Service Selection Boards (SSB). These Medical Boards are termed as ‘Special Medical Board’ (SMB). Candidates who clear SSB interview are referred to Aimed Forces Medical Services Hospital with identification documents. Staff Surgeon of Hospital wil identify the candidate, guide the candidate to fil the relevant portions of the AFMSF-2, organize investigations and examination by Medical, Surgical, Eye, ENT, Dental specialists. Female candidates: are examined by Gynaecology Specialist also. After examination by Specialists, the candidate ig brought before Medical Board. Medical Board once satisfied with findings of Specialists will dectare fitness of candidate. if any candidate is declared ‘Unfit by SMB, such candidates can request for ‘Appeal Medical Board’ (AMB). Detailed procedure for AMB will be provided by President SMB. 12, Miscellaneous aspects: {@) Clinical methods of examinations are laid down by O/ DGAFMS. (b) Female candidates wil be examined by female medics! officers and ‘specialists. In case of non availabilty they will be examined by Medical Officerin the presence of female attendant (©) Fitness following surgery: Candidates may be declared ft after surgery. However, there should not be any complication; scar should be healthy, well healed and attained required tensile strength. The candidate shall be considered ft after 01 year of opemslaproscopic surgeries for hemia and twelve weeks of laparoscopic abdominal surgery for cholesystectomy. For any other surgery, fitness shall be ‘considered only after 12 weeks of the laparoscopic surgery and 12 manths after an ‘open surgery. Candidate shall be unfit for any surgeries for injuries, ligament tear, and meniscus tear of any joint, irrespective of duration of surgery, ‘) a.