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AACT to Sponsor MRO Course at NACCT in San Antonio
Michael G. Holland, MD, FAACT
The American Academy of Clinical Toxicology will sponsor a two-day Medical Review Officer's (MRO) training course on September 26 & 27, 2009. The course will begin on the final day of NACCT, just after the last symposium concludes, and will continue the following day. Participants will be eligible for 14 hours of CME, and the course will fulfill the US Department of Transportation's (DOT) training requirements that will enable physician's attending the course to take a qualifying exam to become certified as an MRO.
The DOT requires that all safety-sensitive employees in the transportation industry be enrolled in mandatory breath alcohol and urine drug screening programs. The drug screens are required for pre-employment, post-accident, random, return to duty, and for reasonable suspicion. Drug screen results are required to be reviewed by a certified MRO to investigate whether there is a valid medical explanation for the drug test result. The DOT requires that an MRO be a licensed physician who is familiar with the regulations, has received at least 12 CME hours of specialized training in the MRO functions, and has passed a certifying exam. This course will fulfill the training requirements that then allow participating physicians to take the certifying exam offered by either AAMRO or MROCC (on-line or take-home exams available for a separate fee).
The DOT has been requiring testing since a train accident in Chase, MD in 1987 killed 16 people and injured many others. NTSB investigation revealed that the engineer had disabled warning signals and had ignored warning lights, which caused that crash. The brakeman and engineer later admitted to smoking marijuana while on duty. Public and Governmental outrage led to rapid initiation of the federal drug testing program.
Employees covered by these requirements include employees in six industries regulated by the DOT: The Federal Aviation Administration (FAA); Federal Transit Administration (FTA); The Federal Railroad Administration (FRA); The Federal Motor Carrier Safety Administration (FMCSA; formerly FHWA); The US Coast Guard (USCG- now under Homeland Security but drug screening is still regulated by DOT); and The Research and Special Projects Administration (RSPA- the pipeline industry). By far the largest group is the FMCSA, covering in excess of 11 million employees (in contrast, all the other agencies together amass only one tenth of the number of FMCSA-covered employees) (this is the primary reason most DOT testing programs refer to "truck drivers").
However, MRO duties are not restricted to the federally-regulated testing programs. Most MROs find that regulated testing accounts for only about 10% of their practice. Non-regulated testing involves the same types of testing as DOT (pre-employm., post- accident, reasonable suspicion, etc), but for the private sector. As many of us who are employed by medical centers already know, many hospitals have begun performing pre-placement urine drug screening on new employees. Those involved in Occupational Medicine know that most major employers have been performing drug testing for many years. While not required by federal statute, virtually all of these non-regulated drug-testing programs use the services of an MRO, and require that the MRO be certified as defined by the federal programs. A few states even require it for non-regulated testing that occurs within their jurisdiction.
While non-physicians are not eligible to become certified as an MRO, many have taken these courses to learn about the process, and many work in offices where they provide assistance to industry and to MROs. Join us at NACCT 2009 for the MRO course. |
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