Order of the Ministry of Health on medical examination of children. Routine medical examinations of children: age, tests and specialists

To keep children healthy: the procedure for undergoing medical examinations has changed

Ministry of Health Russian Federation approved a new procedure for minors to undergo medical examinations: preventive, preliminary (upon admission to educational institutions) and periodic (during the period of study in them). Olga Evgenievna Shitova, Deputy Chief Physician for Pediatrics at Federal State Budgetary Institution Clinical Hospital No. 172 of the Federal Medical and Biological Agency of Russia, talks about how they will now be carried out.

The new procedure establishes the rules for undergoing medical examinations, both during the period of children’s education and during their admission to educational institutions, emphasizes Olga Evgenievna Shitova, Deputy Chief Physician for Pediatrics of Clinical Hospital No. 172 of the FMBA of Russia. – Surely, some parents may have a question: what is a medical examination? This is a complex of medical measures and interventions, which includes examination by medical specialists, as well as laboratory and instrumental studies. They are aimed at identifying pathological conditions, diseases, and risk factors in minors in order to subsequently carry out more effective preventive work or, if necessary, treatment.

Medical examinations are divided into three groups - preliminary, preventive and periodic.

Preliminary examinations are carried out upon admission of a child to any organized group, be it a children's preschool, school, college, technical school, institute, - - Periodic medical examinations are carried out annually in various volumes while the child is studying at school or attending kindergarten. Each age has its own scope of research. It may, for example, include only an examination by a pediatrician and laboratory tests, or an examination by two or three specialists and laboratory tests. This list is specified in the appendix to the Order of the Ministry of Health of the Russian Federation dated December 21, 2012 No. 1346n.

Preventive medical examinations are carried out among minors of decreed ages (1, 3, 7, 10, 14, 15, 16 and 17 years). In this case, the child is examined by 8-10 specialists, in addition, laboratory tests are carried out (general blood test, blood sugar test, urine test) and instrumental studies (fluorography, ECG, ultrasound diagnostics, namely ultrasound of the heart, abdominal cavity, thyroid gland and reproductive sphere).

Before undergoing the listed medical examinations, in particular, preventive and periodic ones, the parent must obtain informed voluntary consent to medical intervention (to undergo an examination), explains Olga Evgenievna Shitova, Deputy Chief Physician for Pediatrics of Clinical Hospital No. 172 of the FMBA of Russia. – If a parent does not want his son or daughter to undergo an examination, he has the right to refuse by putting his decision in writing. The child's legal representative has this right. In addition, we would like to remind you that from the age of 15, children can fill out informed voluntary consent on their own.

Periodic medical examinations will be carried out during the children's education. On schedule. Parents of schoolchildren will be notified in advance about the start date of the examination through the class teacher, and mothers and fathers of children attending kindergartens will be warned.

An important point: the results of the examination will be entered into the child’s medical record. By the way, during a preventive (extended examination), a medical card for a preventive examination of a minor will also be filled out, where all the results of the examination will be entered. One copy of such a card will be given to the parent so that he can become familiar with the child’s health status in more detail.

If the child needs to undergo a preliminary examination upon admission to study, the parent must come to the children's clinic at their place of residence and write an application addressed to the head of this unit stating that his son or daughter needs to undergo a preliminary medical examination before entering a kindergarten or school.

Previously, preventive examinations were carried out on a smaller scale and on the basis educational institution, - says Olga Evgenievna Shitova.– Now, according to the Order of the Ministry of Health of the Russian Federation, all medical examinations must be carried out in children's clinics. In this case, the child must be accompanied by a legal representative, in most cases they are the parents. We ask mothers and fathers to pay attention to this and, if possible, accompany the child to the medical examination. Since this practice is new, for the transition period, in agreement with the education department, we came to an agreement that for now schoolchildren will be accompanied by class teacher with members of the parent committee. Accompanying a child for a medical examination probably has its pros (you can ask a specialist a question) and cons (you have to take time off from work), but I think that when it comes to the child’s health, the parent always makes the right decision. For our part, we, doctors, will try to reduce the time it takes for children to undergo a medical examination as much as possible. We will try to ensure that the medical examination does not take the child more than two days. To do this, on weekdays - from Monday to Friday, with the exception of Tuesday, from 8 to 9 o'clock, narrow specialists, laboratory, ultrasound and x-ray will work only to conduct preventive medical examinations.

Why two days? The fact is that the results of laboratory tests, as a rule, arrive the next day, and without them, the diagnosis of specialists will be incorrect. The conclusion based on the results of the medical examination will be made by the local or school pediatrician. After this, the parent will be given one copy of the preventive examination medical record.

For now, the child will come with the class, but I remind you once again that the presence of parents (or representatives of the parent committee) is necessary. From 2015, we will probably move to the idea that all parents will accompany their children to medical examinations. So far we have chosen a softer option, so that people have become accustomed to the innovation, and we have understood how to better organize this process.

The purpose of the new procedure for medical examinations for minors is to change the approach to the prevention and treatment of diseases. It turns out that now children will undergo certain medical examinations annually. Thus, the possibility of identifying pathological conditions, diseases, and risk factors in minors at an early stage increases. A early diagnosis disease or risk of its occurrence - important point effective treatment or recovery. For example, based on the results of a medical examination, each parent of a child of maternity age will have in their hands a card containing the diagnosis of the child identified during the examination. And he will have the opportunity to contact a specialist with the child at a convenient time to undergo, if necessary, additional examinations and health improvement. Doctors hope that the new order will increase parental responsibility for the child’s health.

Also, based on the results of the medical examination, the health group will be determined. physical development, and a conclusion is issued about the physical education group that the child can attend.

In Dimitrovgrad, according to the new procedure, medical examinations will begin in October. Let's start with the social city. Children's clinic No. 1 is expecting the arrival of fourth and eighth grade students. Currently, the Education Department is preparing lists. After agreeing on the schedule of medical examinations, the information will be communicated to parents and children. On parent meetings will be asked to fill out an informed voluntary consent form for a medical examination. The same work will be carried out in kindergartens.

Students in 4th grade will undergo a preventive (extended) medical examination, and 8th graders will receive a periodic examination.

A complete list of studies during medical examinations (Order of the Ministry of Health of the Russian Federation dated December 21, 2012 No. 1346n) can be found on the website of Clinical Hospital No. 172 of the FMBA of Russia (). For the convenience of users, this section is highlighted with a special icon “New procedure for medical examinations of minors.”

We also invite parents who have questions on this topic to send them to the “Electronic Trust Box” of Federal State Budgetary Institution Clinical Hospital No. 172 of the Federal Medical and Biological Agency of Russia (This e-mail address is being protected from spambots. You need JavaScript enabled to view it) , says Olga Evgenievna Shitova. - Please include contact numbers for feedback in your messages. In addition, we plan to provide clarifications on incoming questions in the section “New procedure for medical examinations of minors.” To obtain more timely information and resolve your issue “on the spot,” we recommend contacting the head of children’s clinics. Explanations of an informational nature can be given to you medical workers educational institutions of the city.

We hope that you, dear parents, will understand the new procedure for medical examinations for minors. What could be more valuable than preserving the health of children?

Before a child enters a kindergarten, educational or sports institution, he must undergo a complex of medical examinations - screening. Medical examination of children in 2018 can be carried out for each child, however, more detailed diagnostics are not intended for everyone. What is included in the screening, and what is the procedure for completing the procedure?

What is medical examination

This is a set of measures that is aimed at identifying and preventing the development of various diseases in all groups of the population. Screening consists of preventive medical examinations, consultations with doctors, and studies that are carried out at a person’s established age. Since 2013, medical examinations for adults and children have become part of the compulsory health insurance system.

Where and when takes place in 2018

Free examination is carried out at the city clinic. Parents need to take the child to a medical institution at the place of temporary or permanent registration or study. When you can undergo screening, ask at the children's clinic. From January 2018, the medical examination schedule for different age groups will be known. You must make an appointment with a doctor in advance through the reception of a healthcare institution or via an electronic terminal.

Why is medical examination needed?

Timely diagnosis allows for early identify a dangerous disease and carry out appropriate therapy. There are pathologies that are asymptomatic at the initial stage. The earlier the disease is detected, the faster it is treated. A medical examination of children is a necessary set of procedures that should not be neglected. Timely identification of risk factors for pathology is sometimes more important than direct treatment at an advanced stage. Medical examination of the child population is aimed at this.

Healthy children

Often, during screening, a specialist discovers conditions under which a certain disease may develop. If you adjust your lifestyle, you can really avoid the pathological condition. For example, if you are prone to obesity, you need to change your diet and add physical activity. Parents already know about this, but if the doctor backs up his recommendations with test results and outlines all the “prospects” for obesity, mom and dad will take the problem more seriously.

Children's medical examination and series preventive measures significantly reduce the percentage of development of the most common non-communicable diseases in the population aged 1-17 years. These include:

• stomach and duodenal ulcers, gastritis, enterocolitis, gastroenteritis;
• pathologies of the intestines, gall bladder;
• diabetes mellitus;
• curvature of the spine, flat feet;
• problems with hearing, vision;
• helminthic infestations.

Disabled children

In-depth free examinations are offered to children with congenital or acquired chronic diseases that have led to disability. Additional medical examinations are needed to monitor health status, prevent deterioration, and respond to deviations in a timely manner. Clinical observation of children helps to select the most effective therapy and achieve success in treatment or maintaining a stable condition.

Sports medical examination for children

A medical examination of minors is required for those who plan to compete. Ideally, everyone who attends should undergo a sports medical examination for children in 2018. sports sections and receives a high load. The children are carefully examined by a sports doctor and specialists appropriate for their age. Additionally, the following studies can be carried out:

• ECG on an exercise bike;
• Ultrasound of the heart;
• X-ray of the lungs.

It is very important to look at what happens to the heart under load. Detailed screening identifies cardiovascular, respiratory system problems or risk factors. If there are no deviations in health, you can continue sports activities. If problems are detected, additional tests and examinations are prescribed, on the basis of which a conclusion is made whether the child can receive high-intensity exercise.

Medical examinations of children and adolescents according to order 1346n

The Ministry of Health has adopted an order that determines the procedure for medical examination. In 2018, in-depth screening is required for boys and girls aged 1, 3, 6, 7, 10, 14-17 years. To undergo a free preventive examination, you must present a compulsory health insurance policy (CHI). Stages of medical examination:

1. Visit to the pediatrician. The specialist measures height, weight, some body parameters, and asks about the child’s well-being. Writes out directions for tests, tells you which doctors need to be seen.
2. Donating blood, urine, undergoing tests required by age.
3. Visiting multidisciplinary doctors.

Specialists conduct preventive, preliminary and periodic medical examinations. The first are carried out at established age periods to identify pathologies and risk factors. Preliminary examinations are required upon admission to educational institutions. Periodic consultations are necessary for dynamic monitoring of health status. Medical examination of children in 2018 differs for different age groups.

Children of the first year of life

The babies are closely monitored. A scheduled appointment with a pediatrician is carried out monthly. In-depth medical examination of children under one year is carried out at 1,3, 6, 12 months. Infants need to undergo the following doctors:

• Neurologist. Assesses the child's neuropsychic state.
• Pediatric surgeon. Examines the genitals for phimosis, prolapse and hydrocele of the testicles, identifies hernia, joint dysplasia.
• Ophthalmologist. Detects visual impairments.
• Traumatologist-orthopedist. Examines the musculoskeletal system.
• Pediatric dentist. Evaluates the condition of the gums, teeth, bite, frenulum.
• Otolaryngologist. Detects ENT pathologies.
• Child psychiatrist. Needed for children with suspected mental development disorders.

Clinical examination of children in the first year of life includes various studies: neonatal and audiological screening, ultrasound of the abdominal cavity, hip joints, neurosonography, general tests blood and urine, examination of glucose levels, stool for oocyte and enterobiasis, ECG. Which specific doctors need to go to the established age period, the local pediatrician will report.

Medical examination of preschool children

From one year to two years, planned pediatrician appointments are carried out once every three months. From two to three years old, parents bring their children to the doctor once every 6 months. At two years old, the child additionally visits only a pediatric dentist, and at three years old undergoes a full medical examination. The list of doctors remains the same as for one year of age, with the addition of an obstetrician-gynecologist for girls and a pediatric urologist-andrologist for boys.

At 4 and 5 years old, a preschooler only sees a pediatrician and a pediatric surgeon, and takes general blood and urine tests. At the age of 6, the list of doctors expands slightly: a neurologist, ophthalmologist, and dentist are added. Seven-year-old children will again have to undergo in-depth screening according to the list of doctors as for three-year-old children. Additionally, an ECG and ultrasound of the abdominal organs, heart, thyroid gland, and reproductive organs are prescribed.

In kindergarten

Preschool institutions organize medical examinations themselves. Parents sign a paper that authorizes medical examination. Not all doctors come to kindergarten. To meet with some, you need to visit the clinic at your place of registration or study. If the specialists who took kindergarten, questions arise, they call the parents. Often such examinations are formal in nature, since doctors need to see a large number of children in a short time.

At school

Every year the student must undergo specialist tests. Clinical examination of adolescents takes place without the participation of parents - the school class is collected and taken to the clinic. They tell you which doctors you need to see. Screening is carried out quickly, often superficially. Medical examination at school will make sense if each parent takes their child individually. The list of doctors at 7 years old is the same as for three-year-olds; at 10 years old, a gynecologist and andrologist are excluded from the list.

Doctors by age:

• 8, 9, 13 years: pediatrician;
• 11 years: pediatrician, surgeon, ophthalmologist;
• 12 years: pediatrician, gynecologist/urologist-andrologist;
• 14-17 years: in-depth medical examination, the list of doctors is determined by age. An endocrinologist and an adolescent psychiatrist are added to the standard list.

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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on individual characteristics specific patient.

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Will the Ministry of Health save on tests?

Since April of this year, there have been tough discussions on the draft new rules for clinical examination. The State Duma considered the original project to be flawed. Some deputies expressed the opinion that the Ministry of Health was trying to save money on tests, since the Project provided for a reduction in the list of mandatory studies.

For example, let's take blood and urine tests. They were asked not to be carried out on those citizens who did not have obvious symptoms. As the Ministry of Health commented, the benefits of these tests are not scientifically substantiated, and nowhere in the world are they carried out in screening examinations. Thirdly, WHO did not include them in the list of recommended ones.

List of tests as part of clinical examination since 2018

Women 39 -51 years old: fluorography, mammography

Citizens 49 – 74 years old: stool test for occult blood for citizens (additional tests to detect intestinal cancer).

Men (from 35 years old) and women (from 45 years old) - electrocardiography.

Citizens (over 75 years old): appointment with an otolaryngologist after examination by a therapist.

Preventive medical examinations of minors instead of periodic and preliminary

Until the end of 2017, Order No. 1346 of December 21, 2012 is in force. On January 1, Order of the Ministry of Health of Russia dated August 10, 2017 N 514n “On the Procedure for Conducting Preventive Medical Examinations of Minors” comes into effect. This Order also includes a new accounting form No. 030-PO/u17 and a stat. reporting.

As mentioned above, the volume of medical examinations will be reduced only nominally. Previously, there were 3 types of medical examinations: preliminary, periodic and preventive. Now everything together bears one common name - preventive medical examinations of minors. One can only guess how educational institutions that operate according to the old rules will adapt to the new rules: Order of the Ministry of Education and Science dated April 8, 2014 No. 293 (Procedure for the admission of children to kindergartens), requirements of SanPiN 2.4.1.3049-13 (Decree of the Chief Sanitary Doctor dated 15 May 2013 No. 26). The need to undergo preliminary medical examinations is also indicated by the Order of the Ministry of Health of March 3, 2000 No. 241, which approved the form of the child’s medical record. This card must contain information about routine medical examinations.

Summary, data for a medical report upon admission to educational institution will be entered based on the results of the preventive examination.

Explanations from the Ministry of Health regarding the cancellation of preliminary medical examinations

According to Federal law 323-FZ “On Health Protection”, preliminary medical examinations are required for workers who apply for work in institutions. This law does not mention preliminary medical examinations of children.

The main goals of preventive medical examinations

Activities allow you to identify diseases and determine your health group. The intention to identify children prone to using narcotic and psychotropic substances is especially emphasized. It is important to note that for the early detection of drug addiction in children, a separate Order of the Ministry of Health dated October 6, 2014 No. 581n was developed. And for the detection of tuberculosis - Order No. 124n of March 21, 2017.

Reducing the volume of medical research during preventive medical examinations

Excluded from the list:

Blood glucose level

Blood hormone levels

Fluorography of the lungs (regulated by Order 124n)

Appointment with a neurologist – children 3 months old.

11-14 years old - only appointments with some specialists are left.

Medical examinations for children 1 year and 9 months, children 2 years and 6 months.

Complete blood count and general urine test for children 3,6,9 months, 2,4,5,8,9 years.

Newclarifications: In January 2018, the Ministry of Health clarified the list of studies and also changed a number of provisions for clinical examination. Read about it

What is included in the list of medical examinations for children?

For children aged 1 month. - dentist,

For children aged 1 year – an orthopedic traumatologist.

What other changes?

Inspected by a surgeon. If the institution does not have a pediatric surgeon, the appointment can be carried out by a surgeon, but first he must.

Now medical examinations can be carried out on the territory of an educational institution.

Previously, the presence of a parent (legal representative) was required for examination of children under 15 years of age. Now a signed consent is enough. This consent is issued by an authorized person (pediatricians, local pediatricians, general practitioners) 5 days before the preventive examination.

Came into force on January 1, 2018 new order“On conducting preventive medical examinations of minors” No. 514n dated August 10, 2017. It replaced the order of 2012, in which, for each age of the child, a list of doctors and additional tests was prescribed that should be done for the child free of charge. Today we compare tables with this data from two orders and pay attention to the differences between them and innovations.

The first examination of a newborn is a traditional examination of the baby by a pediatrician. Important: screenings are “timed” for this examination: neonatal screening for congenital hypothyroidism, phenylketonuria, adrenogenital syndrome, cystic fibrosis and galactosemia, as well as audiological screening. All these screenings are usually carried out for the baby in the maternity hospital. If they were not done in the maternity hospital, then neonatal screening for five hereditary syndromes should be done within 1 month of the baby’s life, audiological - in the first three months.

IN 1 month The child should first be examined by a pediatrician, neurologist, pediatric surgeon, or ophthalmologist. Now an examination by a pediatric dentist has been added to this list. The list of studies remained unchanged; it includes ultrasound of the abdominal cavity, kidneys, heart, hip joints and neurosonography.

IN 2 months The baby is examined by a pediatrician (no changes have occurred). Now at this age, the clinic will still do a general blood and urine test - these are innovations for 2018.

IN 3 months Now there is no mandatory consultation with a neurologist (but a pediatrician and an orthopedic traumatologist remain). A general blood test and urine test were also excluded - they were postponed to the second month of the child’s life.

IN 4 and 5 months Both according to the old and new standards, the baby must be examined only by a pediatrician.

Now the pediatrician will be the only one who will examine children in 6, 7, 8, 9, 10 and 11 months. Consultations with a pediatric surgeon and neurologist at 6 months, general blood and urine tests at 6 and 9 months are excluded from this year as mandatory.

IN 1 year Previously, children were examined by a whole team of specialists: a pediatrician, a neurologist, a pediatric surgeon, a dentist, an ophthalmologist, an ENT doctor and a psychiatrist. Starting this year, consultations with a dentist, ophthalmologist and psychiatrist are not required every year, but an orthopedic traumatologist has been added to the mandatory list of doctors. The list of tests included general blood and urine tests and an ECG. Glucose level testing has been removed as mandatory since 2018.

IN 1 year 3 months an examination by a pediatrician is mandatory (nothing has changed here).

IN 1 year 6 months— the baby is also examined only by a pediatrician. A general blood and urine test has become optional.

IN 1 year 9 months from 2018, children for preventive purposes will not undergo examinations at all.

IN 2 years The list of examinations includes: a pediatrician, a pediatric dentist and a child psychiatrist. The child also undergoes a general blood and urine test.

IN 2 years 6 months Medical examinations are now also cancelled.

IN 3 years the children are again examined by a team of doctors: pediatrician, neurologist, pediatric surgeon, pediatric dentist, ophthalmologist, ENT doctor, urologist or gynecologist. Examination by a child psychiatrist at this age is now excluded. Among the tests: general blood and urine tests remain, and glucose level tests are no longer on the mandatory list.

IN 4 years Previously, children were examined by a pediatrician and a surgeon; now the surgeon has been replaced by a pediatric dentist and general blood and urine tests have been excluded.

IN 5 years The child will also be examined only by a pediatrician and a pediatric dentist, and will not undergo any tests.

IN 6 years— future schoolchildren will be examined by a huge team of specialists: a pediatrician, neurologist, surgeon, dentist, orthopedic traumatologist, ophthalmologist, ENT doctor, psychiatrist, gynecologist or urologist. Half of these specialists are new in 2018. In addition to the tests that 6-year-olds had previously undergone (general blood and urine tests), almost the entire range of ultrasound examinations have been added: abdominal organs, kidneys and heart. An ECG was also added, and the study of glucose levels, on the contrary, was excluded from this year.

IN 7 years On the contrary, the number of specialists has decreased. Now children will be examined by a pediatrician, neurologist, dentist, ophthalmologist and ENT doctor. Among the studies: a general blood and urine test remains, all ultrasound and ECG will be done a year earlier.

IN 8 and 9 years old The medical examination now only includes a consultation with a pediatrician and a pediatric dentist. There will be no further examinations or consultations at this age.

IN 10 years the child will be examined by: a pediatrician, a neurologist, a pediatric dentist, an endocrinologist, an orthopedic traumatologist and an ophthalmologist. Consultations with an ENT doctor and a psychiatrist “went away,” as did an ECG and a study of blood glucose levels. All that remains is a general blood and urine test.

IN 11 and 12 years old Only a pediatrician and a pediatric dentist are waiting for children for a medical examination. All tests from the medical examination at this age were also excluded.

IN 13 years old Previously, children were examined only by pediatricians. Now they have added consultations with pediatric dentists and ophthalmologists. On the contrary, all analyzes were excluded.

IN 14 years old Previously, a team of doctors during a medical examination included 8 specialists. Now there are 4 of them left: a pediatrician, a pediatric dentist, a urologist or gynecologist and an adolescent psychiatrist. All tests and studies, including ultrasound, are now canceled at the age of 14 during medical examinations.

IN 15, 16 and 17 years old children will be examined by a full list of specialists, which has remained virtually unchanged compared to previous years. These are a pediatrician, surgeon, dentist, urologist or gynecologist, endocrinologist, neurologist, orthopedic traumatologist, ophthalmologist, ENT doctor and adolescent psychiatrist. Only the number of studies has changed. At 15 years old: general blood and urine tests, as well as EC, to which was added an ultrasound of the abdominal organs and kidneys. At 16 years old: only general blood and urine tests remained, at 17 years old - the same plus an ECG without testing the glucose level, which was done before.

Summing up the material, we noted that now medical examinations of children are even more “concentrated” in certain years, much more attention will be paid to dental problems in the development of children, and children will be less likely to undergo tests for preventive purposes.

The older a person gets, the more often he needs to undergo preventive examinations to identify hidden diseases and risk factors. And once every three years, every citizen of our country can do this for free - at the expense of the state, which bears all the costs of general medical examination. About why this opportunity should not be neglected, and about various aspects of medical examination in your new article said Candidate of Medical Sciences, osteopath, neurologist Alexander Ivanov.

PREVENTION IS EASIER THAN CURE!

One of the measures taken by the state to care about the health of the population is medical examination, that is, a preventive examination of people who have no complaints.

In our country, medical examinations resumed in 2012. In 2015, Order No. 36 of the Ministry of Health of the Russian Federation was published, which declares the right of all citizens of the Russian Federation who have reached the age of 21 to free medical examination once every three years.

The idea is undoubtedly wonderful and is aimed at identifying the first signs of diseases that a person is not even aware of. Prevention is easier than cure. Russia has a high mortality rate from diseases of the cardiovascular system, oncology, diabetes mellitus and lung diseases. General medical examination of the country's population is aimed at preventing these socially significant diseases.

WHERE DOES THE PHYSICAL EXAMINATION TAKE PLACE, WHO IS ELIGIBLE

According to the order of the Ministry of Health of the Russian Federation No. 36, medical examination is voluntary, no one will punish you if you suddenly do not pass it. But it is important to remember that this year people born in the following years (see Figure 1) have the right to undergo a list of approved studies and consultations free of charge according to the order of the Ministry of Health. So, in 2018, citizens of the Russian Federation born in:

1919, 1922, 1925, 1928, 1931, 1934, 1937, 1940, 1943, 1946, 1949, 1952, 1955, 1958, 1961, 1964, 1967, 1970, 1973, 1976, 79, 1982, 1985, 1988, 1991, 1994, 1997.

To undergo medical examination, you can go to the clinic at your place of residence (where you are assigned), and the medical institution has no right to refuse you. The referral is issued if you have a passport and compulsory medical insurance policy. If you work, then the employer, according to the legislation of the Russian Federation, has no right to interfere with your medical examination.

HOW DOES THE CHECK-UP PROCEED?

Medical examination takes place in two stages. At the first stage, possible chronic diseases and their risk factors are identified in a person: a survey and questioning of the patient is carried out in order to identify bad habits and risk factors (smoking, drinking alcohol, taking psychotropic and narcotic substances, assessing nutritional patterns, physical activity). In addition, the following is carried out:

• Anthropometry (measurement of height, weight, waist circumference and determination of BMI - body mass index).
• Blood pressure measurement.
• Express method for determining the level of total cholesterol and glucose in the blood; measurement of intraocular pressure (after 60 years).
• Electrocardiography (men 35 years and older, women 45 years and older).
• Cytological examination of a smear from the cervix (for women from 30 to 60 years old).
• Fluorography.
• Mammography (for women from 39 to 48 years old - once every 3 years, for women from 50 to 70 years old - once every 2 years).
• Examination of feces for occult blood using the immunochemical method (once every 2 years from 49 to 73 years).
• Determination of PSA in the blood of men at 45 years old and at 51 years old.
• HIV testing (from 21 years of age).

This year, clinical and biochemical blood tests, urine tests, and ultrasound of the abdominal organs were removed from the primary stage of medical examination. They will be done if there are complaints.

The first stage ends with an examination and consultation with a therapist, a health group is determined, recommendations on nutrition and physical activity are given, and indications for the second stage of medical examination are determined.

Based on the results of the initial stage of screening, all patients are divided into three health groups: the first group is relatively healthy, the second group is people with a high risk of developing heart and vascular diseases, the third group is sick. The third group is subject to mandatory dispensary observation and treatment.

The second stage of medical examination is carried out to clarify the state of a person’s health using additional examination methods. It may include consultations with specialized specialists.

So, the second stage is:

• Examination by a neurologist if you suspect an acute cerebrovascular accident.
• Duplex scanning of the brachycephalic arteries.
• Consultation with a urologist or surgeon if elevated PSA in the blood more than 1 nanogram per milliliter.
• Examination by a coloproctologist or surgeon in case of a positive stool test for occult blood with a referral for further examination - sigmoidoscopy, fibrocolonoscopy.
• Spirometry for suspected diseases of the respiratory system and in smokers.
• Examination by a gynecologist if there is a change in the cervical smear or mammography.
• Examination by an ENT doctor and an ophthalmologist.

The second stage ends with an examination by a therapist. If necessary, the person is sent for further examination on the recommendation of a specialist doctor.

HOW TO PREPARE FOR A CHECKPOINT

Before coming to the clinic on the appointed day, you must not eat for several hours (take tests on an empty stomach) and not have intense physical activity. Take a jar of morning urine (150 milliliters) with you. If you are over 45 years old, then you need to prepare a stool occult blood test. If you have the results of tests performed earlier, do not forget to take them with you. The second stage of clinical examination takes place more individually, based on the results of the first stage. Don't forget your compulsory medical insurance policy and passport!

HEALTH SYSTEM “SEVEN D” ACCORDING TO IVANOV

In my author’s “Seven D” health system, medical examination is mandatory, and its frequency is at least once a year, starting from the age of 25. In addition to the above analyzes and studies for the mandatory medical examination program of 2018, I recommend supplementing the picture of your health with information on the following parameters (of course, these procedures are paid for independently):

• Serum iron level, ferritin.
• Microelements and macroelements (zinc, selenium, magnesium, calcium, sulfur, chromium, iodine).
• Heavy metals (mercury, lead, aluminum, cadmium)
• Vitamin D.
• Vitamin B12.
• Folic acid.
• Omega-3 index.

These indicators can significantly affect your level of health and the prognosis of life expectancy and quality of life.

RESUME

2. Clinical examination is aimed at identifying chronic diseases and risk factors for their formation, which ultimately improves the quality and length of a person’s life.

3. You can undergo medical examination at the clinic at your place of residence; for this you need a compulsory medical insurance policy and a passport.

4. Clinical examination takes place in two stages, based on the results of which health groups are formed, diseases are identified and treatment and clinical observation are carried out.

5. You can supplement information about your health with additional research (microelements, macroelements, vitamins, heavy metals), but this is no longer included in the standard paid for by the state, however, knowledge of this data and its correction can significantly influence a person’s health.

Take care of yourself and be healthy!

Alexander Ivanov