Application to join OEUK's Registered Doctors List

Personal Details

Please note: The email address and telephone number entered below will only be used by OEUK to keep in touch with you and to distribute relevant information. This information will not be published on our website.

First name

Last name

Email Address

Telephone

Year of qualification

Postgraduate degrees/diplomas

Medical registration

Please enter the details of your medical registration with the UK General Medical Council in the fields below to allow OEUK to verify your registration and process your application. Your registration body will be the General Medical Council (GMC) and your Registration Number will be your GMC Reference Number.

Please enter the details of your medical registration with the UK General Medical Council in the fields below to allow OEUK to verify your registration and process your application. Your registration body will be the General Medical Council (GMC) and your Registration Number will be your GMC Reference Number.

GMC Reference Number

Clinic details

Please note: the clinic email address and telephone number entered below will be displayed on the registered doctors list on our website to allow prospective patients to get in touch with you after your application has been accepted.

Name of Clinic

Address line 1

Address line 2

Address line 3

City

County/Region

Postcode

Country

Clinic email address

Clinic telephone

Relevant experience

For entry to the Registered Examining Doctors List applicants should show:

Experience of offshore oil and gas (or remote) medicine
Other relevant/transferable experience in occupational medicine
That they will commence working under the direct supervision of a doctor already on the registered doctors list
Other relevant applicable experience

Please select the option that best describes your practice in occupational medicine

If you selected 3 or 4 above, please state your main area of clinical practice:

Your personal relevant experience

Please describe your experience, past and present, in offshore oil and gas medicine

Please describe your experience, past and present, in any other form of remote medicine

Please describe your present activities in occupational medicine

Please describe your reason(s) for requesting entry to the examining doctor list (i.e. what are the circumstances that require you to undertake OEUK medicals?)

Your practice

How would you describe your organisation

If you selected Other, please indicate your organisation type below

Facilities

The Guidelines for Medical Aspects of Fitness for Offshore Work require the following assessments to be carried out:

Clinical and occupational history
Height, weight and body mass index
Visual acuity
Urinalysis
Audiometry, to standards defined in BS EN ISO 8253-1:2010, and British Society of Audiology Recommended Procedure for Pure-tone air-conduction threshold audiometry, with and without masking [Sept 2011] (http://bit.ly/BSApta)
Appropriate relevant clinical examination, to include an assessment of dental health
Additional tests if indicated

Please provide the following details: Audiometer make and model, acoustic booth details and other relevant information relating to meeting the requirements of BS EN ISO 8253-1:2010

Attach a copy of your current audiometer calibration certificate at the end of this form. Applications submitted without a certificate will not be processed.

Certain offshore workers may be designated as emergency response team members and require a higher level of physical fitness than standard offshore workers. The Medical Guidelines require these workers to undergo further evaluation including a fitness test and determination of VO2 max. This may be by Chester Step Test or any other suitable testing method. Provide details of VO2 max test to be used

Declaration

By clicking the checkbox below, I certify that the above information is correct. If included on the Registered Examining Doctors List, I agree to adhere to the OEUK Guidelines for Medical Aspects of Fitness for Offshore Work and to have my services audited by OEUK. I certify above information is correct

Attach a copy of your current audiometer calibration certificate here. To upload multiple files, press ‘Choose files’ button and hold down the ‘Ctrl’ key on your keyboard to select multiple files.

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