​The Recreational Scuba Training Council (RSTC) diving medical screening system was first published in 1989.  This screening questionnaire was a collaborative project orchestrated by and through the Undersea and Hyperbaric Medical Society (UHMS) Diving Committee and subsequently endorsed by the RSTC.  
 
Since its inception, this tool has become the most frequently used method of efficiently and effectively screening scuba divers for training or diving activity participation.
 
After almost 30 years, there was sufficient evidence to support a revision, and an independent international group of diving medical experts, the Diver Medical Screen Committee (DMSR), was brought together in 2017 to initiate an evidence-based review and an updated diver screening questionnaire underwent field testing for efficacy and screening sensitivity and was published in June 2020.

As a dive professional, you know a student for any certification course – that is from beginner courses and all continuing education courses must fill out the RSTC diving medical questionnaire (in addition, if you run a club and organised events it is strongly recommended that you hold an in date medical on file and it is annually reviewed).
 
If there are any YES answers on the questionnaire then the student must get a physician’s approval to dive prior to participating in any training with you (the latest form is 2020 Diver Medical Participant Questionnaire)
 
So, cut and dried – well our training agencies would have us believe that, but it is never that simple.

​In the context of the Diver Medical Participant Questionnaire, the term “Physician” has a specific meaning. 
 
In most countries, this means a medical doctor, one who focuses on the non-surgical treatment of patients’ conditions.
 
The ideal medical provider to perform fitness to dive examinations has undergone training in diving and hyperbaric medicine as evidenced by board certification or certificate of added qualification (the designation of these qualifications varies around the world). 
 
However, the Diver Medical screening system was designed to equip physicians who don’t have this specialised training with resources to assist in their medical consultations.  The Diving Medical Guidance to the Physician provides insight from the Diver Medical Screen Committee into medical conditions as they relate to diving, and where there is any doubt concerning a patient’s condition, the Divers Alert Network has referral specialists around the world that can be reached for this purpose or in the UK an AMED doctor (http://www.ukdmc.org/medical-referees/)

1. What happens when a student gets a properly signed medical form by a physician, but you are still not comfortable teaching that student with the particular medical condition.
2. What happens if the physician writes something in their remarks or attaches a letter or note telling you what the student can or cannot do?
3. Or the student tells you that they had to go to several physicians before one would sign it.
4. Or during training something comes up or happens which brings the divers medical into question.
5. Or a student becomes ill or injured during training

​During your course orientation or initial conversations with potential students stress the need for absolute truth and accuracy on these forms because once underwater there is nothing worth seeing that is worth risking their and your life over.

You have a student who has truthfully completed the medical statement with a YES and then gets a physician’s signature that allow them to proceed, but you are not comfortable with their fitness to dive.
 
Maybe the person is showing signs or symptoms, acting in a manner that you know will be not only challenging for them or the other student(s) but for you and your instructional team; more importantly safety becomes questioned or flagged in the training risk assessment.  We all get challenging students at times but what we are talking about is where the student is actually presenting a challenge to their own safety or that of others around them.
 
We are not physicians and our training agencies say if the student has a medical, they can commence training. If a student had a YES, you do not get to play physician and say, “Oh you do not need a physician signature that’s nothing.” As an instructor, you can refuse to accept to teach a student with a physician signed medical form.  We are granted this by our certification agencies because we must be comfortable for our safety and the students, we have a duty of care to while teaching diving courses.

If you are not comfortable teaching someone you must be able to articulate the reasons why, but you can say no, even if the student has a signed medical.

Medicals prior to the 2020 Diver Medical there was a section for Physicians to write comments, this has now been removed with the Physician only able tick Approved or Not Approved on the Diver Medical in the Physician’s Evaluation Form section, but this does not stop the Physician from writing additional notes or attaching a letter or note!
 
If a Physician does attached a letter or note, then in PADI terms the instructor manual covers this very clearly and states that there can be no restrictions or conditions noted by the physician (for example depth limits, water temperature restrictions etc.)

​This always raises a red flag, and you should understand the reason for this and that can be done with a “Oh really, why was that” type of question.
 
It could be that their local physician was not comfortable signing a medical questionnaire as they declared they are not a diving doctor and do not understand the implications – Great that is honesty.
 
It could be the local surgery policy is to not sign these types of forms and we are seeing this more and more in our local area.
 
It could be the cost of the local physician to sign was prohibitive – yes it happens.
 
Now it could be that one physician advised the student to not come diving and the student then ‘shopped’ around until they found a physician who would sign it.
 
In this latter case, politely advise them to have a conversation with a diving AMED, after all they understand diving medicine.

​Yes, there are times a student fills in the medical statement and puts a NO when they should have put a YES.  After all they want to come diving and experience all of the amazing things we talk about and put over our social media channels, who would not want to experience that after all.
 
Something might come up in conversation with a member of your professional team it might be something you see – it could be a serious scar and they have put NO to major surgery.  It is at this point you need an open and honest conversation with the student and politely point out the NO on the medical statement and see if it changes to a YES, it probably will and then stop training until you have a signed medical statement from a physician.

In PADI terms the instructor manual covers this very clearly and states that a student diver who becomes ill or injured during a PADI course is to complete a new Medical statement before further in water activities.  Use the medical form to rescreen the student to determine if the changed medical condition would cause the diver to check off something new on the medical.  If so, the diver must be cleared for diving by a physician prior to resuming in water trainin

​We have had forms signed by our local GP practices and potentially the student has paid a lot of money to get that signature, but we inwardly question if the physician actually read the guidance documentation or did any research into the student’s condition as it relates to diving.  Because they have approved someone with a condition that we have previously seen students not approved to dive.  We might not be physicians but a number of us are aware of conditions and medication that a student would be advised not to dive with or on.
 
In this case, you technically cannot decline to train the student, unless the criteria outlined in part one is present.  What we do is gently refer the student to a diving doctor which here in the UK is an AMED doctor and we give our students the name of number of our local ones, explaining that we think the student would benefit from talking to the AMED doctor as they are understanding diving medicine whereas their doctor probably does not.  In fact, if a student declares a medical condition in our early conversations, we advise them to go to an AMED over and above their local physician. Our local chamber doctor has been incredibly helpful over the years.

We are an inclusive sport, and we should do everything we can to include disabled divers.  There are plenty of parliamentary acts to ensure that no one is unfairly discriminated against and quite rightly.  But everyone needs a medical BEFORE they can undertake any diver training.
 
But let us take just one example - you have someone who is morbidly obese, and they receive a yes from their physician.  (This potentially should not happen – see the DDRC article that answers the question “Can I dive if obese” on https://www.ddrc.org/diving/can-i-dive/can-i-dive-if-obese/)
 
But you are uncomfortable teaching this individual.  It could be an operational risk – you are concerned that you would physically not be able to exit them from the pool or open water site in an emergency.  The rental equipment is not going to fit, and you are not going to train them without exposure protection.  This would require a well-articulated message that states all of this.  Plus, other professionals can help with the message The Dive Centre Risk Assessment has raised a number of issues that we cannot remediate that would make you the student safe and us the instructional team able to safely deliver the course.
 
Everyone has to be “Fit to Dive” and we have other articles that cover this subject as Fit to Dive covers your physical, emotional and mental fitness

Just another reason (if you need one!) to become a PADI Professional, you can get to travel the world.

Just another reason (if you need one!) to become a PADI Professional, you can get to travel the world.

One of the great reasons for becoming a PADI professional be that a Divemaster, instructor or above is funding travel.  

Experiencing the world on a gap year diving and working your way around - what an experience and adventure!

As many diving jobs are seasonal you could spend maybe three months in Thailand, then take off to Bali for another two months or have a working holiday in Australia.  But hopping from one contract to another means you could get to work in some of the most beautiful places in the world - so much adventure and underwater things to see and explore also what a great thing to place on your CV?

Maybe you do not want short term work but a long-term position - well they are out there but experience is important.  

Just maybe you find another love on your travels and decide to settle down in another part of the world - what great stories you would have for your children and grandchildren.

What is stopping your journey?  Nothing...  Here at Dive Rutland we run a full suite of professional training courses AND we can also provide you with the value add training such as how to operate a compressor, gas blend, first aid and so much more.  You could become one of the most sought after dive professionals.

Now is really the time to start or continue your journey.  Be prepared for the world to open back up and get out there.

Just another reason to become a Dive professional is that you get to work out in nature

You get to feel the warmth of the sun on your skin and that always makes you feel better, yes, you also get the wind and rain but that’s exhilarating.
 
Being under the water with the fishes, the coral, the grasses, the sharks, whales, rays and dugongs is amazing and being able to share your passion with others is an amazing opportunity.
 
So go on, join us and become a dive professional, we are here to help you with your journey

The first step of the journey is to become a Divemaster, this will open up many doors such as that gap year be you having a year out from studying, work or just life, find out more by having a look at our PADI Divemaster course

And if you want to progress further up the professional ladder then we have something for you to.  contact us to discuss your next steps, we truly are that "one stop shop"

We are really pleased to finally let you into a secret that Bridget and Tracey have been keeping along with Sam Adcock

PADI approached us during the early part of 2020 to be part of the BETA team to test a potentially new certification called PADI Junior Divemaster

A programme that will potentially make the mainstream certification list for those aged 15 - 17 who have completed PADI Junior Rescue and are wanting to progress and become a fully fledged PADI Divemaster but they need to wait until they are 18.

But if you are already 18 and Rescue then you can start your Divemaster course now.

The Junior Divemaster course is a subset of the PADI Divemaster course with some modifications to performance requirements

Included is skill development, stamina workshops, dive site set up and management training and much more, all conducted over a series of pool and open water sessions.  Knowledge development forms a key part of the course and includes self-study through eLearning followed by a written exam.  All the same as for the PADI Divemaster course

Sam completed the Search and Recovery speciality back in August at Rutland Water and not only gained and extra speciality but gained a a credit towards both the Junior and the next step of completing the mainstream Divemaster certification

This program has now moved out of BETA and into a fully fledged PILOT by by extending to PADI Youth Approved Training Centres, so we are now allowed to tell you and invite any junior diver to come and be part of the program.  Not yet a Rescue Diver... lets get you started.

Our Classroom table has taken advantage of the current lockdown and had a facelift all curtesy of Digital Deadline

PADI are processing ALL Assistant Instructor certifications until the end of January 2021 Free of Charge, saving YOU £78.00

Are you a Divemaster and not sure if instructing is for you, maybe want more time before taking that step to Open Water Instructor then become an Assistant Instructor and get more involved with students and their ongoing development but most of continuing to develop in the sport you love doing.

As a diving professional you can 

• Travel the world
• Make a difference, save the ocean
• Be part of a global community
• Stay fit and healthy
• Have flexible working hours 

But most of all CHANGE LIVES!

HOW?

• By installing confidence in others
• Improving people's self esteem
• Help people reach their personal goals
• Give people a purpose in life
• Make lifelong friends
• Gain respect from others

So what are you waiting for.. Get in touch and discuss your next steps, we are flexible and can arrange courses to suit your timescales which can include our virtual classroom