Recruitment Medical: The Disclosed Knee Pain

The disclosure is recorded verbatim, with date and time, read back to the candidate, and placed in the file before the medical officer sees him. It is not edited, softened or removed on request.

The reason is that the record exists to protect three parties: the candidate against a later allegation of concealment, the service against inducting a man whose condition was known and ignored, and the medical officer against acting on an incomplete file. A statement made in a formal examination is not a draft; a candidate may add a written clarification, but he cannot unmake the fact that he said it. He should also be told, in plain terms, the consequence of a false declaration - that discovery after enrolment is far worse than a finding at the rally.

Then the file goes to the medical officer with the observation only. You do not classify, you do not reassure him that he is fit, and you do not tell him he is finished. Your role is to ensure that the medical officer has the information, that the candidate is examined for it, and that whatever the finding, it is recorded in the prescribed form with reasons.

The prescribed standards, not the assisting officer, fix the thresholds; the officer's task is to see that each finding is measured and recorded so the standard can be applied.

• Healed forearm fracture, no implant, full painless movement, equal grip: a structural finding that is normally assessable on the day by examination and history. It becomes a specialist question only if movement is limited, deformity or nerve symptoms appear, or the injury interferes with load-bearing tasks.
• BMI 28.6, waist 96 cm: decided by measurement against the prescribed weight-for-height and waist criteria, not by appearance. This is a computation, and the candidate should be told what was measured.
• Vision 6/12 correcting to 6/6 with normal colour vision: decided against the prescribed visual standards for the category applied for; correctable acuity and colour vision are the two facts that matter and both are recorded.
• Asymptomatic flexible flat feet: usually a recording finding unless painful on weight-bearing or associated with deformity.
• Bilateral knee pain on running, three months, no swelling, no treatment: this is a symptom, not a diagnosis. It needs a cause: overuse, malalignment, patellofemoral pain, or something more. Expect observation, a rest-and-review instruction, or orthopaedic opinion, and expect the decision to be 'temporary unfitness, review' rather than a permanent verdict today.

The candidate should be told which of these are pending, because most rejections that are appealed are rejections the candidate did not understand.

Say it plainly and without moralising: the statement stays in the file; what he says to a medical officer cannot be taken back, and asking to take it back would itself be recorded and would damage his credibility far more than knee pain will.

Then give him the honest balance. Concealment has a bad expected value: an injury that hurts after 5 km will surface in training, typically at the worst time, and the outcome then is not a rejected application but a discharge, a lost year and a record. A disclosed condition, by contrast, has an ordinary route - examination, possibly specialist opinion, and often a temporary finding with a review date, which is recoverable.

Explain the process: the medical officer will examine and record a category; if he is found unfit, he is entitled to the prescribed review or appeal route, and the assisting officer will make sure he knows the form, the time limit and where to submit it. Confirm that nothing said will be repeated to other candidates. Advise him to bring any treatment records to the review, and, since he plays volleyball twice a week, to note that in his own words rather than have it inferred.