Screening measures are widely used in medicine to assess the increased probability that members of a defined population have a particular condition and therefore require more extensive assessment. The rationale for prospective screening of late career physicians (LCPs) is drawn from the following circumstances: Senior physicians-prone to the vicissitudes of aging-comprise nearly a third of the US physician workforce, physicians are poor at self-evaluation, data suggest many have clinically relevant cognitive decline, and screening is an evidence-based, method to detect individuals at risk and determine whether a comprehensive evaluation is necessary. A handful of professional organizations (eg, surgeons, obstetricians, and a growing number of medical staff credentialing committees) have developed policies in this arena. This focused review compares cognitive screening methods used or recommended for LCPs, with particular attention to the psychometric properties, ease of operational implementation, and appropriate application to physicians-a population selected for high cognitive reserve and skills. Further, we identify gaps in knowledge and practice, including the need for more career-span normative data on physicians' cognitive and work performance. Stakeholders can improve rehabilitation and other supports to LCPs in transition, calling upon the unique expertise of those neuropsychologists who are trained on conducting fitness for duty evaluations, as well as rehabilitation professionals who can assist in developing modifications to practice when indicated or facilitate graceful transitions to retirement when necessary.

中文翻译：

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晚期职业医师的认知筛查工具：批判性审查。

筛查措施在医学中广泛使用，以评估特定人群的成员患有特定疾病的可能性增加，因此需要更广泛的评估。对晚期职业医生 (LCP) 进行前瞻性筛查的基本原理来自以下情况： 资深医生——容易衰老——占美国医生队伍的近三分之一，医生自我评估能力差，数据表明许多有临床相关的认知能力下降，筛查是一种基于证据的方法，用于检测有风险的个体并确定是否需要进行综合评估。少数专业组织（例如，外科医生、产科医生和越来越多的医务人员资格认证委员会）已经制定了该领域的政策。这篇重点审查比较了 LCP 使用或推荐的认知筛查方法，特别关注心理测量特性、操作实施的简便性以及对医生的适当应用——选择具有高认知储备和技能的人群。此外，我们确定了知识和实践方面的差距，包括需要更多关于医生认知和工作表现的职业跨度规范数据。利益相关者可以改善对处于过渡期的 LCP 的康复和其他支持，呼吁那些接受过适合职责评估培训的神经心理学家的独特专业知识，以及能够在需要时协助制定实践修改或促进优雅过渡的康复专业人员必要时退休。