Late-career physicians (LCPs) are at risk for cognitive changes that may affect their ability to practice medicine. This review aggregates and discusses research that has examined cognitive functioning among physicians, typically when clinically referred for various medical and psychological reasons that may interfere with their ability to practice medicine. Special consideration is devoted to the role of approaches for examining cognitive functioning (e.g., cognitive screening, cognitive testing, & neuropsychological assessment), normative challenges, and cultural factors that should be considered when evaluating a physician. Based on published studies, there is evidence supportive of the use of cognitive testing and neuropsychological assessment among physicians in a fitness for duty setting. However, prospective studies designed to identify physicians at-risk (i.e., to prevent medical error) are lacking. Additional research is warranted to establish physician-based normative reference groups and aid in test interpretation and prognostication. Moreover, given limitations associated with cognitive testing in isolation, there is a potential role for comprehensive neuropsychological assessment to identify cognitive changes in physicians and provide a supportive pathway to preserve physicians’ ability to practice medicine.

职业生涯晚期的医生 (LCP) 面临认知变化的风险，这可能会影响他们行医的能力。这篇综述汇总并讨论了检查医生认知功能的研究，通常是在临床上因各种可能干扰他们行医能力的医学和心理原因而转诊时。特别考虑了检查认知功能的方法（例如，认知筛查、认知测试和神经心理学评估）的作用、规范性挑战和评估医生时应考虑的文化因素。根据已发表的研究，有证据支持在适合值班的医生中使用认知测试和神经心理学评估。然而，缺乏旨在识别处于危险中的医生（即防止医疗差错）的前瞻性研究。需要进行额外的研究以建立基于医师的规范参考组并帮助测试解释和预测。此外，鉴于与孤立的认知测试相关的局限性，综合神经心理学评估可能会识别医生的认知变化并提供支持性途径以保持医生的行医能力。