Passing a periodic medical examination at the hospital. How to draw up an order to undergo a periodic medical examination. What conclusion did the RF Armed Forces reach regarding medical examinations for trade workers?

The article contains the procedure for conducting a medical examination, taking into account recent changes, the algorithm for conducting a periodic medical examination, an explanation of when it is necessary to conduct an unscheduled one, and what fines may be imposed for failure to conduct a medical examination.

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New medical examinations for enterprise employees in 2019

A medical examination (MO) is a comprehensive examination of an employee in order to identify negative changes in his health and determine his suitability to perform job duties. First of all, a medical examination is necessary for personnel who are exposed to harmful and hazardous production factors (HAPF) in the workplace. The list of such factors and the procedure for undergoing medical examinations by employees are established by Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 No. 302n.

In March 2018, the approved changes came into force. It was expanded (clause 20 of Appendix No. 2): instead of workers of social shelters and nursing homes, workers of social service organizations providing social services must now be sent to the Ministry of Defense:

• in stationary form of social services;
• semi-stationary form of social services;
• in the form of social services at home.

The procedure for conducting a medical examination in Appendix No. 3, as well as the requirements for documents confirming its completion, have not changed.

The service was created to simplify routine tasks, including those related to organizing a medical examination. The service will automatically generate completed lists of contingents, referrals for medical examinations and draw up a schedule of medical examinations; in addition, in the service you can view paragraph of order 302n and the frequency of medical examinations simply by typing the name of a specific position.

Article 213 of the Labor Code of the Russian Federation - medical examinations

For what purposes are mandatory periodic medical examinations carried out?

The following employees must undergo periodic preventive medical examinations.

• Those exposed to harmful or dangerous production factors, in the presence of which mandatory preliminary and periodic medical examinations are carried out.
• Performing work specified in the list, during the performance of which mandatory preliminary and periodic medical examinations of workers are carried out.
• . If these jobs involve persons under 21 years of age, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).
• Involved in underground work. Such employees undergo periodic medical examinations annually (clause 12 of Appendix 2 to Order No. 302n).
• Employed in organizations of the food industry, public catering and trade, water supply facilities, medical organizations and child care institutions (Article 213 of the Labor Code of the Russian Federation). The frequency of medical examinations for specific professions is given in Appendix No. 2 to Order No. 302n.
• Athletes. They undergo medical examinations annually (Article 348.3 of the Labor Code of the Russian Federation).
• Persons under 18 years of age. They undergo medical examinations annually (Article 266 of the Labor Code of the Russian Federation).

The List specifies the jobs and professions during which workers must undergo mandatory preliminary and periodic medical examinations, regardless of what is established at these workplaces and the availability of vocational training.

*If the listed jobs involve persons under 21 years of age, they undergo medical examinations annually (Article 213 of the Labor Code of the Russian Federation).

Medical examinations should be carried out already in the presence of harmful or dangerous production factors specified in the list at the workplace, and their level does not matter.

The following factors are exceptions:

• 3.5. – ;
• 3.8., 3.9. - air temperature;
• 3.12. – light environment;
• 4.1. – physical overload;
• 4.4.1., 4.4.2., 4.4.3. – sensory loads.

For these factors, medical examinations are carried out only if working conditions are classified as harmful or dangerous based on the results of the special assessment assessment.

How to organize a preliminary medical examination

When hiring, for example, accountants, programmers, management personnel and other office employees who work at a computer more than 50 percent of the time, the employer is obliged to send them for a medical examination (clause 3.2.2.4 of the List of harmful and (or) hazardous production factors, approved by Order No. 302n). The frequency of MO is once every two years.

Passing a periodic medical examination

The procedure for conducting periodic medical examinations is regulated by Order No. 302n. The algorithm is as follows:

The medical organization, within 30 days after the completion of periodic medical examinations, summarizes their results. Then, together with the territorial bodies of Rospotrebnadzor and representatives of the employer, it compiles in four copies, which are sent within five working days from the date of approval:

• employer;
• to the center of occupational pathology of a constituent entity of the Russian Federation;
• to the territorial body of Rospotrebnadzor.

One copy of the final act is kept in the medical organization for 50 years.

When are extraordinary medical examinations of employees carried out?

Extraordinary medical examinations are carried out on the basis of medical recommendations specified in the final report of the medical examination.

• at work with harmful or dangerous working conditions, including underground;
• at work related to traffic;
• athletes ();
• working in food industry organizations, public catering and trade, water supply facilities, medical organizations and child care institutions, etc.

The employer has the right to send an employee to an extraordinary medical examination in the following cases:

• at the request of the workers themselves (Article 219 of the Labor Code of the Russian Federation);
• in accordance with the recommendations of specialists who participated in preliminary or periodic examinations, as well as for epidemiological indications;
• in accordance with ;
• according to the conclusion of the territorial bodies of Rospotrebnadzor with mandatory justification in the direction of the reasons;
• when a case of nosocomial infection is detected, by decision of specialists from Rospotrebnadzor authorities and institutions.

In the absence of the grounds listed above, the employer does not have the right to send the employee for an extraordinary medical examination without his consent.

An employee is obliged to immediately notify his immediate or superior manager about a deterioration in his health, including the manifestation of signs of an acute occupational disease (Article 214 of the Labor Code of the Russian Federation). The employer, if there are clear signs indicating a decrease in the employee’s ability to work, can send him for an extraordinary medical examination.

Who to refer for a medical examination

Responsibility for failure to undergo a medical examination in the organization

The employer is responsible not only for the timely organization of medical education for employees at its own expense, but also for the admission to work of persons who have not undergone a preliminary or periodic examination, or who are not allowed to work for medical reasons. If inspectors of regulatory authorities establish such a fact, the employer may incur administrative liability.

According to Part 3 of Art. 5.27.1 of the Code of Administrative Offenses of the Russian Federation, the fine will be as follows:

• for officials – from 15,000 to 25,000 rubles;
• for persons carrying out entrepreneurial activities without forming a legal entity - from 15,000 to 25,000 rubles;
• for legal entities – from 110,000 to 130,000 rubles.

The amount of the fine is calculated based on the number of employees who have not completed the mandatory training. If, due to the lack of a medical examination, the employee’s health is seriously harmed or his death occurs, the officials will bear the consequences (Article 143 of the Criminal Code of the Russian Federation).

Mandatory medical examinations of employees are not the good will or “whim” of the employer, but a legal requirement. Monitoring the health of personnel makes it possible to increase labor efficiency at the enterprise, prevent the occurrence of epidemics or mass occupational morbidity, and creates conditions for the growth and development of employees. If a specialist has not passed the medical commission in the absence of valid reasons, he is prohibited from being allowed to perform labor functions.

The concept of “mandatory medical examination” has replaced the previously used term “medical examination”. Both of these mean a set of medical measures carried out to assess the health status of hired specialists, identify possible deviations and occupational diseases at the initial stage, and prevent them.

Mandatory periodic medical examinations perform the following tasks:

• help avoid work-related injuries and epidemics;
• make it possible to identify occupational diseases at an early stage and begin their treatment in a timely manner;
• increase labor productivity at the enterprise: it is known that performance indicators depend on the health status of personnel;
• allow you to track the state's health dynamics;
• are part of the company’s operating concept and contribute to the professional growth of staff, etc.

Control over the passage of medical commissions is legally assigned to the head of the organization. According to the provisions of Art. 212 of the Labor Code of the Russian Federation, financing these activities is the task of the employing company. Days of visiting doctors and taking tests are not considered days off or time off; employees retain their average earnings.

Mandatory medical examinations: main types

Labor legislation distinguishes the following types of medical examinations:

• Preliminary

This includes visiting a therapist and specialists and taking tests for applicants for vacant positions in the organization. The purpose of the activities is to determine whether a particular candidate is suitable for an open position. For certain categories of persons, a medical examination is mandatory under the Labor Code of the Russian Federation; for others, it is carried out at the free will of the employer.

• Periodic

Designed to identify possible occupational diseases in the early stages, identify factors that make individual specialists unfit for work, and help management track the dynamics of staff health. Is it mandatory to undergo a medical examination at work? Yes, if the employee is under 21 years of age, if his working conditions are considered harmful or dangerous.

In general, periodic inspections are carried out every two years. An exception is employees under the age of 21, for whom a medical examination must be organized every 12 months.

• Extraordinary

They are organized in emergency situations: at the request of the workers themselves, if an increase in morbidity is detected during a previous examination, if a dangerous occupational disease is discovered in one of the workers.

The provision on mandatory preliminary medical examinations allows for the possibility that the results of a medical commission alone will not be enough to determine the suitability of the health status of individuals for the position held. Then an extraordinary examination will be required. It may happen that working conditions at the enterprise deteriorate sharply, and some employees develop suspicious symptoms. In order to prevent the outbreak of an epidemic, it will be necessary to organize tests and visits to doctors.

List of employees subject to mandatory medical examinations

The legislation stipulates that the decision of the employing company or the content of collective agreements may establish the obligation to undergo medical examinations for representatives of any profession. However, the legislation (Articles 213, 298, 266 of the Labor Code of the Russian Federation) provides a list of areas of activity for which this rule is immutable:

• high-altitude work;
• work in public catering outlets;
• raising children, caring for the sick;
• livestock and poultry farms;
• water supply to the population;
• hotel business;
• swimming pools and spas;
• pharmaceuticals, etc.

Important! Regardless of the specifics of the company’s activities, the rule on mandatory medical examinations applies to employees under 21 years of age.

If an employee resists a mandatory preliminary medical examination upon joining the staff, he cannot be hired. If a person refuses to appear for a periodic medical examination, this is regarded as a violation of labor functions. Such a disciplinary offense entails extreme punishment - termination of the contract between the company and the specialist. The admission of such a person to work contrary to the current rules entails the imposition of penalties on the legal entity by regulatory authorities.

What are mandatory preliminary medical examinations?

According to the provisions of the Labor Code, there are categories of applicants who must attend a medical examination in order for their employment to take place. These include:

• persons under 18 years of age;
• specialists working on a rotational basis;
• workers with harmful and dangerous working conditions;
• persons engaged in food trade, catering, working in children's and health care institutions.

Mandatory medical examinations before employment are financed by the potential employer, as stated in Art. 212 Labor Code of the Russian Federation. The basis for visiting doctors is a referral issued by the company. The law does not prohibit contacting any health care institution, but practice shows that it is better to go to the hospital chosen by the employing organization.

The fact of being sent for a medical examination should not be regarded as a 100% guarantee of employment. If it is revealed that a citizen’s health does not allow him to perform certain functions, he will not be able to be hired.

The duration of the mandatory medical examination upon hiring is agreed upon with the candidate. As a rule, the duration of the procedure does not exceed a week. It is considered complete when a person has visited all the specialists whose opinion is significant for his specialty and passed tests.

The medical commission issues a certificate of suitability for the profession. One copy is given to the citizen for presentation to a potential employer, the second is filed in the patient’s personal card, which is created immediately after presentation of the referral.

Based on the results of the mandatory medical examination when hiring, the employing company must present one of the following documents:

• doctors’ conclusions with a conclusion about the compliance or non-compliance of the proposed position;
• certificate 086/у – for minor applicants;
• medical book - if the job requires it.

An employee who has not passed a mandatory periodic medical examination cannot be hired for a vacant position, regardless of knowledge and qualifications. If a person’s health does not meet the requirements of the profession, he cannot be employed.

Important! Allowing an employee to work without undergoing inspection is punishable by a fine of up to 25 thousand rubles for the management of the company and individual entrepreneur, up to 130 thousand rubles. – for a legal entity.

How are mandatory medical examinations organized for workers of certain categories?

The procedure for organizing regular medical commissions can be reduced to the following steps:

• First

The organization compiles a list of employees who need to be sent to a medical examination. The document contains information on the list of positions subject to inspection, the number of their representative employees, and the legislative basis for the examination of doctors. He is endorsed by the general director of the company.

After compiling the list, it must be sent to the territorial division of Rospotrebnadzor in accordance with the actual address of the legal entity. The organization has 10 days to do this.

• Second

Conducting mandatory preliminary and periodic medical examinations involves searching for a health care institution that will accept workers. An agreement is concluded with him, which stipulates significant terms of cooperation. The cost of services falls on the shoulders of the hiring company.

Important! The selected hospital or clinic must have a license to conduct medical examinations.

• Third

The organization issues an order on mandatory medical examination, which specifies the staffing units sent to the medical examination and the schedule of the event. Workers get acquainted with the document against signature.

• Fourth

Each employee who needs to visit doctors is given a referral issued in accordance with the requirements of Order 302n. You must take it with you to the healthcare facility along with your passport and personal medical card.

The procedure for conducting mandatory preliminary medical examinations presupposes that, based on their results, employees are issued conclusions indicating whether they are fit for further work due to health reasons. If a discrepancy or occupational illness is detected, the specialist may be transferred to another position, suspended for the period of treatment (up to 4 months) or dismissed under Art. 77 Labor Code of the Russian Federation.

When conclusions for all employees are collected, the company draws up a final report, which systematizes the results of the inspection. The document is signed by the heads of the employing organization and the clinic, after which it is sent to the territorial body of Rospotrebnadzor.

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How to conduct a medical examination of medical workers, what tests should medical workers take, which doctors should they go through? Is there a law on medical examinations in Russia? Read about how to organize a medical examination of different categories of medical workers in our material.

From this article you will learn:

• Law on medical examinations: does such a regulatory act exist in Russia?
• The order of procedures that involves a medical examination (medical examination) of medical workers;
• What tests does a medical examination of different categories of medical workers necessarily include?
• Medical examination of medical workers: what are the features of the procedure.

Passing a medical examination by medical workers

The Labor Code describes categories of workers who must undergo medical examinations upon employment and during their work activities. The document also regulates the actions of employers, as well as the financial side of medical examinations. Benefits and budget subsidies for medical examinations are expected for government medical institutions.

The law on medical examinations, if approved, will completely regulate the entire procedure for undergoing a medical examination.

Medical examination of medical workers: procedure for carrying out the procedure

Passing a medical examination by medical workers primarily depends on whether the medical institution or organization itself is public or private.

Medical examination of medical workers of government institutions

Municipal organizations and state medical and preventive institutions must organize a medical examination (physical examination) once a year for subordinates of any rank, qualification, or academic degree. Some individuals may be tested twice a year or for health reasons, indications, or in the event of epidemics and increased cases of infection with dangerous diseases. For categories of employees engaged in work paid from the state budget (government organizations, institutions, centers) there is no need to have a medical record.

For specialists of all professions:

• check with a dermatologist;
• check with a venereologist with a preliminary test for RW;
• check by therapist;
• vaccination (immunity to diphtheria);
• blood test (detection of typhoid fever);
• test (smear) for STDs (sexually transmitted infections);
• analysis for the presence of intestinal infections.

Medical examination of clinic medical workers

For clinic employees, a medical examination is mandatory, but medical examinations and hygienic training for employees are not carried out (regardless of their position).

The medical examination program for doctors, orderlies, and other health workers includes the following list of specialists who must be seen:

• expert in narcology;
• ophthalmologist;
• otorhinolaryngologist;
• psychiatrist;
• neurologist;
• dermatovenerologist;
• oncologist;
• allergist;
• endocrinologist;
• therapist.

An examination by a neurologist, allergist, endocrinologist and ophthalmologist is necessary for those categories of doctors and medical personnel who, in their work, come into direct contact with chemically and biologically hazardous environments.

The program requires tests:

• blood (clinical general analysis);
• urine (clinical general analysis + sugar + protein);
• blood (biochemical screening);
• blood (syphilis test);
• test for gonorrhea;
• analysis for hepatitis B, C*;
• analysis for the detection of typhoid fever**;
• analysis for staphylococcus***.

*According to the list of necessary tests, which involves a medical examination of medical workers, it includes a test for hepatitis. This test is taken by all employees, without exception, whose employment involves contact with patients with these diseases or with material carrying this infection. According to the regulations in force in the Russian Federation (which are collectively called the “law on medical examinations”), the analysis must be performed after the employee’s consent to donate blood has been obtained.

**A test for typhoid fever and other intestinal infections must take place when a medical worker gets a job. During work, analysis can only be done if there are indications for this or if an epidemic has occurred.

*** Testing for staphylococcus is performed using a sample from the nasopharynx. Such a clinical assessment must be carried out upon entry into a medical position. In the future, the employee is asked to undergo this examination every six months.

A special feature of the results of medical examinations is the strict recording of data in the medical record. For specialists working with newborns, in maternity hospitals, as well as pathology departments and children's departments, the presence of this document is a prerequisite. Such requirements are assumed.

According to current regulations and legislative acts, neither state nor commercial medical centers or institutions have the right to allow citizens to work who do not have a medical book or it is filled out improperly.

Medical examination for pharmacists

Employees who work in pharmacies have close contact with a lot of people. Therefore, they can both be potential spreaders of infections and be exposed to various diseases transmitted by airborne droplets and through touch. A medical examination of medical workers (pharmacists) should be carried out by doctors before taking on duties, as well as a medical examination (medical examination) according to the approved schedule. This schedule should not include scheduled visits to clinic specialists less than once a calendar year. Such conditions are enshrined in.

In terms of the procedure for undergoing a medical examination, workers employed in the medical industry are also treated like pharmacy employees. The medical examination of medical workers is the same for pharmacists, medicine packers, and people involved in the sale of medicines.

Medical examination of medical workers provided for this category of working specialties includes the following procedures:

• mandatory monitoring of the condition by a narcologist;
• conducting a psychiatric assessment;
• therapeutic examination in the clinic;
• visiting the dentist;
• check with an otorhinolaryngologist;
• dermatovenerological examination.

In addition to a medical assessment, workers in this category of professions must pass the following tests:

• blood (clinical tests for infectious agents, as well as testing for hemoglobin, platelets, red blood cells, ESR leukocytes) and biochemical blood screening;
• blood for RW and HIV testing;
• analysis of HBs and HCV (hepatitis B and hepatitis C);
• urine (protein, sugar, sediment analysis)
• smear for gonorrhea infection;
• radiography (digital fluorography is allowed);
• analysis for the detection of helminthiasis;
• for women - an examination by an obstetrician-gynecologist, and after 40 years - an additional ultrasound of the breast or mammography.

When applying for a new position, a person is required to take a swab from the throat and nose (determination of staphylococcus). This test can only be requested later if it is preceded by a doctor's testimony. The main list of mandatory doctors and tests is carried out routinely and during employment. If necessary, a medical examination can be repeated more often than once a year. The basis for this is the epidemically difficult situation in the region or the health of the employee.

The medical examination data is recorded in a personal health passport, which must be issued to each employee at the clinic. After the medical examination has been completed, this medical document must be kept in the registry of the medical institution where the annual scheduled examination is carried out. After entering the therapist’s conclusion, the “passport” must be given to the owner.

Permission to work for health workers

When the medical examination of medical workers is completed, you should check the conclusions of the medical examination and the correctness of filling out certificates or medical books. If the conclusion does not have contraindications for entering work or continuing medical practice, working in medical positions and professions, the specialist is allowed to work.

The list of those diseases that are an obstacle to the ability to occupy jobs in medical institutions is indicated in full in (clause 48 of Appendix 3).

The legislation does not contain data on HIV carriers, so admission of such workers is also possible.

Admission to work in medical institutions after a medical examination of medical workers has been completed, can also be carried out after a check with an occupational pathologist. Its task is to identify the connection between detected health deviations or obvious diseases and professional working conditions. If a connection is identified, the employee must be sent to an occupational pathology center, where a professional opinion of the commission is given. The authorized federal body, which oversees sanitary and epidemiological well-being, must be notified of the diagnosis.

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A medical examination is a set of measures to study health, identify possible pathologies and prevent them.

Periodic medical examinations of enterprise employees are carried out in order to identify early diseases that may be dangerous to others or make the employee unfit to perform certain jobs. It allows you to track the dynamics of changes in health, as well as identify possible occupational diseases and minimize the harm caused to a person’s well-being.

Who should undergo a medical examination

First of all, periodic medical examination is necessary:

• citizens employed in high-altitude work;
• people working in the catering industry;
• employees of educational organizations and medical institutions;
• employees working in the field of hairdressing, beauty salons, laundries, baths;
• employees of pharmaceutical companies;
• persons whose work is related to water supply systems;
• workers of poultry farms and livestock enterprises;
• citizens employed in hazardous and/or hazardous production.

But on the initiative of the director of the organization or the team itself, people of any profession can undergo periodic medical examinations. The legislation defines only some specialties whose representatives must undergo regular medical examinations.

Frequency of medical examinations

Requirements for the frequency and procedure for conducting medical examinations are indicated:

• in the Labor Code of the Russian Federation (articles, and);

According to these documents, employees under the age of 21 must undergo a medical examination annually.

As a rule, each organization draws up its own calendar plan for conducting periodic medical examinations and, according to it, sends employees for testing. The calendar plan is agreed upon by the medical center with the employer and approved by the head of the medical organization.

Procedure for conducting a medical examination

Step 3. Making a plan

Based on the list of names (within 10 days from the date of its receipt, but no later than 14 days before the agreed date of examination), the medical center draws up a calendar plan for conducting periodic examinations.

Step 4. Prepare the order

The employer issues an order on the frequency of the medical examination and the order in which it is completed. Persons sent for medical examination must familiarize themselves with the order at least 10 days before it takes place.

Step 5. Issue directions

After this, employees should be given directions for a medical examination. There is no approved form for this document, so it is drawn up in any form.

Step 6. Workers undergo inspection

With a referral in hand, employees must come to the medical institution with which the contract was concluded within the time period specified in the document. They must also have a passport and a referral from the employer.

During the medical examination, employees retain their average earnings. If an employee refuses to undergo an inspection, the director will have to suspend him from work and not pay his salary until the inspection is completed. If the inspection was missed due to the fault of the employer or due to factors beyond the control of the employee or the head of the company, non-admission to perform duties is considered idle time and is paid in the amount of 2/3 of the worker’s average salary.

What to do after the examination

Upon completion of the event, the medical institution draws up a final report (within 30 days). A certified document signed by the head of the medical center and the enterprise is sent to the territorial department of Rospotrebnadzor for approval.

Now let’s talk about how the results of periodic medical examinations of the organization’s employees are compiled. After employees undergo a medical examination, the employer must collect conclusions signed and certified by the seal of the medical institution with the results of the examination.

Based on the medical report, the employee’s membership in one of the dispensary groups is determined, followed by indication in the medical card and health passport of recommendations for the prevention of diseases, including occupational diseases. And if there are medical indications - for further observation, treatment and rehabilitation.

Who pays for medical examinations

All expenses for conducting a routine medical examination, as well as, are paid by the director of the enterprise: this is a requirement articles 212 And 213 Labor Code of the Russian Federation. Subsequently, the state compensates him for part of the costs of medical examinations through the Social Insurance Fund.

Employer's liability

It is still unknown when exactly the amendment will come into force. Therefore, for now, employers must plan medical examinations for all employees whose activities are carried out under the influence, among other things, of the electromagnetic field of the broadband frequency spectrum.

How is the list of employees who must undergo preliminary and periodic medical examinations (employees of a medical organization - rehabilitation center) determined? Should all employees of the organization undergo a primary medical examination, even those who do not have harmful factors in the workplace, for example, accounting workers, an engineer, a cultural organizer, an accompanist (according to the special assessment, the frequency of undergoing neither primary nor periodic medical examinations is not indicated, since there are no harmful factors according to appendices 1 and 2 to the order of the Ministry of Health and Social Development of Russia dated April 12, 2011 N 302n)?

On this issue we take the following position:
There is no need for medical examinations (both preliminary and periodic) for the employees indicated in the question.

Justification for the position:
Passing medical examinations, including preliminary and periodic ones, is mandatory only in cases provided for by law (, Labor Code of the Russian Federation). Part two of this article, in order to protect public health and prevent the occurrence and spread of diseases, obliges employees of medical organizations to undergo mandatory preliminary (upon employment) and periodic medical examinations.
According to part four of the Labor Code of the Russian Federation, work during which mandatory preliminary and periodic medical examinations are carried out, the procedure for conducting such examinations is determined by the federal executive body authorized by the Government of the Russian Federation. Based on this norm, the Ministry of Health and Social Development of Russia, by its order dated April 12, 2011 N 302n (hereinafter referred to as Order N 302n), approved the List of works during the performance of which mandatory preliminary and periodic medical examinations (examinations) of workers are carried out (hereinafter referred to as the List).
According to clause 17 of the List, such work includes the work of medical personnel of medical institutions. The nomenclature of medical organizations, approved by order of the Ministry of Health of the Russian Federation dated August 6, 2013 N 529n, stipulates that rehabilitation centers are classified as treatment and preventive institutions.
As you can see, paragraph 17 of the List refers specifically to medical personnel. According to the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation,” a medical worker is an individual who has a medical or other education, works in a medical organization and whose labor (official) responsibilities include the implementation of medical activities , or an individual who is an individual entrepreneur directly engaged in medical activities. The nomenclature of positions for medical workers and pharmaceutical workers was approved by order of the Ministry of Health of the Russian Federation dated December 20, 2012 N 1183n. The positions “Accountant”, “Engineer”, “Cultural organizer”, “Accompanist” are not included in the list of positions for medical workers.
Since periodic medical examinations (examinations) of employees of medical organizations are necessary to perform only certain types of work, and the work of these employees is not related to medical activities, we believe that the requirement of part two of the Labor Code of the Russian Federation to undergo periodic medical examinations by virtue of the specified clause 17 of the List of Works does not apply to them.
However, it should be noted that in law enforcement practice there is also a different point of view on this matter, according to which mandatory preliminary and periodic medical examinations are mandatory for any employees of medical organizations. In particular, this approach can be found in arbitration practice concerning the provision of services in medical organizations by third-party providers (see, for example, the decision of the Arbitration Court of the Perm Territory dated March 21, 2018 in case No. A50-36295/2017, the decision of the Moscow Arbitration Court dated January 20 .2015 in case No. A40-43725/2014, as well as in consultations with Rostrud specialists (see answer 3, answer 4 from the portal "Online inspection.RF")). In support of their conclusions, both the courts and Rostrud specialists refer to the provisions of clause 15.1 of the Sanitary and Epidemiological Rules and Standards SanPiN 2.1.3.2630-10, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2010 N 58 (hereinafter referred to as SanPiN 2.1.3.2630 -10), according to which the personnel of organizations engaged in medical activities must undergo preliminary and periodic medical examinations with the execution of a final commission report.
In our opinion, this position is not sufficiently substantiated due to the fact that part four of the Labor Code of the Russian Federation indicates that the list of works for which preliminary and periodic medical examinations are mandatory is established by a federal government body authorized by the Government of the Russian Federation. Rospotrebnadzor and the chief state sanitary doctor of the Russian Federation are not vested with such powers (see Federal Law of March 30, 1999 N 52-FZ “On the Sanitary and Epidemiological Welfare of the Population”, Regulations on the Federal Service for Surveillance in the Sphere of Protection of Consumer Rights and Human Welfare, approved by the Government of the Russian Federation dated June 30, 2004 N 322). In addition, the chapter, which includes clause 15.1, is called “Requirements for working conditions of medical personnel.”
In conclusion, we note that the stated position is our expert opinion. Considering the contradictory opinions on this issue, it is impossible to exclude claims from regulatory authorities in this case. For official clarification, we recommend contacting the official competent government body - the Ministry of Labor and Social Protection of the Russian Federation by mail (127994, GSP-4, Moscow, Ilyinka St., 21) or by filling out the application form on the official website of the department (http: //www.rosmintrud.ru/reception/ask).

Prepared answer:
Expert of the Legal Consulting Service GARANT
Rachenkova Yulia

Response quality control:
Reviewer of the Legal Consulting Service GARANT
Komarova Victoria

The material was prepared on the basis of individual written consultation provided as part of the Legal Consulting service.