Full Text
REGD. No. D. L.-33004/99
The Gazette of India
CG-DL-E-10042024-253643
EXTRAORDINARY
PART I—Section 1
PUBLISHED BY AUTHORITY
No. 105]
NEW DELHI, WEDNESDAY, APRIL 10, 2024/CHAITRA 21, 1946
2489 GI/2024
(1)
MINISTRY OF HEALTH AND FAMILY WELFARE
(Department of Health)
NOTIFICATION
New Delhi, the 10th April, 2024
RULES
No.A.12011/02/2024-CHS-I.—The rules for a Competitive Examination for the Combined Medical Services
to be held by the Union Public Service Commission in 2024 for the purpose of filling vacancies in the following
services/posts, are with the concurrence of Ministries/Departments concerned, Delhi Municipal Corporation and New
Delhi Municipal Council, published for general information:-
Category-I
Medical Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service
Category-II
(a) Assistant Divisional Medical Officer in the Railways.
(b) General Duty Medical Officer in New Delhi Municipal Council.
(c) General duty Medical Officer Gr-II in Municipal Corporation of Delhi.
All candidates (male/female/transgender) are requested to carefully read these Rules and the examination
notice of the UPSC derived from these Rules.
The examination will be conducted by the Union Public Service Commission in the manner prescribed in
Appendix I to these Rules.
The date(s) on which and the place(s) at which the examination will be held shall be fixed by the
Commission.
2. A candidate may compete in respect of anyone or more of the services/posts mentioned above. A candidate
who qualifies on the results of the written part of the examination will be required to indicate clearly in the Detailed
Application Form the services/posts for which he/she wishes to be considered in the order of preferences. The
candidate is advised to indicate his/her preferences as he/she wishes so that having regard to his/her rank in order of
merit due consideration can be given to his/her preferences while making appointments. While indicating preference a
candidate shall have to indicate choice between Category I and Category II first duly keeping in view the eligibility
for the two categories of posts/services in terms of Rule 5(a)&(b) below. Subsequently the candidate will also indicate
preferences among services/ posts of Category II. In case preference for none of the Services is indicated, the
candidate will not be considered for Service Allocation. Candidates will be recommended by the Commission based
on the preference of categories given by them in the Detailed Application Forms, order of merit and number of
vacancies.
(i) Candidates are advised to examine their eligibility for both categories carefully while exercising preferences
of categories and services in terms of Rules 5(a)&(b).
(ii) No request for addition/alteration in the preferences already indicated by a candidate in his/her Detailed
Application Forms will be entertained by the Commission/Ministry of Health & Family Welfare.
(iii) Once cadre has been allocated to a candidate, no request for change of cadre shall be entertained by the
Commission/Ministry of Health & Family Welfare.
3. The number of vacancies to be filled on the basis of results of the examination will be specified in the Notice
issued by the Commission.
Reservation will be made for candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other
Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability in respect of vacancies as
may be fixed by the Government.
4. A candidate be either:
(i) a citizen of India, or
(ii) a subject of Nepal, or
(iii) a subject of Bhutan, or
(iv) a Tibetan refugee who came over to India before the 1st January, 1962 with the intention of permanently
settling in India; or
a person of Indian origin who has migrated from Pakistan, Burma, Sri Lanka or East African Countries of
Kenya, Uganda, The United Republic of Tanzania, Zambia, Malawi, Zaire and Ethiopia or from Vietnam
with the intention of permanently settling in India:
Provided that a candidate belonging to categories (ii), (iii), (iv) and (v) above shall be a person in whose
favour a certificate of eligibility has been issued by the Government of India.
A candidate in whose case a certificate of eligibility is necessary, may be admitted to the examination but the
offer of appointment may be given only after the necessary eligibility certificate has been issued to him by the
Government of India.
5. (a) A candidate for this examination must not have attained the age of
32 years as on 1st August, 2024
i.e. he must have been born not earlier than 2nd August, 1992. However, for Medical Officers Grade in General Duty
Medical Officers Sub-cadre of Central Health Service, the upper age limit must not exceed 35 (thirty five years) as on
1st August, 2024.
(b) The upper age- limit is relaxable as follows:
(i) Up to a maximum of five years if a candidate belongs to a Scheduled Caste or a Scheduled Tribe.
(ii) Up to a maximum of three years in the case of candidate belonging to Other Backward Classes
who are eligible for reservation applicable to such candidates.
(iii) Up to a maximum of three years in the case of Defence Services Personnel, disabled in operations
during hostilities with any foreign country or in a disturbed area and released as a consequence
thereof.
(iv) Up to a maximum of five years in the case of Ex-servicemen including Commissioned Officers and
ECOs/SSCOs who have rendered at least five years Military Service as on 1st August, 2024 and
have been released (i) on completion of assignment (including those whose assignment is due to be
completed within one year from 1st August, 2024 otherwise than by ways of dismissal or discharge
on account of misconduct of inefficiency), or (ii) on account of physical disability attributable to
Military Service or (iii) on invalidment.
(v) Up to a maximum of five years in the case of ECOs/SSCOs who have completed an initial period
of assignment of five years of Military Service as on 1st August, 2024 and whose assignment has
been extended beyond five years and in whose case the Ministry of Defence issues a certificate that
they can apply for Civil Employment and that they will be released on three months' notice on
selection from the date of receipt of offer of appointment.
(vi) Up to a maximum of ten years in the case of Persons with Benchmark Disability viz. (a) blindness
and low vision, (b) deaf and hard of hearing, (c) Locomotor disability including cerebral palsy,
leprosy cured, dwarfism, acid attack victims and muscular dystrophy, (d) autism, intellectual
disability, specific learning disability and mental illness; (e) multiple disabilities from amongst
person under clauses (a) to (d) of Section 34 of the Rights of Persons with Disabilities Act, 2016
including deaf-blindness.
Note I- Candidates belonging to the Scheduled Castes, the Scheduled Tribes and the Other Backward Classes
who are also covered under any other clauses of Rule 5 (b) above, viz. those coming under the category of
Ex-servicemen, and Persons with Benchmark Disability will be eligible for grant of cumulative age-
relaxation under both the categories.
Note II- The details of Functional Classification (FC) and Physical Requirements (PR) of each service are indicated in
Appendix IV of these Rules which are identified and prescribed by the respective Cadre Controlling
Authorities (CCAs) as per the provisions of Section 33 and 34 of the Rights of Persons with Disabilities
Act, 2016. Only those category (ies) of disability (ies) mentioned in Appendix IV shall apply for the
examination under Persons with Benchmark Disability (PwBD) Category. Therefore, the candidates
belonging to the Persons with Benchmark Disability categories are advised to read it carefully before
applying for the examination.
Note III- The term Ex-servicemen will apply to the persons who are defined as Ex-servicemen in the Ex-servicemen
(Re-employment in Civil Services and Posts) Rules, 1979, as amended from time to time.
Note IV- The age concession under Rule 5(b) (iv) and (v) will be admissible to Ex-servicemen i.e. a person who has
served in any rank whether as combatant or non-combatant in the Regular Army, Navy and Air Force of
the Indian Union and who either has been retired or relieved or discharged from such service whether at
his own request or being relieved by the employer after earning his or her pension.
Note V- Notwithstanding the provision of age-relaxation under Rule 5(b)(vi) above, a Person with Benchmark
Disability will be considered to be eligible for appointment only if he/she after such physical examination
as the Government or appointing authority, as the case may be, may prescribe is found to satisfy the
requirements of physical and medical standards for the concerned Services/Posts to be allocated to the
Persons with Benchmark Disability by the Government.
SAVE AS PROVIDED ABOVE THE AGE LIMITS PRESCRIBED CAN IN NO CASE BE RELAXED
(c) The date of birth accepted by the Commission is that entered in the Matriculation or Secondary School
Leaving Certificate or in a certificate recognised by an Indian University as equivalent to Matriculation or in an
extract from a Register of Matriculates maintained by a University which must be certified by the proper authority of
the University or in the Higher Secondary or an equivalent examination certificate.
No other document relating to age like horoscopes, affidavits, birth extracts from Municipal Corporation,
Service records and the like will be accepted.
The Expression Matriculation/Higher Secondary Examination Certificate in this Part of the instructions
include the alternative certificates mentioned above.
Note 1:- Candidates should note that only the date of birth as recorded in the Matriculation/ Secondary Examination
Certificate or an equivalent certificate on the date of submission of application will be accepted by the
Commission and no subsequent request for its change will be considered or granted.
Note 2:- Candidates should also note that once a date of birth has been submitted by them and entered in the records
of the Commission for the purpose of admission to an Examination, no change will be allowed
subsequently or at any other Examination of the Commission on any ground whatsoever.
Provided that in case of an inadvertent/ unintentional/typographical error committed by a candidate in
indicating the date of birth in the Online Application Form, the candidate may make a request to the Commission for
subsequent rectification along with supporting documents, as specified in the Rule 5 (c) of the Examination Rule and
the request may be considered by the Commission, if the same is made within a definite time frame as may be
notified by the Commission in its Notice for the Examination.
6. A candidate must have passed the written and practical part of the final M.B.B.S. Examination.
Note 1: A candidate who has appeared/or is yet to appear at the final M.B.B.S. Examination may also apply. Such
candidates will be admitted to the examination if otherwise eligible but the admission would be deemed to
be provisional subject to cancellation, if they do not produce proof of having passed the written and
practical parts of the final M.B.B.S. Examination along with the Detailed Application Forms which will be
required to be submitted to the Commission by the candidates who qualify on the result of the written part
of the examination. Such proof of passing the requisite examination should have been issued latest by the
closing date of Detailed Application Forms of the Combined Medical Services Examination, 2024.
Note 2: A candidate who has yet to complete the compulsory rotating internship is educationally eligible for
admission to the examination but on selection he/she will be appointed only after he/she has completed the
compulsory rotating internship.
7. Candidates must pay the fee prescribed in the Commission's Notice.
8. All candidates in Government service, whether in permanent or temporary capacity or as work charged
employees other than casual or daily rated employees or those serving under the Public Enterprises are however,
required to submit an undertaking that they have informed in writing their Head of Office/Department that they have
applied for the examination.
Candidates should note that in case a communication is received from their employer by the Commission
withholding permission to the candidates applying for/ appearing at the examination their application shall be
rejected/candidature shall be cancelled.
9. The decision of the Commission with regard to the acceptance of the application of a candidate and his/her
eligibility or otherwise for admission to the examination shall be final.
The candidates applying for the examination should ensure that they fulfil all the eligibility conditions for
admission to the Examination. Their admission at all the stages of examination for which they are admitted by the
Commission viz. Written Examination and Interview Test will be purely provisional subject to their satisfying the
prescribed eligibility conditions. If on verification at any time before or after the Written Examination or Interview
Test, it is found that they do not fulfil any of the eligibility conditions; their candidature for the examination will be
cancelled by the Commission.
10. No candidate shall be admitted to the examination unless he/she holds a certificate of admission from the
Commission.
11(1). A candidate who is or has been declared by the Commission to be guilty of:-
(a) Obtaining support for candidature by the following means, namely:-
(i) offering illegal gratification to; or
(ii) applying pressure on; or
(iii) blackmailing or threatening to blackmail any person connected with the conduct of the examination;
or
(b) impersonation; or
(c) procuring impersonation by any person; or
(d) submitting fabricated / incorrect documents or documents which have been tampered with; or
(e) uploading irrelevant or incorrect photo/ signature in the application form in place of actual photo/signature;
or
(f) making statements which are incorrect or false or suppressing material information; or
(g) resorting to the following means in connection with the candidature for the examination, namely :-
(i) obtaining copy of question paper through improper means; or
(ii) finding out the particulars of the persons connected with secret work relating to the examination; or
(iii) influencing the examiners; or
(h) being in possession of or using unfair means during the examination; or
(i) writing obscene matter or drawing obscene sketches or irrelevant matter in the scripts; or
(j) misbehaving in the examination hall including tearing of the scripts, provoking fellow examinees to
boycott examination, creating a disorderly scene and the like; or
(k) harassing, threatening or doing bodily harm to the staff employed by the Commission for the conduct of
the examination; or
(1) being in possession of or using any mobile phone (even in switched-off mode) pager or any electronic
equipment or programmable device or storage media like pen drive, smart watches etc or camera or
bluetooth devices or any other equipment or related accessories (either in working or switched-off mode)
capable of being used as a communication device or during the examination; or
(m) violating any of the instructions issued to candidates along with their admission certificates permitting
them to take the examination; or
(n) attempting to commit or, as the case may be, abetting the commission of all or any of the acts specified in
the foregoing clauses;
In addition to being liable to criminal prosecution, shall be disqualified by the Commission from the
Examination held under these Rules; and/or shall be liable to be debarred either permanently or for a
specified period:-
I. by the Commission, from any examination or selection held by them;
II. by the Central Government from any employment under them;
and shall be liable to face disciplinary action under the appropriate rules if already in service under
Government;
Provided that no penalty under this rule shall be imposed except after:-
(i) giving the candidate an opportunity of making such representation in writing as the candidate may
wish to make in that behalf; and
(ii) taking the representation, if any, submitted by the candidate within the period allowed for this purpose,
into consideration.
(2) Any person who is found by the Commission to be guilty of colluding with a candidate(s) in committing or
abetting the commission of any of the misdeeds listed at the clauses (a) to (m) above will be liable to action in terms
of the clause (n) above.
12. Candidates who obtain such minimum qualifying, marks in the written examination as may be fixed by the
Commission in their discretion shall be summoned by them for an interview for a personality test:
Provided that candidates belonging to the Scheduled Castes or the Scheduled Tribes or the Other Backward
Classes or Economically Weaker Sections or Persons with Benchmark Disability may be summoned for an interview
for personality test by the Commission by applying relaxed standards if the Commission are of the opinion that
sufficient number of candidates from these communities are not likely to be summoned for interview for personality
test on the basis of the general standard in order to fill up the vacancies reserved for them.
13. (1) After interview the Commission will prepare two separate merit lists one for Category I i.e. the Medical
Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service and the other for Category II
i.e. Non-CHS (viz. Ministry of Railways, New Delhi Municipal Council, Municipal Corporation of Delhi) on the basis
of the ranks/preferences of the candidates and vacancies. For preparation of result, the candidates shall be arranged by
the Commission in the order of merit on the basis of aggregate marks finally awarded to each candidate in the
Examination. Thereafter, the Commission, based on the preference exercised by the candidates, shall recommend
candidates to both Categories in order of respective merit for each category. The Commission shall for the purpose of
recommending candidates against unreserved vacancies, fix separate qualifying marks (hereinafter referred to as
general qualifying standards) with reference to the number of unreserved vacancies to be filled up in CHS and other
remaining Services/Posts on the basis of the Examination. For the purpose of recommending reserved category
candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, the Economically
Weaker Sections and Persons with Benchmark Disability against reserved vacancies the Commission may relax the
qualifying standards with reference to number of reserved vacancies to be filled up in each of these categories on the
basis of the examination.
Provided that the candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward
Classes, the Economically Weaker Sections and Persons with Benchmark Disability who have not availed themselves
of any of the concessions or relaxations in the eligibility or selection criteria, at any stage of the Examination and who
after taking into account the general qualifying standards are found fit for recommendation by the Commission shall
not be recommended against the vacancies reserved for the Scheduled Castes, the Scheduled Tribes, the Other
Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability but shall in the first
instance be recommended by the Commission against the unreserved vacancies.
Note: The facility of scribe alongwith compensatory time which is available for eligible candidates belonging to
PwBD category and the disability of such candidates which he is suffering from in respect of Medical Fitness, shall
not be treated as relaxation/concession.
(2) While making service allocation for the Services/posts in Category II the candidates belonging to the
Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, Economically Weaker Sections and Persons
with Benchmark Disability recommended against unreserved vacancies may be adjusted against reserved vacancies by
the Government if by this process they get a service of higher choice in the order of their preference.
(3) For preparation of the merit list for the services/posts in Category II, the Commission may further lower
the general qualifying standards to take care of any shortfall of candidates for appointment against resultant
unreserved vacancies and any surplus of candidates against reserved vacancies arising out of the process as per
provisions of this rule, the Commission may make the recommendations in the manner prescribed in sub-rules (4) and
(5).
(4)(a)(1) While recommending the candidates for the services/posts in Category-II the Commission shall in the
first instance, take into account the total number of vacancies of Category-II only. This total number of recommended
candidates shall be reduced by the number of candidates belonging to the Scheduled Castes, the Scheduled Tribes, the
Other Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability who acquire the
merit at or above the fixed general qualifying standards for these services/posts without availing themselves of any
concession or relaxation in the eligibility or selection criteria in terms of the proviso to sub-rule (1).
(4)(a)(2) While exercising the method defined in sub-rule (4)(a)(1), due consideration may be taken to secure
the vacancy(ies) for PwBD candidates expected to be recommended from Reserve List and if required, the total
number of recommended candidates shall be reduced appropriately in addition to reduction as per sub-rule (4)(a)(1).
(4)(b) Along with this list of recommended candidates for the services/posts in Category-II only, the
Commission shall also maintain a consolidated reserve list of candidates which will include candidates from
unreserved, reserved categories and PwBD category, ranking in order of merit below the last recommended candidate
under each category. The consolidated reserve list so maintained shall be treated as confidential till the process of
recommendation(s) in term of sub-rule (5) is finally concluded by the Commission. The number of candidates in each
of these categories will be equal to the number of reserved category candidates who were included in the first list
without availing of any relaxation or concession in eligibility or selection criteria as per proviso to sub-rule(1) and
reduction in recommendation against unreserved vacancy(ies), if any, in light of sub-rule (4)(a)(2).
(4)(c) The number of reserved category in the Consolidated Reserve List, from each category of Schedule
Caste, Schedule Tribe, Other Backward Class, Economically Weaker Section and Persons with Benchmark Disability
will be equal to the Respective number of candidates reduced in each category while recommending candidates in the
first instance as per sub-rule 4(a)(1) and 4(a)(2).
(5) The candidates recommended in terms of the provisions of sub-rule (4), shall be allocated by the
Government to the services/posts in Category-II and where certain vacancies still remain to be filled up, the
Government may forward a requisition to the Commission requiring it to recommend, in order of merit from the
reserve list, the same number of candidates as requisitioned for the purpose of the unfilled vacancies in each category.
Note: Reserve list is not a waiting list to cater to vacancies arising out of other reasons such as candidates not turning
up to join, being found medically unfit, left out on account of medical fitness for limited services, resignation or any
other reasons. Commission will not take into account such vacancies for release of Reserve list.
(6) No consolidated reserve list will be maintained by the Commission for Category-I as the provisions of sub-rule
(2), (3), (4) and (5) above are not applicable for allocation of candidates to Category-I.
14. The minimum qualifying marks as specified under rules 11 and 12 may be relaxable at the discretion of the
Commission in favour of Persons with Benchmark Disability in order to fill up the vacancies reserved for them.
15. The form and manner of communication of the result of the examination to individual candidates shall be
decided by the Commission in their discretion and the Commission will not enter into correspondence with them
regarding the results.
16. Subject to other provisions contained in these rules, successful candidates will be considered for appointment
on the basis of the order of merit assigned to them by the Commission and preference expressed by them for various
posts.
17. Success in the examination confers no right to appointment unless Government are satisfied after such
enquiry as may be considered necessary that the candidate with regard to his/her character and antecedents is suitable
in all respects for appointment to the service. The appointment will be further subject to the candidate satisfying the
appointing authority of his/her having satisfactorily completed the compulsory rotating internship.
18. A candidate must be in good mental and bodily health and free from any physical defects likely to interfere
with the discharge of his/her duties as an officer of the Service. A candidate who after such physical examination, as
Government or the appointing authority, as the case may be prescribe is found not to satisfy these requirements will
not be appointed. The Regulations relating to Physical/Medical Examination of candidates are given in Appendix-III
to these Rules. A Medical Board Report Format for medical examination is given at Appendix – VIII.
All candidates who qualify for interview/personality test on the basis of written part of the examination shall
be required to undergo the medical examination normally on the next working day immediately after the day of
interview/ personality test of the concerned candidate (there shall be no medical examination on Saturdays, Sundays
and closed holidays). Arrangements for the complete medical examination including X-Ray of chest of candidates will
be made by the Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi and intimation in this regard
shall be given by the Ministry to the concerned candidates. In case a candidate does not receive any intimation about
the arrangements made for his/her Medical Examination before he/she leaves for his/her interview/personality test
he/she should contact personally to the concerned authority in Ministry of Health and Family Welfare immediately
after his/her interview/personality test is over. The concerned candidate may have to stay in Delhi until his/her
Medical Examination is over, therefore the candidate should take this fact in consideration and make his/her own
arrangements for stay in Delhi for the purpose of completion of Medical Examination formality. No extension
postponement of the date fixed for the Medical Examination shall be allowed under any circumstances. Also no
TA/DA shall be admissible for the purpose of completion of the formality of Medical Examination of the concerned
candidate.
To be passed as fit for appointment, a candidate must be in good mental and bodily health and free from any
physical defect likely to interfere with the discharge of his duties as an officer of the service. A candidate, who after
such medical examination as Government or the appointing authority, as the case may be, may prescribe, is found not
to satisfy these requirements will not be appointed. A candidate who has been left out on account of medical fitness
for limited services and no vacancy being available at his turn cannot be allocated to any service for which he is not fit
and where vacancies exists. Candidates declared medically unfit as per medical standards specified in Appendix – III
will be left out from the allocation process.
19. For being considered against the vacancies reserved for them the Persons with Benchmark Disability should
have disability of forty per cent (40%) or more. However, such candidates shall be required to meet one or more of the
physical requirements/abilities indicated in Appendix – IV which may be necessary for performing the duties in the
concerned Services/Posts.
20. The eligibility for availing reservation against the vacancies reserved for the Persons with Benchmark
Disability shall be the same as prescribed in "The Rights of Persons with Disabilities Act, 2016." The candidates of
Multiple Disabilities will be eligible for reservation under category (e) - Multiple Disabilities only of Section 34(1) of
RPwD Act, 2016 and shall not be eligible for reservation under any other categories of disabilities i.e. (a) to (d) of
Section 34(1) of RPwD Act, 2016 on account of having 40% and above impairment in any of these categories of
PwBD.
Provided further that the Persons with Benchmark Disability shall also be required to meet special eligibility
criteria in terms of Functional Classification and Physical Requirements (abilities/disabilities) (FC&PR) consistent
with requirements of the identified service/post as may be prescribed by its Cadre Controlling Authority. A list of
services identified suitable for Persons with Benchmark Disability alongwith the Functional Classification and
Physical Requirements is at Appendix IV.
21. A candidate will be eligible to get the benefit of community reservation only in case the particular caste to
which the candidates belongs is included in the list of reserved communities issued by the Central Government. The
candidates will be eligible to get the benefit of the Economically Weaker Section reservation only in case the
candidate meets the criteria issued by the Central Government and in possession of such eligibility certification.
The OBC candidates applying for Combined Medical Services Examination, 2024 must produce OBC (Non-
Creamy Layer) certificate based on the Income for the Financial Year (FY) 2021-2022, 2022-2023 and 2023-2024 and
issued on/after 01.04.2024 (after the completion of FY 2023-24) but not later than the closing date of the application
for Combined Medical Services Examination-2024 i.e. 30.04.2024.
If a candidate indicates in his/her application form for Combined Medical Service Examination that he/she
belongs to Unreserved Category but subsequently writes to the Commission to change his/her category, to a reserved
one, such request shall not be entertained by the Commission. Further, once a candidate has chosen a reserved
category, no request shall be entertained for change to other reserved category viz. SC to ST, ST to SC, OBC to
SC/ST or SC/ST to OBC. SC to EWS, EWS to SC, ST to EWS, EWS to ST, OBC to EWS, EWS to OBC. No
reserved category candidates other than those who qualified each stage of the Examination on General standard shall
be allowed to change (on their request or as decided by the Commission/Government based on the documents
submitted by them) their category from reserved to unreserved or claim the vacancies (Service/Cadre) for unreserved
category after the declaration of final result by UPSC. In cases where such candidates do not qualify on General
Standard, their candidature shall be cancelled.
Further, no Person with Benchmark Disabilities (PwBD) of any sub-category there under shall be allowed to
change his/her sub-category of disability.
While the above principle will be followed in general, there may be a few cases where there was a gap not
more than 3 months between the issuance of a Government Notification enlisting a particular community in the list of
any of the reserved communities and the date of submission of the application by the candidate. In such cases the
request of change of community from general to reserved may be considered by the Commission on merit. In case of
a candidate unfortunately becoming persons with benchmark disability during the course of the examination process,
the candidate should produce valid document showing him acquiring a disability to the extent of 40% or more as
defined under the RPwD Act, 2016 to enable him to get the benefits of PwBD reservation.
22. Candidates seeking reservation/relaxation benefits available for SC/ST/OBC/EWS/PwBD/Ex-servicemen
must ensure that they are entitled to such reservation/relaxation as per eligibility prescribed in the Rules/Notice. They
should be in possession of all the requisite certificates in the prescribed format in support of their claims as stipulated
in the Rules/Notice for such benefits, by the closing date of the application for Combined Medical Services
Examination, 2024. (Prescribed Format of Disability Certificate should be submitted by Persons with Benchmark
Disability candidates as per Form V to Form VII (as applicable) of Min of Social Justice and Empowerment
Notification dated 15th June, 2017 as at Annexure-III).
A candidate of Combined Medical Examination, 2024 will be eligible to get the benefit of the
Economically Weaker Section reservation only in case the candidate meets the criteria issued by the Central
Government and is in possession of requisite Income & Asset Certificate based on the income for Financial Year (FY)
2023-22 and issued on/after 01.04.2024 (after the completion of FY 2023-24) but not later than the closing date of
the application for Combined Medical Services Examination-2024 i.e. 30.04.2024.
23. No person,-
(a) Who has entered into or contracted a marriage with a person having a spouse living; or
(b) Who having a spouse living has entered into or contracted a marriage with any person;
shall be eligible for appointment to service:
Provided that the Central Government may, if satisfied that such marriage is permissible under the personal
law applicable to such person and the other party to the marriage and there are other grounds for so doing, exempt any
person from the operation of this rule.
24. Brief particulars relating to the Services/Posts to which recruitment is being made through this examination
are given in Appendix II.
Smt. ROLI SINGH, Addl. Secy.
APPENDIX-I
SCHEME OF EXAMINATION
The examination shall be conducted according to the following plan:-
Part-I
WRITTEN EXAMINATION – (500 marks)
The candidates will take the written examination in two Papers, each Paper carrying a maximum of 250 marks. Each
Paper will be of two hours duration.
Part-II
PERSONALITY TEST: (100 Marks):
Personality test carrying 100 marks of such of the candidates who qualify on the results of the written examination.
(A) WRITTEN EXAMINATION:
1. The components and syllabi of two Papers and the weightage to different components in the two papers are given
below:
Paper I
(Code No. 1)
General Medicine and Paediatrics:
Maximum
Marks: 250
Total questions in Paper I = 120 (96 from General Medicine and 24 from Paediatrics);
Syllabus of Paper-I
(a) General Medicine including the following:
(i) Cardiology
(ii) Respiratory diseases
(iii) Gastro-intestinal
(iv) Genito-Urinary
(v) Neurology
(vi) Hematology
(vii) Endocrinology
(viii) Metabolic disorders
(ix) Infections/Communicable Diseases
a) Virus
b) Rickets
c) Bacterial
d) Spirochetal
e) Protozoan
f) Metazoan
g) Fungus
(x) Nutrition/Growth
(xi) Diseases of the skin (Dermatology)
(xii) Musculoskelatal System
(xiii) Psychiatry
(xiv) General
(xv) Emergency Medicine
(xvi) Common Poisoning
(xvii) Snake bite
(xviii) Tropical Medicine
(xix) Critical Care Medicine
(xx) Emphasis on medical procedures
(xxi) Patho physiological basis of diseases
(xxii) Vaccines preventable diseases and Non vaccines preventable diseases
(xxiii) Vitamin deficiency diseases
(xxiv) In psychiatry include – Depression, psychosis, anxiety, bipolar diseases and Schizoprenia.
(b) Paediatrics including the following -
(i) Common childhood emergencies,
(ii) Basic new born care,
(iii) Normal developmental milestones,
(iv) Accidents and poisonings in children,
(v) Birth defects and counseling including autism,
(vi) Immunization in children,
(vii) Recognizing children with special needs and management, and
(viii) National programmes related to child health.
Paper II
(Code No. 2)
Marks : 250
(a) Surgery
(b) Gynaecology & Obstetrics
(c) Preventive & Social Medicine
Total questions in Paper II = 120 (40 questions from each part.)
Syllabus of Paper – II
(a) Surgery
(Surgery including ENT, Ophthalmology, Traumatology and Orthopaedics)
(I) General Surgery
i) Wounds
ii) Infections
iii) Tumours
iv) Lymphatic
v) Blood vessels
vi) Cysts/sinuses
vii) Head and neck
viii) Breast
ix) Alimentary tract
a) Oesophagus
b) Stomach
c) Intestines
d) Anus
e) Developmental
x) Liver, Bile, Pancreas
xi) Spleen
xii) Peritoneum
xiii) Abdominal wall
xiv) Abdominal injuries
(II) Urological Surgery
(III) Neuro Surgery
(IV) Otorhinolaryngology E.N.T.
(V) Thoracic surgery
(VI) Orthopedic surgery
(VII) Ophthalmology
(VIII) Anesthesiology
(IX) Traumatology
(X) Diagnosis and management of common surgical ailments
(XI) Pre-operative and post operative care of surgical patients
(XII) Medicolegal and ethical issues of surgery
(XIII) Wound healing
(XIV) Fluid and electrolyte management in surgery
(XV) Shock patho-physiology and management.
(b) GYNAECOLOGY & OBSTETRICS
(I) OBSTETRICS
i) Ante-natal conditions
ii) Intra-natal conditions
iii) Post-natal conditions
iv) Management of normal labours or complicated labour
(II) GYNAECOLOGY
i) Questions on applied anatomy
ii) Questions on applied physiology of menstruation and fertilization
iii) Questions on infections in genital tract
iv) Questions on neoplasma in the genital tract
v) Questions on displacement of the uterus
vi) Normal delivery and safe delivery practices
vii) High risk pregnancy and management
viii) Abortions
ix) Intra Uterine growth retardation
x) Medicolegal examination in obgy and Gynae including Rape.
(III) FAMILY PLANNING
i) Conventional contraceptives
ii) U.D. and oral pills
iii) Operative procedure, sterilization and organization of programmes in the urban and rural
surroundings
iv) Medical Termination of Pregnancy
(c) PREVENTIVE SOCIAL AND COMMUNITY MEDICINE
I Social and Community Medicine
II Concept of Health, Disease and Preventive Medicine
III Health Administration and Planning
IV General Epidemiology
V Demography and Health Statistics
VI Communicable Diseases
VII Environmental Health
VIII Nutrition and Health
IX Non-communicable diseases
X Occupational Health
XI Genetics and Health
XII International Health
XIII Medical Sociology and Health Education
XIV Maternal and Child Health
XV National Programmes
XVI Management of common health problems
XVII Ability to monitor national health programmes
XVIII Knowledge of maternal and child wellness
XIX Ability to recognize, investigate, report, plan and manage community health problems including
malnutrition and emergencies.
2. The written examination in both the papers will be completely of objective (Multiple choice answers) type.
The question Papers (Test Booklets) will be set in English only.
3. General Instructions for Examination:
3.1 Candidates must write the papers in their own hand. In no circumstances will they be allowed the help of a
scribe to mark the answers for them. However, the Persons with Benchmark Disabilities in the categories of blindness,
locomotor disability (both arm affected–BA) and cerebral palsy will be eligible for the facility of scribe. In case of
other category of Persons with Benchmark Disabilities as defined under section 2(r) of the RPwD Act, 2016, such
candidates will be eligible for the facility of scribe on production of a certificate to the effect that the person concerned
has physical limitation to write, and scribe is essential to write examination on his/her behalf, from the Chief Medical
Officer/Civil Surgeon/ Medical Superintendent of a Government Health Care institution as per proforma at
Appendix-V.
Further, for persons with specified disabilities covered under the definition of Section2(s) of the RPwD Act, 2016 but
not covered under the definition of Section 2 (r) of the said Act, i.e. persons having less than 40% disability and
having difficulty in writing will be provided the facility of scribe subject to production of a certificate to the effect that
person concerned has limitation to write and that scribe is essential to write examination on his/her behalf from the
competent medical authority of a Government healthcare institution as per proforma at Appendix – VII.
3.2 The candidates have discretion of opting for his/her own scribe or request the Commission for the same.
The details of scribe i.e. whether own or the Commission's and the details of scribe in case candidates are bringing
their own scribe, will be sought at the time of filling up the application form online as per proforma at Appendix - VI
(for Candidate having 40% disability or more) and Appendix – IX (for Candidate having less than 40% disability and
having difficulty in writing).
3.3 The qualification of the Commission's scribe as well as own scribe will not be more than the minimum
qualification criteria of the examination. However, the qualification of the scribe should always be matriculate or
above.
3.4 The Persons with Benchmark Disabilities in the category of blindness, locomotor disability (both arm
affected-BA) and cerebral palsy will be eligible for Compensatory Time of twenty minutes per hour of the
examination. In case of other categories of Person with Benchmark Disabilities, such candidates will be eligible for
this facility on production of a certificate to the effect that the person concerned has physical limitation to write from
the Chief Medical Officer/Civil Surgeon/ Medical Superintendent of a Government Health Care institution as per
proforma at Appendix – V.
Further, for persons with specified disabilities covered under the definition of Section 2(s) of the RPwD Act, 2016 but
not covered under the definition of Section 2(r) of the said Act, i.e. persons having less than 40% disability and having
difficulty in writing will be provided compensatory time subject to production of a certificate to the effect that person
concerned has limitation to write from the competent medical authority of a Government healthcare institution as per
proforma at Appendix-VII.
3.5 Facility of Scribe and/or Compensatory time in eligible candidate will be provided, if desired by them.
Note (1): The eligibility conditions of a scribe, his/her conduct inside the examination hall and the manner in which
and extent to which he/she can help the eligible candidate (as defined above) in writing the Combined Medical
Services Examination shall be governed by the instructions issued by the UPSC in this regard. Violation of all or any
of the said instructions shall entail the cancellation of the candidature of candidate in addition to any other action that
the UPSC may take against the scribe.
Note (2): The criteria for determining the percentage of visual impairment shall be as follows :—
+-----------------+-----------------+------------+--------------------+
| Better eye | Worse eye | Per Cent | Disability category|
| Best Corrected | Best Corrected | Impairment | |
+=================+=================+============+====================+
| 6/6 to 6/18 | 6/6 to 6/18 | 0% | 0 |
+-----------------+-----------------+------------+--------------------+
| | 6/24 to 6/60 | 10% | 0 |
+-----------------+-----------------+------------+--------------------+
| | Less than 6/60 to 3/60 | 20% | I |
+-----------------+-----------------+------------+--------------------+
| | Less than 3/60 to No Light | 30% | II (One eyed person)|
| | Perception | | |
+-----------------+-----------------+------------+--------------------+
| 6/24 to 6/60 | 6/24 to 6/60 | 40% | III a (low vision) |
+-----------------+-----------------+------------+--------------------+
| Or | Less than 6/60 to 3/60 | 50% | III b (low vision) |
+-----------------+-----------------+------------+--------------------+
| Visual field less than 40 up to | Less than 3/60 to No Light | 60% | III c (low vision) |
| 20 degree around centre of | Perception | | |
| fixation or heminaopia | | | |
| involving macula| | | |
+-----------------+-----------------+------------+--------------------+
| Less than 6/60 to 3/60 | Less than 6/60 to 3/60 | 70% | III d (low vision) |
+-----------------+-----------------+------------+--------------------+
| Or | Less than 3/60 to No Light | 80% | III e (low vision) |
| Visual field less than 20 up to | Perception | | |
| 10 degree around centre of | | | |
| fixation | | | |
+-----------------+-----------------+------------+--------------------+
| Less than 3/60 to 1/60 | Less than 3/60 to No Light | 90% | IV a (Blindness) |
| Or | Perception | | |
| Visual field less than 10 degree | | | |
| around centre of fixation | | | |
+-----------------+-----------------+------------+--------------------+
| Only HMCF | Only HMCF | 100% | IV b (Blindness) |
+-----------------+-----------------+------------+--------------------+
| Only Light Perception | Only Light Perception | | |
+-----------------+-----------------+------------+--------------------+
| No Light Perception | No Light Perception | | |
+-----------------+-----------------+------------+--------------------+
Note (3): The concession admissible to blind/low vision candidates shall not be admissible to those suffering from
Myopia.
4. The Commission have discretion to fix qualifying marks in any or both the papers of the examination.
5. Penalty for wrong answers
There will be penalty (Negative Marking) for wrong answers marked by a candidate in the objective
type question papers.
(i) There are four alternatives for the answers to every question. For each question for which a wrong answer
has been given by the candidate, one third of the marks assigned to that question will be deducted as penalty.
(ii) If a candidate gives more than one answer, it will be treated as a wrong answer even if one of the given
answers happens to be correct and there will be same penalty as above for that question.
(iii) If a question is left blank i.e. no answer is given by the candidate, there will be no penalty for that question.
Candidates are not permitted to use calculators for answering objective type papers. They should, therefore
not bring the same inside the Examination Hall.
6. Both the Papers of the CMSE will be of MBBS standard.
7. (B) PERSONALITY TEST – (100 marks):
Candidates who qualify in the written examination will be called for Interview/ Personality Test to be
conducted by the Union Public Service Commission. The Interview/ Personality Test will carry 100 marks.
The Interview for Personality Test will be intended to serve as a supplement to the written examination for
testing the General Knowledge and ability of the candidates in the fields of their academic study and also in the nature
of a personality test to assess the candidate's intellectual curiosity, critical powers of assimilation, balance of
judgement and alertness of mind, ability for social cohesion, integrity of character, initiative and capability for
leadership.
APPENDIX-II
Brief particulars relating to the services/posts to which recruitment is being made through this examination
are given below:-
(1) Assistant Divisional Medical Officer in the Railways:
(a) The post of Assistant Divisional Medical Officer in the Indian Railway Health Service is in Group 'A" Junior
Scale in level 10 of Pay Matrix Rs. 56100-177500/- and it carries Non-Practising Allowance as per
rules/orders in force from time to time. Private practice is prohibited. The candidate will be bound to
observe the orders which the Ministry of Railways or any other competent authority may issue from time to
time restricting or prohibiting private practice by him/her.
(b) A candidate will be appointed on probation for a period of one year which may be extended by the
Government if considered necessary. On satisfactory completion of the probation candidates will be eligible
for confirmation in the junior scale of the Indian Railway Health Service.
(c) The appointment of probationers can be terminated by one month's notice in writing on either side during the
period of probation in terms of Rule 301 (3) of the Indian Railway Establishment Code, Volume-I.
Such notice is not however, required in cases of dismissal or removal as a disciplinary measure after
compliance with the provisions of Clause (2) of Article 311 of the Constitution and compulsory retirement
due to mental or physical incapacity.
(d) A candidate will have to undergo training as prescribed by the Ministry of Railways and pass all the
Departmental Examinations.
(e) A candidate will be governed by the "Contributory Pension System" effective from 01-01-2004 as per orders
of the Government.
(f) A candidate will be eligible for leave in accordance with the leave rules as in force from time to time and
applicable to officers of his status.
(g) A candidate will be eligible for free Railway Passes and Privilege Ticket Orders in accordance with, the rules
in force from time to time.
(h) A candidate will be required to pass the examination in Hindi of an approved standard within the period of
probation and failure to do so shall involve liability to termination of service.
(i) Under the rules every person appointed to the above post shall, if so required be liable to serve in any
Defence Service or post connected with the Defence of India for a period of not less than four years including
the period spent on training, if any:
Provided that such person:
a) Shall not be required to serve as aforesaid after the expiry of ten years from the date of such
appointment.
(b) Shall not ordinarily be required to serve as aforesaid after attaining the age of 45 years.
(j) A candidate will be governed in respect of matters specifically referred to above as well as other matter by
the provisions of the Indian Railway Establishment Code and the extant orders as amended/issued from time
to time.
(k) A candidate will undergo Foundation Course training initially and after completion of Foundation Course,
the candidate may also be posted to the Railway Health Units/Dispensaries at way side stations, ADMOs are
also liable to transfer to any Railway.
(l) Prospects of promotion including pay scale and allowances attached to the higher grades will be as per the
provisions of Railway Medical Service Recruitment Rules, 2000 and the orders and instructions issued by the
Ministry of Railways from time to time.
(m) Duties and Responsibilities:
Assistant Divisional Medical Officers:
(i) He will attend the indoor wards, and out patient department daily and as required.
(ii) He will carry out physical examination of candidates and of employees in service in accordance with
the regulations in force.
(iii) He will look after family welfare, public health and sanitation in his jurisdiction.
(iv) He will carry out examination of vendors.
(v) He will be responsible for discipline and proper discharge of duties of the Hospital Health Unit Staff.
(vi) He will carry out duties assigned to him specially if any and will prepare returns and indents connected
with his speciality.
(vii) He will maintain and ensure upkeep of equipments in his charge.
Note 1:- When an ADMOs is posted at the Headquarter of a division under the charge of CMS/Addl.CMS/MS
Incharge he will assist the CMS/Addl.CMS/MS Incharge in all his duties but may be specially
assigned with certain duties and responsibilities.
Note 2:- ADMOs will also be required to perform such other duties as may be assigned to them from time to time.
II. Medical Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service:
(a) The posts are temporary but likely to continue indefinitely. Candidates will be appointed to Junior Group `A`
scale and they will be on probation for a period of 2 years from the date of appointment which may be
curtailed or extended at the discretion of the Competent Authority. They will be confirmed after the
satisfactory completion of probation.
(b) The candidates can be posted anywhere in India in any dispensary or hospital under any organisation
participating in the Central Health Service across India. Private Practice of any kind whatsoever including
Lab. and consultant practice is prohibited.
(c) The scale of pay admissible to the Medical Officer of CHS is in the Level-10 (Rs. 56,100 to Rs.1,77,500/-) of
the pay matrix and NPA as per orders issued by the Government from time to time, and the promotional
avenues will be available as per the provision of CHS Rules, 2014 and the orders and instructions issued by
the Government from time to time.
III. General Duty Medical Officer in the New Delhi Municipal Council:
(a) Pay Matrix Level-10 Rs.56,100-1,77,500/- + restricted Non-practicing allowance (NPA).
(b) Ordinary rules regarding pensions, gratuity, confirmation etc. as enforced in the Council from time to
time will be applicable.
(c) The candidate will be on probation for a period of two years from the date of appointment which may be
extended at the discretion of the competent authority. On satisfactory completion of the probation period will
continue in the temporary capacity till confirmed against the permanent vacancy.
(d) The candidate can be posted anywhere within the jurisdiction of the N.D.M.C. in any of the
hospital/dispensaries/M & C family welfare Centres/Primary Health Centres etc.
(e) Private practice of any kind whatsoever is prohibited.
(f) The appointment can be terminated on one month's notice on either side during the period of probation and
thereafter, while employed in temporary capacity, NDMC reserves the right to one month's pay in lieu of
notice.
(g) GDMO shall be entitled for promotion as Senior Medical Officer in the Pay Matrix Level-11 Rs.67700-
208700/- and from Senior Medical Officer to Chief Medical Officer in the Pay Matrix Level-12 Rs.78800-
209200/- and from Chief Medical Officer to Chief Medical Officer (Non-functional Selection Grade) in the
Pay Matrix Level-13 Rs. 118500-214100/- and Senior Administrative Grade Pay Matrix Level-14
Rs.144200-218200/-.
(IV) General Duty Medical Officer Gr.II in Municipal Corporation of Delhi:
(i) Salary at the minimum of first cell of Rs.56,100/- in the level 10 of 7the Pay Matrix under 7th CPC
(corresponding to pre-revised scale in PB-3 Rs.15600-39100+GP Rs.5400/-) plus NPA and other admissible
allowances as per rules.
(ii) The candidates will be on probation for a period of two year from the date of appointment which may be
curtailed or extended at the discretion of the Competent Authority. On satisfactory completion of the
probation period, he will continue in the temporary post till confirmed against the permanent vacancy.
(iii) The candidate can be posted anywhere within the jurisdiction of the Municipal Corporation of Delhi in
anyone of the Hospital/Dispensaries/M&CW and Family Welfare Centres/Primary Health Centres etc.
(iv) Private practice of any kind whatsoever is prohibited.
(v) The appointment can be terminated on one month's notice on either side during the period of probation and
thereafter while employed in temporary capacity. The Municipal Corporation of Delhi reserves the right to
pay one month's pay in lieu of notice. Prospects of promotion including pay scale and allowances attached to
the higher grades shall be according to the provisions of Recruitment Regulations.
APPENDIX-III
REGULATIONS RELATING TO THE PHYSICAL/MEDICAL EXAMINATION OF CANDIDATES:
(a) FOR GENERAL/SC/ST/OBC/EWS CANDIDATES :
The regulations are published for the convenience of candidates and to enable them to ascertain the probability of
their possessing the required physical standards. The regulations are also intended to provide guidelines to the medical
examiners. All posts to be filled on the basis of Combined Medical Services Examination are Group 'A' "Technical"
posts. All kinds of notices and information relating to the medical examination of the Transgender candidates
including the medical parameters for Transgender candidates for various service(s) would be posted on the dedicated
web page of the Ministry of Health & Family Welfare before the commencement of the medical examination of
Combined Medical Services Examination 2024 after due consultation with all the concerned nodal authorities and all
the Cadre Controlling Authorities of the participating service (s) in Combined Medical Services Examination, 2024.
2. (a) The Government of India reserve to themselves absolute discretion to reject or accept any candidate after
considering the report of the Medical Board.
(b) To be passed as "fit" for appointment, a candidate must be in good mental and bodily health and free from
any physical defect likely to interfere with the efficient performance of the duties of his/her appointment.
(c) In the matter of co-relation of age-limit, height, weight and chest girth of candidates of India (including
Anglo-Indian race), it is left to the Medical Board to use whatever co-relation of figure is considered most
suitable as a guide in the examination of the candidates. Trunk and limbs should be proportionate, no minimum
height be insisted upon, if found fit otherwise. If there be any disproportion with regard to height, weight and
chest girth, the candidates should be hospitalized for investigation and X-Ray of the chest taken before the
candidate is declared fit or unfit by the Board.
3. The candidate's height will be measured as follows:-
He/She will remove his/her shoes and be placed against the standard with his/her feet together and the weight
thrown on the heels and not on the toe or other sides of the feet. He/She will stand erect without rigidity and with
heels, calves, buttocks and shoulders touching the standard, the chin will be depressed to bring the vertex of the head level
under the horizontal bar and the height will be recorded in centimeters and parts of a centimeter to halves.
4. The candidate's chest will be measured as follows :-
He/She will be made to stand erect with his/her feet together and to raise arms over his/her head. The tape
will be so adjusted round the chest that its upper edge touches the inferior angles of the shoulder blades behind
and lies in the same horizontal plane when the tape is taken round the chest. The arms will then be lowered to
hang loosely by the side and care will be taken that the shoulders are not thrown upwards or backwards so as to
displace the tape the candidate will then be directed to take a deep respiration several times and the maximum
expansion of the chest will be carefully noted and the minimum and maximum will then be recorded in
centimeters 84-89, 86-93.5 etc. in recording the measurement fractions of less than half a centimeter should not
be noted.
N.B.- The height and chest of the candidates should be measured twice before coming to a final decision.
The candidates will also be weighed and his/her weight recorded in kilograms; fractions of half a kilogram should
not be noted.
5. (a) The candidate's eye-sight will be tested in accordance with the following rules. The result of each test will be
recorded:
(i) General- The candidate will be directed to a general examination to the detection of any disease or
abnormality of his eyes. The candidate will be rejected if he suffers from any morbid conditions of eye(s),
eyelids or contiguous structure of such a short as to render or are likely to render him/her unfit for service
on a future date.
(ii) Visual Acuity- The examination for determining the acuteness of visions includes two tests- one for
distant and the other for near vision. Each eye will be examined separately.
(b) There shall be no limit for maximum naked eye vision but the naked eye vision of the candidates shall however
be recorded by the Medical Board or other medical authority in every case, as it will furnish the basic information
in regard to the condition of the eye.
(c) The following standards are prescribed for distant and near vision with or without glasses for different types of
services:
Class of Service
+-----------------------+----------------------------------+----------------------------------+
| | Indian Railway Health Service | Service other than IRHS |
| | (Technical) | (Technical) |
| +-----------------+----------------+-----------------+----------------+
| | Better eye | Worse eye | Better eye | Worse eye |
| | | | (corrected vision)| |
+=======================+=================+================+=================+================+
| 1. Distant Vision | 6/6 or 6/9 | 6/9 or 6/12 | 6/6 or 6/9 | 6/12, 6/18 |
| | | | | or Nil |
+-----------------------+-----------------+----------------+-----------------+----------------+
| 2. Near Vision | J1 | J2 | J1 | J2, J3 or |
| | | | | Nil |
+-----------------------+-----------------+----------------+-----------------+----------------+
| 3. Type of Correction | Spectacles, IOL/corneal surgeries viz. | J2 | Spectacles, IOL |
| Permitted | (LASIK, excimer surgeries etc.) may be | | LASIK laser |
| | permitted. Vision should be stable and | | surgery |
| | should come up to the required standard. | | |
| | Ophthalmic Board to clear fitness. The | | |
| | Surgery should have been done at least one | | |
| | year previously. | | |
+-----------------------+-----------------+----------------+-----------------+----------------+
| 4. Limits of refractive | ±4.00D | | Fundus is normal and | |
| error permitted | In case where power of lens is >-4D, | | without pathological | |
| | a special ophthalmic Medical Board to | | Myopia | |
| | clear the case ruling out Pathological | | | |
| | Myopia | | | |
+-----------------------+-----------------+----------------+-----------------+----------------+
| 5. Colour vision | Higher grade colour perception (Ishihara | | Low Grade Colour vision is acceptable. | |
| Requirements | test EGL-1.3 mm aperture) | | | |
+-----------------------+-----------------+----------------+-----------------+----------------+
6. Whether binocular vision needed?
Binocular vision is necessary in case of squint. In deserving cases, a special Ophthalmic Medical Board to clear cases on case-to-case basis.
No
(d) (i) In respect of the Technical Services mentioned above and any other service concerned with the safety of
public the total amount of Myopia(including the cylinder) shall not exceed -4.00 D total amount of
Hypermetropia(including the cylinder) shall not exceed +4.00 D:
Provided that in case a candidate in respect of the "Technical" services is found unfit on ground of high
myopia, the matter shall be referred to a Special Board of three ophthalmologists to declare whether this myopia is
pathological or not in case it is not pathological, the candidate shall be declared fit provided he/she fulfils the visual
requirements otherwise.
(ii) In every case of myopia, fundus examination should be carried out and the results recorded. In the event
of pathological condition being present which is likely to be progressive and affect the efficiency of the candidate,
he/she should be declared unfit.
(e) Field of Vision: The field of vision shall be tested in respect of all services by the confrontation
method. When such test gives unsatisfactory or doubtful result the field of vision should be determined on the
perimeter.
(f) Night Blindness: Broadly there are two types of night blindness: (i) as a result of Vitamin A deficiency and (ii) as
a result of Organic disease of Retina-common cause being Retinitis Pigmentosa. In (i) the fundus is normal, generally
seen in younger age group and ill-nourished persons and improves by large doses of Vitamin A. In (ii) the fundus is
often involved and mere fundus examination will reveal the condition in majority of cases. The Patient in this category
is an adult and may not suffer from malnutrition. For both (i) and (ii) dark adaptation test will reveal the condition. The
patient in this category is an adult and may not suffer from malnutrition. For both (i) and (ii) dark adaptation test
will reveal the condition.
(g) Colour Vision : The testing of colour vision shall be essential in respect of the Technical Services mentioned
above.
Colour perception should be graded into higher and lower grade depending upon the size of aperture in the
lantern as described in the table below: -
+---------------------------+------------------------------+------------------------------+
| Grade | Higher Grade Colour Perception | Lower Grade Colour Perception|
+===========================+==============================+==============================+
| 1. Distance between the lamp and the | 16 ft | 16 ft |
| candidate. | | |
+---------------------------+------------------------------+------------------------------+
| 2. Size of aperture | 1.3 mm | 13 mm |
+---------------------------+------------------------------+------------------------------+
| 3. Time of exposure | 5 seconds | 5 seconds |
+---------------------------+------------------------------+------------------------------+
For Indian Railway Health Service Higher Grade colour vision is essential but for other services lower grade
colour vision will be considered sufficient.
Satisfactory colour vision constitutes recognition with ease and without hesitation of Signal red, Signal Green
and White Colours. The use of Ishihara's plates, shown in good light and a suitable Edrige Green's Lantern shall be
considered quite dependable for testing colour vision. While either of the two tests may ordinarily be considered
sufficient in respect of the services other than IRHS, it is essential to carry out the lantern test for IRHS. In doubtful
cases where a candidate fails to qualify when tested by only one of the two tests, both the tests should be employed.
However, both the Ishihara's plates and Edrige Green's Lantern shall be used for testing colour vision of the
candidates for appointment to the Indian Railway Health Service.
(h) Ocular condition other than visual acuity :
(i) Any organic disease, or a progressive refractive error, which is likely to result in lowering visual acuity,
should be considered a disqualification.
(ii) Squint: For Indian Railway Health Service where the presence of binocular vision is essential, squint, even if
the vision acuity in each eye is of the prescribed standard, should be considered a disqualification. For other
services, the presence of squint should not be considered as a disqualification, if the visual acuity is of the
prescribed standard.
(iii) If a person has one eye or if he has one eye which has normal vision and the other eye is amblyopic or has
subnormal vision the usual effect is that the person is lacking stereoscopic vision for perception of depth.
Such vision is not a disqualification for services other than IRHS. The Medical Board may recommend as fit,
such persons:-
Provided the normal eye has 6/6 distant vision. Jl near vision with or without glasses provided the
error in any meridian is not more than 4 dioptres for distant vision.
full field of vision.
normal colour vision wherever required:
provided the board is satisfied that the candidate can perform all functions for the particular job in
question.
(iv) Contact Lenses: During the Medical Examination of the candidates, the use of contact lenses is not to be
allowed. It is necessary that when conducting eye tests the illumination of the typed lettes for distant vision
should have an illumination of 15 foot candles.
GUIDELINES FOR SPECIAL OPHTHALMIC BOARD
Special Ophthalmic Board for eye examination shall consist of 3 ophthalmologists:
(a) Cases where the Medical Board has recorded visual function within normal prescribed limits but
suspects a disease of progressive and organic nature which is likely to cause damage to the visual
function should refer the candidates to a Special Ophthalmic Board for opinion as part of the first
Medical Board.
(b) All cases of any type of surgery on eyes, IOL, refractive corneal surgery, doubtful cases of colour defect
should be referred to special ophthalmic board.
(c) In such cases where a candidate is found to be having high myopia or high hypermetropia the Central
Standing Medical Board/State Medical Board should immediately refer the candidates for a Special
Board of three Ophthalmologists constituted by the Medical Superintendent of the hospital with the
Head of the Department of Ophthalmology of the Hospital or the Seniormost Ophthalmologist as the
Chairman of the Special Ophthalmic Board. The Ophthalmologist/Medical Officer who has conducted
the preliminary ophthalmic examination cannot be a part of the Special Board.
The examination by the Special Board should preferably be done on the same day.
Whenever it is not possible to convene the Special Board of three Ophthalmologists on the day of
the medical examination by the Central Standing Medical Board/State Medical Board, the Special
Board may be convened at an earliest possible date.
decision. The Special Ophthalmic Board may carry out detailed investigations before arriving at their
decision.
The Medical Board's report may not be deemed as complete unless it includes the report of
the Special Medical Board for all such cases which are referred to it.
GUIDELINE FOR REPORTING ON BORDER LINE UNFIT CASES
In border line cases of substandard visual acuity, subnormal colour vision, the test will be repeated
after 15 minutes by the Board before declaring a person unfit.
6. Blood Pressure: The Board will use its discretion regarding Blood Pressure. A rough method of calculating
normal maximum systolic pressure is as follows :
(i) with young subjects of 15-25 years of age, the average is about 100 plus the age.
(ii) with subjects over 25 years of age, the general rule of 110 plus half the age seems quite satisfactory.
N.B--As a general rule any systolic pressure over 140 mm and diastolic over 90 mm should be regarded as
suspicious and the candidate should be hospitalized by the Board before giving their final opinion regarding
the candidate's fitness or otherwise. The hospitalization report should indicate whether the rise in blood
pressure is of a transient nature due to excitement etc. or whether it is due to any organic disease. In all such
cases X-ray and electrocardiographic examination of heart and blood urea clearance test should also be done
as routine. The final decision as to fitness or otherwise of a candidate will, however, rest with the medical
board only.
Method of taking Blood Pressure: - The mercury manometer type of instrument should be used as a rule.
The measurement should not be taken within fifteen minutes of any exercise or excitement. Provided the
patient and particularly his/her arm is relaxed, he may be either lying or sitting and the arm is supported
comfortably at the patient's side in a more or less horizontal position. The arm should be freed from the
cloth to the shoulder. The cuff completely deflated should be applied with the middle of the rubber over the
inner side of the arm and its lower edge an inch or two above the bend of the elbow. The following returns of
cloth bandage should spread evenly over the bag to avoid bulging during inflation.
The brachial artery is located by palpitation at the bend of the elbow and the stethoscope is then
applied lightly and centrally over it below but not in contact with the cuff. The cuff is inflated to about 200
mm. Hg. and then slowly deflated. The level at which the column stands when soft successive sounds are
heard represents the Systolic Pressure. When more air is allowed to escape the sound will be heard to
increase in intensity. The level at which the well heard clear sounds change to soft muffed fading sounds
represents the diastolic pressure. The measurements should be taken in a fairly brief period of time as
prolonged pressure of the cuff is irritating to the patient and will vitiate the reading. Rechecking if necessary
should be done only a few minutes after complete deflation of the cuff. Sometimes as the cuff is deflated
sounds heard at a certain level may disappear as pressure falls and reappear at a still lower level. This silent
gap may cause error in readings.
7. The urine (passed in the presence of the examiner) should be examined and the results recorded. Where a Medical
Board finds sugar present in candidate's urine by the usual chemical tests, the Board will proceed
with the examination with all its other aspects and will also specially note down any signs or symptoms
suggestive of diabetes. If except for the glycosuria the Board finds the candidate conforms to the standard of
medical fitness required they may pass the candidates as fit, subject to the glycosuria being non-diabetic and
the Board will refer the case to a specified Specialist in Medicine who has hospital and laboratory facilities at
his/her disposal. The Medical Specialist will carry out whatever examinations, clinical and/or laboratory, he
considers necessary including a standard blood sugar tolerance test, and will submit his/her opinion to the
Medical Board upon which the Medical Board will base its final opinion "fit" or "unfit". For this purpose the
candidates will not be required to appear in person before the Board on the second occasion. To exclude the
effect of medication it may be necessary to retain a candidate for several days in hospital under strict
supervision.
8. For appointment against posts which do not prescribe any elaborate training : It shall no longer be necessary
to declare a woman candidate as "Temporarily Unfit if she is found to be pregnant during medical
examination before appointment against posts which do not prescribe any elaborate training, i.e., she can be
appointed straightaway on the job.
For posts/services that prescribe a training prior to joining working post a women candidate who as a result of test
is found to be pregnant should be declared temporary unfit until the confinement is over. She should be re-examined
for a fitness certificate six weeks after the date of confinement subject to the production of a medical certificate of
fitness from registered medical practitioner.
9. The following additional points should be observed : -
(a) that the candidate's hearing in each ear is good and that there is no sign of disease of the ear. In case it is
defective the candidate should be got examined by an ENT Specialist; provided that if the defect in hearing is
remediable by operation or by use of a hearing aid a candidate cannot be declared unfit on that account
provided he/she has no progressive disease in the ear. This provision is not applicable in the case of IRHS.
The following are the guidelines for the medical examination authority in this regard :
+--------------------------------+--------------------------------------+--------------------------------------+
| | Indian Railways Health Services | Services other than IRHS |
| | (Technical) | (Technical) |
+================================+======================================+======================================+
| 1. Marked or total deafness in one | Unfit | Fit, if the deafness is up to 30 |
| ear other ear being normal. | | decibel in higher frequency. |
+--------------------------------+--------------------------------------+--------------------------------------+
| 2. Perceptive deafness in both ears in | Fit, if the deafness is up to 30 | Fit, if the deafness is up to 30 |
| which some improvement is | decibel in speech frequencies of | decibel in speech frequencies |
| possible by a hearing aid. | 1000-4000. | of 1000-4000. |
+--------------------------------+--------------------------------------+--------------------------------------+
| 3. Perforation of tympanic membrane | (i) One ear normal, other ear | (i) One ear normal, other ear |
| of central or marginal type. | having perforation of | having perforation of |
| | tympanic membrane- | tympanic membrane- |
| | 'Temporary Unfit'. Under | 'Temporary Unfit'. |
| | improved conditions of | Under improved |
| | Ear Surgery, a candidate | conditions of Ear |
| | with marginal or other | Surgery, a candidate with |
| | perforation in both ears | marginal or other |
| | should be given a chance | perforation in both ears |
| | by declaring him | should be given a chance |
| | temporarily unfit and then | by declaring him |
+--------------------------------+--------------------------------------+--------------------------------------+
he may be considered under 4(ii) below.
temporarily unfit and then he may be considered under 4(ii) below.
(ii) Marginal or attic perforation in both ears-'Unfit'.
(ii) Marginal or attic perforation in both ears-'Unfit'.
(iii) Central perforation in both ears-'Temporarily Unfit'.
(iii) Central perforation in both ears-'Temporarily Unfit'
4. Ears with mastoid cavity subnormal hearing on one side/on both sides.
(i) Either ear normal hearing and other ear with mastoid cavity-'Fit'
(i) Either ear normal hearing and other ear with mastoid cavity-'Fit'
(ii) Mastoid cavity of both sides-'Unfit'
(ii) Mastoid cavity of both sides-'Unfit'
5. Persistently discharging ear operated/unoperated.
'Temporarily Unfit'.
'Temporarily Unfit'.
6. Chronic inflammatory/allergic condition of nose with or with-out bony deformities of nasal Septum.
(i) A decision will be taken as per circumstances of individual cases.
(i) A decision will be taken as per circumstances of individual cases.
(ii) If deviated nasal Septum is present with Symptoms- 'Temporarily Unfit'
(ii) If deviated nasal Septum is present with Symptoms- 'Temporarily Unfit'
7. Chronic inflammatory conditions of tonsils and/or Larynx.
(i) Chronic inflammatory conditions of tonsils and/or Larynx-'Fit'.
(i) Chronic inflammatory conditions of tonsils and/or Larynx-'Fit'.
(ii) Hoarseness of voice of severe degree if present then-'Temporarily Unfit'.
(ii) Hoarseness of voice of severe degree if present then-'Temporarily Unfit'.
8. Benign or locally malignant tumours of the E.N.T.
(i) Benign tumours- 'Temporarily Unfit'.
(i) Benign tumours- 'Temporarily Unfit'.
(ii) Malignant Tumour-'Unfit'.
(ii) Malignant Tumour-'Unfit'.
9. Otosclerosis
If the hearing is within 30 decibels after operation or with the help of hearing aid-'Fit'.
If the hearing is within 30 decibels after operation or with the help of hearing aid-'Fit'.
10. Congenital defects of ear, nose or throat.
(i) If not interfering with functions-'Fit'.
(i) If not interfering with functions-'Fit'.
(ii) Stuttering of severe degree- 'Unfit'.
11. Nasal/Poly
'Temporarily Unfit'.
'Temporarily Unfit'.
(b) that his/her speech is without impediment;
(c) that his/her teeth are in good order and that he/she is provided with dentures where necessary for
effective mastication (well filled teeth will be considered as sound);
(d) that the chest is well formed and his/her chest expansion sufficient and that the hearts and lungs are
sound;
(e) that there is no evidence of any abdominal disease;
(f) that the ear-drum is not ruptured;
(g) that he/she does not suffer from hydrocele, varicose veins or piles;
(h) that his/her limbs, hands and feet are well formed and developed and that there is free and perfect
motion of all joints;
(i) that he/she does not suffer from any inveterate skin disease;
(j) that there is no congenital malformation or defect;
(k) that he/she does not bear traces of acute or chronic disease pointing to an impaired constitution;
(l) that he/she bears marks of efficient vaccination; and
(m) that he/she is free from communicable disease.
10. Radiographic examination of the Chest should be done as a routine in all cases for detecting any abnormality
of the heart and lungs, which may not be apparent by ordinary physical examination in respect of such candidates who
are declared finally successful in Combined Medical Services Examination.
The decision of the Chairman of the Central Standing Medical Board (conducting the medical examination of
the candidate concerned) about the fitness of the candidate shall be final.
In case of doubt regarding health of a candidate the Chairman of the Medical Board may consult a suitable
Hospital Specialist to decide the issue of fitness or unfitness of the candidate for Government Service, e.g. if a
candidate is suspected to be suffering from any mental defect or aberration, the Chairman of the Board may consult a
Hospital Psychiatrist/Psychologist, etc.
2 When any defect is found it must be noted in the certificate and the medical examiner should state
his/her opinion whether or not it is likely to interfere with the efficient performance of the duties, which will be
required of the candidate.
In case where a Medical Board considers that a minor disability disqualifying a candidate for Government
service can be cured by treatment (medical or surgical) a statement to that effect should be recorded by the Medical
Board. There is no objection to a candidate being informed of the Board's opinion to this effect by appointing
authority and when a cure has been effected it will be open to the authority concerned to ask for another Medical
Board.
In the case of candidates who are to be declared “Temporarily Unfit” the period specified for re-examination
should not ordinarily exceed six months at the maximum. On re-examination after the specified period these
candidates should not be declared temporarily unfit for a further period but a final decision in regard to their fitness for
appointment or otherwise should be given. It may be noted that a candidate when suffering from a curable disease can
be declared temporarily unfit by the first Medical Board only. The Medical re-examination shall be deemed to be part
of the 1st Medical Examination and candidates may, if they desire, appeal against its decision. The appellate Medical
Board has to come to a final decision and state clearly whether a candidate is fit or unfit, a candidate cannot be
declared temporarily unfit on the basis of the appellate medical examination.
10. The candidates filing an appeal against the decision of the Medical Board have to deposit an appeal fee
of Rs.100.00 in such manner as may be prescribed by the Government of India in this behalf. Appeals
should be submitted within 21 days of the date of the communication in which the decision of the
Medical Board is communicated to the candidates; otherwise request for second Medical Examination by
an Appellate Medical Board will not be entertained. The Medical Examination by the Appellate Medical
Board would be arranged in New Delhi only and no travelling allowance or daily allowance will be
admissible for the journeys performed in connection with the Medical Examination. The decision of the
Appellate Medical Board will be final and no appeal shall be against the same.
(B) FOR CANDIDATES OF CATEGORY OF PERSONS WITH BENCHMARK DISABILITY AS PER
RPwD Act 2016:
The regulations are published for the convenience of candidates and to enable them to ascertain the probability of
their possessing the required physical standards. The regulations are also intended to provide guidelines to the medical
examiners. All posts to be filled on the basis of Combined Medical Services Examination are Group 'A' "Technical"
posts.
2. (a) The Government of India reserve to themselves absolute discretion to reject or accept any candidate after
considering the report of the Medical Board.
(b) To be passed as "fit" for appointment, a candidate must be in good mental and bodily health and free from
any physical defect likely to interfere with the efficient performance of the duties of his/her appointment.
(c) In the matter of co-relation of age-limit, height, weight and chest girth of candidates of India (including
Anglo-Indian race), it is left to the Medical Board to use whatever co-relation of figure is considered most
suitable as a guide in the examination of the candidates. Trunk and limbs should be proportionate, no minimum
height be insisted upon, if found fit otherwise. If there be any disproportion with regard to height, weight and
chest girth, the candidates should be hospitalized for investigation and X-Ray of the chest taken before the
candidate is declared fit or unfit by the Board.
3. The candidate's height will be measured as follows:-
He/She will remove his/her shoes and be placed against the standard with his/her feet together and the weight
thrown on the heels and not on the toe or other sides of the feet. He/She will stand erect without rigidity and with
heels, calves, buttocks and shoulders touching the standard, the chin will be depressed to bring the vertex of the head level
under the horizontal bar and the height will be recorded in centimeters and parts of a centimeter to halves.
(1) The candidate's chest will be measured as follows :-
He/She will be made to stand erect with his/her feet together and to raise arms over his/her head. The tape
will be so adjusted round the chest that its upper edge touches the inferior angles of the shoulder blades behind
and lies in the same horizontal plane when the tape is taken round the chest. The arms will then be lowered to
hang loosely by the side and care will be taken that the shoulders are not thrown upwards or backwards so as to
displace the tape the candidate will then be directed to take a deep respiration several times and the maximum
expansion of the chest will be carefully noted and the minimum and maximum will then be recorded in
centimeters 84-89, 86-93.5 etc. in recording the measurement fractions of less than half a centimeter should not
be noted.
N.B.- The height and chest of the candidates should be measured twice before coming to a final decision.
The candidates will also be weighed and his/her weight recorded in kilograms; fractions of half a kilogram should
not be noted.
2. Locomotor Disability : Candidates with 40-80% disability are eligible for PwBD quota. Persons with more
than 80% disability are allowed on case to case basis, if and only if, there is an improvement in the functional
competence with the aid of assistive devices. Or in other words, disability is brought down below 80% as
required to perform the necessary functions to be certified so by a designated Special Board.
In case of leprosy cured persons, attention should be paid to loss of sensations in fingers and hands,
amputation, as well as involvement of eyes and corresponding recommendations is looked at.
In case of Cerebral palsy, attention should be paid to impairment of vision, hearing, cognitive function etc
and corresponding recommendations be looked at.
For IRHS : Existing Locomotor disability for PwBD only with functional classification of OA, OL and
BL in direct recruitment of ADMOs in IRHS through CMSE.
Visual Disability :
Candidates with visual acuity disability in range of more than 40% disability are eligible, subject to the
condition that the visual disability is brought down to a level of less than the benchmark of 40% with the
advanced low vision aids and appliances.
This is to be certified so by a designated Special Board.
Visual Acuity:
IRHS: Candidates with 'Sub Standard' Visual Acuity are not suitable to man posts of ADMOs in IRHS.
Colour Vision :
IRHS: Candidates with Colour Vision defects are not suitable to man posts of ADMOs in IRHS.
3. Hearing Disability: Candidates with more than 40% disability to be considered eligible, subject to the
condition that the hearing disability is brought down to a level of less than the benchmark of 40% with the
aid of assistive devices as certified so by a designated Special Board.
In addition to this, individual should have a speech discrimination score of more than 60%.
IRHS: Candidates with Hearing disability are not suitable to man posts of ADMOs in IRHS.
4. Other Disabilities (Autism, Intellectual disabilities, Specific Learning Disabilities and Mental Illness) :
INTELLECTUAL DISABILITY:
i. Autism – Currently not recommended due to lack of objective method to establish presence and extent of
mental illness.
ii. Specific Learning disability: Equal to or more than 40% disability and equal to or less than 80% will be
eligible. But selection will be based on the learning competency evaluated with the help of the
remediation/assisted technology/aids/infrastructural changes by the Expert Panel. [Currently, there is no
quantification scale available to assess the severity of Specific Learning Disability. Therefore, the cut off of
40% is arbitrary and more evidence is needed.
MENTAL ILLNESS:
Currently not recommended due to lack of objective method to establish present and extent of mental illness.
However, the benefit of reservation/quota may be considered in future after developing better methods of
disability assessments.
Autism and Intellectual Disability :
IRHS: Candidates with Autism and Intellectual Disabilities are not suitable to man posts of ADMOs in
IRHS.
GUIDELINES FOR SPECIAL OPHTHALMIC BOARD
Special Ophthalmic Board for eye examination shall consist of 3 ophthalmologists:
(a) Cases where the Medical Board has recorded visual function within normal prescribed limits but
suspects a disease of progressive and organic nature which is likely to cause damage to the visual
function should refer the candidates to a Special Ophthalmic Board for opinion as part of the first
Medical Board.
(b) All cases of any type of surgery on eyes, IOL, refractive corneal surgery, doubtful cases of colour defect
should be referred to special ophthalmic board.
(c) In such cases where a candidate is found to be having high myopia or high hypermetropia the Central
Standing Medical Board/State Medical Board should immediately refer the candidates for a Special
Board of three Ophthalmologists constituted by the Medical Superintendent of the hospital with the
Head of the Department of Ophthalmology of the Hospital or the Seniormost Ophthalmologist as the
Chairman of the Special Ophthalmic Board. The Ophthalmologist/Medical Officer who has conducted
the preliminary ophthalmic examination cannot be a part of the Special Board.
The examination by the Special Board should preferably be done on the same day. Whenever
it is not possible to convene the Special Board of three Ophthalmologists on the day of the medical
examination by the Central Standing Medical Board/State Medical Board, the Special Board may be
convened at an earliest possible date.
decision. The Special Ophthalmic Board may carry out detailed investigations before arriving at their
decision.
The Medical Board's report may not be deemed as complete unless it includes the report of
the Special Medical Board for all such cases which are referred to it.
GUIDELINE FOR REPORTING ON BORDER LINE UNFIT CASES
In border line cases of substandard visual acuity, subnormal colour vision, the test will be repeated
after 15 minutes by the Board before declaring a person unfit.
5. Blood Pressure: The Board will use its discretion regarding Blood Pressure. A rough method of calculating
normal maximum systolic pressure is as follows :
(i) with young subjects of 15-25 years of age, the average is about 100 plus the age.
with subjects over 25 years of age, the general rule of 110 plus half the age seems quite satisfactory.
N.B--As a general rule any systolic pressure over 140 mm and diastolic over 90 mm should be regarded as
suspicious and the candidate should be hospitalized by the Board before giving their final opinion regarding
the candidate's fitness or otherwise. The hospitalization report should indicate whether the rise in blood
pressure is of a transient nature due to excitement etc. or whether it is due to any organic disease. In all such
cases X-ray and electrocardiographic examination of heart and blood urea clearance test should also be done
as routine. The final decision as to fitness or otherwise of a candidate will, however, rest with the medical
board only.
Method of taking Blood Pressure: - The mercury manometer type of instrument should be used as a rule.
The measurement should not be taken within fifteen minutes of any exercise or excitement. Provided the
patient and particularly his/her arm is relaxed, he may be either lying or sitting and the arm is supported
comfortably at the patient's side in a more or less horizontal position. The arm should be freed from the
cloth to the shoulder. The cuff completely deflated should be applied with the middle of the rubber over the
inner side of the arm and its lower edge an inch or two above the bend of the elbow. The following returns of
cloth bandage should spread evenly over the bag to avoid bulging during inflation.
The brachial artery is located by palpitation at the bend of the elbow and the stethoscope is then
applied lightly and centrally over it below but not in contact with the cuff. The cuff is inflated to about 200
mm. Hg. and then slowly deflated. The level at which the column stands when soft successive sounds are
heard represents the Systolic Pressure. When more air is allowed to escape the sound will be heard to
increase in intensity. The level at which the well heard clear sounds change to soft muffed fading sounds
represents the diastolic pressure. The measurements should be taken in a fairly brief period of time as
prolonged pressure of the cuff is irritating to the patient and will vitiate the reading. Rechecking if necessary
should be done only a few minutes after complete deflation of the cuff. Sometimes as the cuff is deflated
sounds heard at a certain level may disappear as pressure falls and reappear at a still lower level. This silent
gap may cause error in readings.
6. The urine (passed in the presence of the examiner) should be examined and the results recorded. Where a
Medical Board finds sugar present in candidate's urine by the usual chemical tests, the Board will proceed
with the examination with all its other aspects and will also specially note down any signs or symptoms
suggestive of diabetes. If except for the glycosuria the Board finds the candidate conforms to the standard of
medical fitness required they may pass the candidates as fit, subject to the glycosuria being non-diabetic and
the Board will refer the case to a specified Specialist in Medicine who has hospital and laboratory facilities at
his/her disposal. The Medical Specialist will carry out whatever examinations, clinical and/or laboratory, he
considers necessary including a standard blood sugar tolerance test, and will submit his/her opinion to the
Medical Board upon which the Medical Board will base its final opinion "fit" or "unfit". For this purpose the
candidates will not be required to appear in person before the Board on the second occasion. To exclude the
effect of medication it may be necessary to retain a candidate for several days in hospital under strict
supervision.
7. For appointment against posts which do not prescribe any elaborate training : It shall no longer be necessary
to declare a woman candidate as "Temporarily Unfit if she is found to be pregnant during medical
examination before appointment against posts which do not prescribe any elaborate training, i.e., she can be
appointed straightaway on the job.
For production of a medical certificate of fitness from registered medical posts/services that prescribe a
training prior to joining working post a women candidate who as a result of test is found to be pregnant
should be declared temporary unfit until the confinement is over. She should be re-examined for a fitness
certificate six weeks after the date of confinement subject to the practitioner.
8. Radiographic examination of the Chest should be done as a routine in all cases for detecting any abnormality
of the heart and lungs, which may not be apparent by ordinary physical examination in respect of such
candidates who are declared finally successful in Combined Medical Services Examination.
The decision of the Chairman of the Central Standing Medical Board (conducting the medical examination of
the candidate concerned) about the fitness of the candidate shall be final.
9. In case of doubt regarding health of a candidate the Chairman of the Medical Board may consult a suitable
Hospital Specialist to decide the issue of fitness or unfitness of the candidate for Government Service, e.g. if
a candidate is suspected to be suffering from any mental defect or aberration, the Chairman of the Board may
consult a Hospital Psychiatrist/Psychologist, etc.
10. When any defect is found it must be noted in the certificate and the medical examiner should state his/her
opinion whether or not it is likely to interfere with the efficient performance of the duties, which will be
required of the candidate.
In case where a Medical Board considers that a minor disability disqualifying a candidate for
Government service can be cured by treatment (medical or surgical) a statement to that effect should be
recorded by the Medical Board. There is no objection to a candidate being informed of the Board's opinion
to this effect by appointing authority and when a cure has been effected it will be open to the authority
concerned to ask for another Medical Board.
In the case of candidates who are to be declared "Temporarily Unfit" the period specified for re-
examination should not ordinarily exceed six months at the maximum. On re-examination after the specified
period these candidates should not be declared temporarily unfit for a further period but a final decision in
regard to their fitness for appointment or otherwise should be given. It may be noted that a Candidate when
suffering from a curable disease can be declared temporarily unfit by the first Medical Board only. The
Medical re-examination shall be deemed to be part of the 1st Medical Examination and candidates may, if
they desire, appeal against its decision. The appellate Medical Board has to come to a final decision and state
clearly whether a candidate is fit or unfit, a candidate cannot be declared temporarily unfit on the basis of the
appellate medical examination.
11. The candidates filing an appeal against the decision of the Medical Board have to deposit an appeal fee of
Rs.100.00 in such manner as may be prescribed by the Government of India in this behalf. Appeals should be
submitted within 21 days of the date of the communication in which the decision of the Medical Board is
communicated to the candidates; otherwise request for second Medical Examination by an Appellate Medical
Board will not be entertained. The Medical Examination by the Appellate Medical Board would be arranged
in New Delhi only and no travelling allowance or daily allowance will be admissible for the journeys
performed in connection with the Medical Examination. The decision of the Appellate Medical Board will
be final and no appeal shall be against the same.
APPENDIX-IV
A list of Services Identified suitable for Persons with Benchmark Disability along with the Functional
Classifications and Physical Requirements
+-----+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
| SI. | Name of the | Category(ies) for which | Functional | Physical Requirements |
| No. | Service | Identified | Classification | |
+=====+===================================+===================================+===================================+===================================+
| (1) | (2) | (3) | (4) | (5) |
+-----+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
| 1. | Assistant Divisional Medical | Locomotor Disability | (i) OA-One arm affected. | S, ST, BN, W, SE, MF, C, |
| | Officer (ADMO) in Indian | | (ii) OL-One leg affected | RW, H |
| | Railway Health Services (IRHS) | | and | S-Sitting, ST-Standing, |
| | | | (iii) BL-Both legs affected | BN-Bending, W– Walking, |
| | | | but not arms. | SE-Seeing, MF- |
| | | | | Manipulation by Fingers, C- |
| | | | | Comm-unication, RW- |
| | | | | Reading and Writing, H- |
| | | | | Hearing. |
+-----+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
| 2. | Medical Officers Grade in Central | (a) OA, OL, BL, LC, DW, AAV | S, ST, W, BN, MF, RW, SE, H, C | |
| | Duty Medical Officers Sub-cadre | (b) SLD | S=Sitting, ST=Standing, W=Walking, BN=Bending, | |
| | of Central Health Service. | (c) MD involving (a) to (b) above | MF=Manipulation with Fingers, RW=Reading & Writing, | |
| | | | SE=Seeing, H=Hearing, C=Communication | |
| | | | Incumbent should be considered with aids & appliances, | |
| | | | Bilateral hand activities should be adequate. | |
+-----+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
| 3. | General Duty Medical Officer Gr.II | a) OA, OL, BL, LC, DW, AAV | NIL | S, ST, W, BN, MF, RW, SE, |
| | in MCD | b) SLD | | H, C |
| | | c) MD involving (a) to (b) above | | |
+-----+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
| 4. | General Duty Medical Officer in | Locomotor Disability | OA & OL only (Functional | S, ST, BN, W, SE, MF, C, |
| | NDMC | | Classification-OH (OA, | RW, H |
| | | | OL) with leprosy cured, | S-Sitting, ST-Standing, |
| | | | dwarfism, acid attack | |
| | | | victims) | BN- Bending, W- Walking, |
| | | | | SE-Seeing, MF- |
| | | | | Manipulation by Fingers, C- |
| | | | | Comm-unication, RW- |
| | | | | Reading and Writing, H- |
| | | | | Hearing. |
+-----+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
APPENDIX – V
Certificate regarding physical limitation in an examinee to write
This is to certify that, I have examined Mr./Ms./Mrs...
(name of the candidate with benchmark disability), a person with
disability as mentioned in the certificate of disability), S/o /D/o.......
a resident of ........................................................................ (Village/District/State) and to state that
he/she has physical limitation which hampers his/her writing capabilities owing to his/her disability.
Signature
Chief Medical Officer/Civil Surgeon /
Medical Superintendent of a Government Health Care Institution.
Note: Certificate should be given by a specialist of the relevant stream/disability (eg. Visual Impairment –
Ophthalmologist, Locomotor disability – Orthopaedic specialist/PMR).
APPENDIX – VI
Letter of Undertaking for Using Own Scribe
(To be filled by the candidates online to the Commission)
I................., a candidate with.................. (name of the disability) appearing for the
(name of the examination)................ bearing Roll No................ at ............. (name of
the centre) in the District ..................................... (name of the State). My qualification is ....................
I do hereby state that ........................... (name of the scribe) will provide the service of
scribe/reader/lab assistant for the undersigned for taking the aforesaid examination.
I do hereby undertake that his qualification is ............................. In case, subsequently it is found that
his/her qualification is not as declared by the undersigned and is beyond my qualification, I shall forfeit my right to
the post and claims thereto.
(Signature of the candidates with Disability)
Place:
Date:
APPENDIX-VII
Certificate for person with specified disability covered under the definition of Section 2(s) of the RPwD Act,
2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having less than 40%
disability and having difficulty in writing
This is to certify that, we have examined Mr./Ms./Mrs.
(name of the candidate), S/o / D/o .............................................................. a resident of
(Vill/PO/PS/District/State), aged...............yrs, a person with
(nature of disability/condition), and to state that he/she has limitation which hampers
his/her writing capability owing to his/her above condition. He/she requires support of scribe for writing the
examination.
2. The above candidate uses aids and assistive device such as prosthetics & orthotics, hearing aid (name to be
specified) which is /are essential for the candidate to appear at the examination, with the assistance of scribe.
3. This certificate is issued only for the purpose of appearing in written examinations conducted by recruitment
agencies as well as academic institutions and is valid upto ........................................................................
(it is valid for maximum period of six
months or less as may be certified by the medical authority)
Signature of medical authority
+-------------------------+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
| (Signature & Name) | (Signature & Name) | (Signature & Name) | (Signature & Name) | (Signature & Name) |
+=========================+===================================+===================================+===================================+===================================+
| Orthopedic/PMR Specialist | Clinical phychologist/ | Neurologist (if | Occupational | Other Expert, as |
| | Rehabilitation | available) | therapist | (if nominated by the |
| | Psychologist/ | | available) | Chairperson (if any) |
| | Psychiatrist/ Special | | | |
| | Educator | | | |
+-------------------------+-----------------------------------+-----------------------------------+-----------------------------------+-----------------------------------+
(Signature & Name)
Chief Medical Officer / Civil Surgeon / Chief District Medical Officer | Chairperson
Name of Government Hospital / Health Care Centre with seal
Place:
Date :
APPENDIX – VIII
MEDICAL BOARD REPORT FORMAT
(To be filled in Triplicate)
For CMSE - 2024
Photograph with
Roll No. &
Discp. written on
the back
Roll No. ..................................................................................................................................................................
Rank No..................................................................................................................................................................
Name of Hospital................................................................................................................ Place .................................
(a) Candidate's statement and declaration.
Candidate must make the statement required below in his/her own hand writing prior to his Medical Examination and
must sign the declaration 'appended thereto'. Their attention is specially directed to the warning contained in the Para
08 below:-
1. Name in full(in block letters) :
3 (c). Whether underwent any eye surgery (including Radial
Keratotomy / Lasik/ Excimer etc.) at any time. If yes, details
thereof:
2 (a). Age : Date of Birth: Place of Birth:
3 (d) (i) whether PwBD candidate - Yes/No
2 (b). Do you belong to races such as Gorkhas,
Garhwalis, Assamese, Nagaland Tribals etc, whose
average height is distinctly lower? Answer 'Yes' or 'No'
and if the answer is 'Yes' state the name of the tribe race
:
(ii) Mention Sub-category of Disability
(ex. OL, OA, BL, etc.)
3 (a). Have you ever had small-pox intermittent or any
fever, enlargement or suppuration of glands, spitting of
Blood, asthma, heart diseases, lung disease, fainting
attacks, rheumatism, appendicitis :
4. Have you suffered from any form of nervousness due to
overwork or any other causes
Or
5. Have you been allotted to any service/posts on the basis of
previous years exams? If yes, give details thereof
Have you joined the said service/ post ....................................
3(b). Any other disease or accident requiring confinement
to bed and medical or surgical treatment :
5.1 Are you enrolled for the PG course? If yes, give details
thereof.
6. Furnish the following particulars concerning your family:-
+----------------+----------------+--------------------------+--------------------------+----------------+----------------+--------------------------+--------------------------+
| Father's age, | Father's age | No. of | No. of | Mother's age | Mother's age | No. of sisters | No. of sisters |
| if living & | at death & | brothers | brothers | , if living & | at death & | living, their | dead, their |
| state of | cause of | living, their | dead, their | state of | cause of | ages & state | ages & cause |
| health | death | ages & state | ages & cause | health | death | of health | of death |
| | | of health | of death | | | | |
+================+================+==========================+==========================+================+================+==========================+==========================+
| (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) |
+----------------+----------------+--------------------------+--------------------------+----------------+----------------+--------------------------+--------------------------+
Present Address..........................................................................................................................................................................................................................................................................
Mobile No....................................................................... Email ID .......................................................... Mobile No. of
Father/Guardian..........................................................................................................................................................................................................................................................................
Identification marks..................................................................................................................................................................................................................................................................
7. Details of medical examination conducted before, if any:-
(a) Place & Date of Medical Board
(b) Service(s)/Post(s) for which examined and
year of Examination
(c) Result of Medical Board Examination if communicated
or known.
8. All the above answers are to the best of my knowledge & belief, true and correct and I shall be liable for
action under law for any material infirmity in the information furnished by me or suppression of relevant material
information. The furnishing of false information or suppression of any factual information would be a disqualification
and is likely to render me unfit for employment under the Government. I am fully aware of the provisions of
Combined Medical Services Examination-2024 Rules. If the fact that false information has been furnished or that
there has been suppression of any factual information comes to notice at any time during my service, my services
would be liable to be terminated.
Candidate's Signature
Signed in my presence
Signature of the Chairperson of the Board
with date and stamp of the Board
(b) Report of the Medical Board on (name of candidate).................................................................................
(Examiner to write and not merely Tick the correct choice)
Physical examination
1. General development: (Good/Fair/Poor)
3. Eyes
i. Any disease
Nutrition (Thin/Average/Obese) .............................................................. ii. Night Blindness ....................................................................
Height (without shoes) ........................................ Cms.
Weight ................................................kg
iii. Colour vision (Higher Grade/Lower Grade)
Temperature ............................................°C
Girth of chest :-
iv. Field of vision ....................................................................
(i) (After full inspiration) ........................................ Cms
Method....................................................................
(ii) (After full expiration) ........................................ Cms
v. Binocular vision ....................................................................
2. Skin - Any obvious disease ....................................................................................................................................................................
vi. Fundus Examination ....................................................................
vii. Visual Acuity
+-----------------+------------+-------------+-------------------------------------+
| Acuity of vision| Naked eye | With glasses| Strength of glasses |
| | | +-----------+--------------+---------+
| | | | Spherical | Cylindrical | Axis |
+=================+============+=============+===========+==============+=========+
| Distant Vision | | | | | |
| R.E. | | | | | |
| L.E. | | | | | |
+-----------------+------------+-------------+-----------+--------------+---------+
| Near Vision | | | | | |
| R.E. | | | | | |
| L.E. | | | | | |
+-----------------+------------+-------------+-----------+--------------+---------+
| Hypermetropia | | | | | |
| (Manifest) | | | | | |
| R.E. | | | | | |
| L.E. | | | | | |
+-----------------+------------+-------------+-----------+--------------+---------+
4. Ears: Inspection ....................................................................................................................................
9.(b) Haemorhoids ....................................................................
Hearing .................................................................... Right Ear
Fistula ....................................................................
Left Ear ....................................................................
10. Nervous System: Indications of nervous or mental
5. Glands ........................................................................ Thyroid
disabilities
6. Condition of teeth & gums....................................................................................................................................
(a) Motor ....................................................................
7. Respiratory System: Does physical examination
reveal anything abnormal in the respiratory organs?
(b) Sensory....................................................................
11. Loco-Motor System: Any abnormality ....................................................................................................................................
If yes, explain fully ....................................................................................................................................................................
12 (A) Genito Urinary System : Any evidence of
Hydrocele, Varicocele etc. ....................................................................................................................................
8. Circulatory system:
Urine analysis (Lab. No..................................)
(a) Heart: Any organic lesions?
(i) Physical Appearance ....................................................................
Rate/Minutes
Standing .................................../Minutes
Sp. Gravity ....................................................................
After hopping 25 times .................../Minutes
(ii) Albumin ....................................................................
Two minutes after hopping ......../Minutes
(b) Blood Pressure:
Sugar ....................................................................
Systolic ................................mm of Hg
Casts....................................................................
Diastolic ................................mm of Hg
(iii) Cells....................................................................
9. Abdomen: Girth .....................................Cms
12(B) *Gyane Examination (for female candidates
(explain if any finding)....................................................................................................................................................................
only)....................................................................................................................................................................
Hernia ....................................................................................................................................................................
(a) Palpable:
Liver ....................................................................................................................................................................
Spleen ....................................................................................................................................................................
Kidneys ....................................................................................................................................................................
Any Mass
(explain)....................................................................................................................................................................
Sign. of Doctor ....................................................................................................................................................................
13. Report of X-ray examination of chest (X-ray
No....................)
14. Is there anything in the health of the candidate likely to render him unfit for the efficient discharge of his duties in
the service for which he is a candidate?
NOTE: *In the case of a female candidate, if it is found that she is pregnant, she should be declared temporarily
unfit, vide Regulation as per notification.
15. Services for which the candidate has been found qualified for the efficient and continuous disch-
please be indicated clearly by √ and services/posts for which he /she is considered unfit if any n
indicated clearly by × :-
i) Indian Railway Health Service (ADMO)
ii) Central Health Service (Medical Officers Grade in General Duty Medical Officers)
iii) New Delhi Municipal Council (GDMO)
iv) Municipal Corporation of Delhi (GDMO Gr.II)
Is the candidate fit for field service?
NOTE: The Board should record their findings strictly in the following certificate
CERTIFICATE
Shri ................................................................ Roll No. ....................................................................
a candidate of CMSE-2024 who has appeared for his first medical examination/ re-examination on
(date) is found to be
(i) Fit
(ii) Unfit on account of ....................................................................................................................................................................
(iii) Temporarily unfit on account of ....................................................................................................................................................................
(pl ensure this matches with findings of Column 14 at page 3
(iv) In case of PwBD please mention the category/sub-category of disability i.e OA, OL, BL, etc. (please refer
Appendix-III of CMSE Rules and ensure PwBD candidates meet with Functional Classification and Physical
Requirements for identified services)
Sign. of Member
with stamp
(containing name)
If co-opted
Sign. of Member
with stamp
(containing name)
Sign. of Member
with stamp
(containing name)
Sign. of Chairperson
with stamp
(containing name)
Date :
Place:
Annexure I
I. Technical Services or posts requiring Higher Grade Colour Perception:-
i) Indian Railway Health Service (ADMO)
II. Technical Services or posts requiring Lower Grade Colour Perception:-
(or Defective Higher Grade Colour Perception – DHGCP)
Central Health Service (Medical Officers Grade in General Duty Medical Officers)
(ii) New Delhi Municipal Council (GDMO)
iii) Municipal Corporation of Delhi (GDMO Gr.II)
Sign. of Member
with stamp
(containing name)
If co-opted
Sign. of Member
with stamp
(containing name)
Sign. of Member
with stamp
(
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