Medical examination at the MPU: what does the doctor check?

What role does the medical examination play in the MPU?

The medical examination is one of the building blocks of every MPU, alongside the questionnaire, the performance test and the psychological interview. The entire assessment day takes about 3 to 4 hours. The page MPU procedure gives an overview of all parts.

It is important to distinguish it from the medical MPU. The medical examination is part of every MPU, including for alcohol, drugs, points or criminal offences. A medical MPU under § 11 FeV (Driving Licence Regulation, Fahrerlaubnis-Verordnung), on the other hand, is a separate question that focuses on an illness or long-term medication. The page Medical MPU explains these cases.

What does the doctor check at the MPU?

At the MPU, the doctor checks three areas: your physical condition, lab values, and your own statements about the reason for the MPU and your consumption. The procedure differs depending on the assessment centre and the question, but the focus is similar:

A central aim is to identify or rule out signs of dependence. This determines what requirements are placed on your change. If there are signs of dependence, this points to hypothesis A1 for alcohol and D1 for drugs. Then, as a rule, therapy and documented abstinence over 12 months are required; controlled drinking is ruled out in the case of dependence. That is why it is so important that your statements, your evidence and the findings form a consistent picture.

What do liver values such as GGT and CDT show?

Liver values such as GGT, GOT, GPT, MCV and CDT are indirect markers. They do not directly show whether you have drunk alcohol, but give indications of possible strain caused by alcohol. They hardly play a role in the proof of abstinence (Abstinenznachweis) today; there are direct markers for this, such as EtG in urine or hair and PEth in blood.

Nevertheless, the values are relevant in the examination. They can additionally show good values that match your account. But they can also reveal contradictions. The assessor compares the amounts you say you drank with your blood alcohol concentration and lab values such as CDT. If you describe low consumption in the interview while the values suggest otherwise, you lose credibility. You can read more about the direct blood marker in the guide The PEth value explained.

What does the doctor talk to you about?

The doctor talks to you about the reason for the MPU and your consumption. This is about how much, how often and over what period you consumed, and how this developed.

The same applies to this conversation as to the psychological interview: answer honestly and consistently. The assessor checks the consistency between the case file, the questionnaire, the lab values and your account. What you tell the doctor should therefore match what you stated in writing and what you later tell the psychologist.

• Do not play anything down: the amounts you state must match the case file.
• List all medication: long-term medication can also be relevant for fitness to drive.
• Be open about uncertainty: better "approximately" than an invented exact figure.

Which documents do you need for the medical examination?

For the medical examination, you mainly need the evidence that supports your statements. Pack it all together the day before:

1. Identity card or passport for the identity check.
2. Proofs of abstinence, complete and in the original, and a drinking log if applicable.
3. Course and therapy certificates, for example under § 70 or § 71 FeV or from traffic therapy (Verkehrstherapie).
4. Specialist findings if there is a medical question, as a rule no older than 3 months.
5. Glasses or contact lenses for the eye test.

Come to the MPU well rested, on time and sober. Consumption the day before does not fit with a credible change.

What also applies if there is a medical question?

If there is a medical question, for example because of diabetes, epilepsy, eyesight or long-term medication, the medical examination becomes much more important. You then usually need a specialist's report, no older than 3 months, with an explicit statement on fitness to drive.

For the eye test, fixed values from Annex 6 FeV apply to group 1 (car and motorcycle): the eye test is passed from 0.7/0.7, an ophthalmologist's examination requires at least 0.5, and the field of vision must cover at least 120°. Stricter limits apply to lorries and buses.

Even with medication such as a stable substitution therapy or ADHD medication, fitness to drive is possible if the treatment is medically supervised, there is no additional consumption and no signs of impairment occur.

Can the medical examination alone decide the result?

The medical examination is one building block of the overall expert report (Gutachten), but the most important part is the psychological interview, lasting 45 to 60 minutes. It covers causes, change and stability. The medical findings feed into this overall assessment.

The findings become significant above all if they give signs of dependence or contradict your statements. Then it becomes difficult to make a stable change credible in the interview. Conversely, unremarkable findings and complete evidence support your account. The page Proof of abstinence explains how to build up the evidence correctly.

What you can do now

1. Check your proofs of abstinence: complete, in the original, from a laboratory accredited under DIN EN ISO/IEC 17025.
2. Put together a written list of your medication and previous illnesses.
3. Obtain specialist findings in good time if there is a medical question, so that they are no older than 3 months.
4. Compare your consumption history with the case file, so that your statements match the values and lab findings.
5. Practise the interview and the procedure: find suitable preparation.