DOccMed best-fit questions: 10 examples with answers

The DOccMed written paper is typically 80 best-fit questions in 1 hour 45 minutes. The Faculty of Occupational Medicine’s DOccMed regulations describe it as “single statements or stems with up to five statements”: you choose the single best possible fit for each question. There is no negative marking. It is the same paper as Part 1 MFOM: the MFOM regulations say the two use the same question sets and have a common pass mark. The Faculty publishes seven example questions without answers. This article gives ten worked examples in that short format. Checked against fom.ac.uk on 29 September 2026.

How to approach a best-fit statement question

In the statement items below, one statement is true and four are false. The same habits work for the short scenarios.

• Read every option. An early option can look right until a later one fits the stem better.
• Name the reason each false option is false. It might be a wrong figure, a rule from a neighbouring regulation or a rule that has since changed. If you cannot say why an option is wrong, you have not ruled it out.
• Watch absolute words. Words such as only, always, never and all make a statement easy to test: one exception you know rules it out. An absolute statement can still be true, so test the fact rather than the word.
• Choose the best fit, not an option that is merely true in some circumstances. Qualifiers in the stem, such as the country, the worker’s age or the regulation named, decide which rule applies (see questions 6 and 7).

Ten example questions

Each question comes from a different module of the Core Revision DOccMed bank. Questions 1, 4, 7 and 10 open with “Regarding…”; questions 3, 6 and 9 give only a topic, like the Faculty’s “Vinyl chloride monomer” example; questions 2, 5 and 8 are short scenarios. Try each one before you open the answer.

Question 1 (biological hazards): hepatitis B serology

Regarding hepatitis B serology in a healthcare worker:

Which of the following statements is true?

A  A positive anti-HBc on its own shows immunity from vaccination
B  Anti-HBs without anti-HBc points to immunity from vaccination, not infection
C  Detectable HBeAg in a carrier indicates that infectivity is low
D  HBsAg positivity indicates immunity after a past infection
E  IgG anti-HBc is the marker used to diagnose acute infection

Show the answer

The answer is B: Anti-HBs without anti-HBc points to immunity from vaccination, not infection.

Hepatitis B vaccines contain recombinant surface antigen only, so a vaccinated person makes anti-HBs but no antibody to the core antigen; anti-HBs with anti-HBc means past infection that has resolved. Because vaccination never produces anti-HBc, isolated anti-HBc is not proof of protection and needs investigating (A). HBeAg reflects active replication and high infectivity (C). HBsAg is the marker of current infection, acute or chronic (D). IgM anti-HBc identifies acute or recent infection; IgG anti-HBc persists for life and cannot date it (E).

Question 2 (fitness for work): driving after a faint

A 35-year-old delivery driver who drives a 3.5-tonne van fainted while standing in a hot queue after giving blood. He had felt light-headed and sweaty beforehand and recovered within a minute. Examination and ECG are normal.

What is the most appropriate advice about driving?

A  Advise him to notify the DVLA, which will then decide on his licence
B  Driving is barred for six months, as after an unexplained blackout
C  He must stop driving for four weeks and notify the DVLA
D  No restriction; he may drive and need not notify the DVLA
E  Refer him urgently to a cardiologist before he drives again

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The answer is D: No restriction; he may drive and need not notify the DVLA.

The history has the three features of reflex vasovagal syncope: provocation (blood donation, heat, prolonged standing), a prodrome (light-headedness and sweating) and a standing posture. A normal examination and ECG make an arrhythmic or structural cause much less likely. For a Group 1 driver (car or van up to 3.5 tonnes), a single reflex syncope with a reliable prodrome that did not occur while driving needs no restriction and no DVLA notification, which rules out A and C; a Group 2 (bus or lorry) driver, by contrast, must notify the DVLA after even one episode. Longer periods off driving apply to unexplained loss of consciousness (B). Urgent cardiology referral is not needed when the features are typical and the ECG is normal (E).

Question 3 (law and ethics): the Mental Capacity Act 2005

The Mental Capacity Act 2005

Which of the following statements is true?

A  A decision that other people regard as unwise shows in itself that the person lacks capacity
B  An assessment of capacity, once made, applies to every future decision the person faces
C  Capacity is decided for the particular decision in question at the time it needs to be made
D  Only a psychiatrist may assess whether a person has the capacity to give consent
E  The Act applies in Scotland, where it replaced the earlier incapacity legislation

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The answer is C: Capacity is decided for the particular decision in question at the time it needs to be made.

Capacity is presumed unless it is established that the person lacks it. It is always assessed for this decision at this time, so a worker with a fluctuating condition may make a valid decision on a good day and each new decision is assessed afresh (B). A person is not to be treated as unable to decide merely because the decision looks unwise to others (A). Capacity is normally assessed by the person who needs the decision, such as the clinician seeking consent; no particular specialty is required (D). The Act covers England and Wales; Scotland has its own legislation (E).

Question 4 (physical hazards): combining noise levels

Regarding combining and averaging noise levels expressed in decibels:

Which of the following statements is true?

A  Adding two equal sources raises the level by about 3 dB
B  Doubling the exposure time raises the daily exposure by 6 dB
C  Each 10 dB increase represents a doubling of the sound energy
D  Four hours at 88 dB(A) gives a daily exposure of 88 dB(A)
E  Machines at 85 and 75 dB(A) together produce about 80 dB(A)

Show the answer

The answer is A: Adding two equal sources raises the level by about 3 dB.

Sound energies add, but decibels do not. Two equal sources double the energy, which raises the level by about 3 dB: two machines at 85 dB(A) together produce about 88 dB(A). A 10 dB increase is a tenfold increase in sound energy, not a doubling (C). Time trades off at 3 dB: doubling the exposure time adds 3 dB, not 6 dB (B), while four hours at 88 dB(A) gives a daily personal noise exposure of about 85 dB(A), the upper exposure action value (D). Decibels cannot be averaged arithmetically: 85 and 75 dB(A) together produce about 85.4 dB(A) because the louder source dominates (E).

Question 5 (musculoskeletal disorders): lumbar support belts for order pickers

After two back injury claims, a distribution centre manager plans to issue lumbar support belts to all order pickers to prevent further injuries. He asks occupational health to endorse the plan.

What is the most appropriate advice?

A  Agree, provided that the belts go only to pickers with a history of back pain
B  Issue the belts together with a refresher training course in lifting technique
C  Proceed, since back belts are recognised protective equipment for lifting
D  Require pre-placement spinal X-rays to find the pickers most at risk
E  Tell him belts have not been shown to prevent injury; review the tasks

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The answer is E: Tell him belts have not been shown to prevent injury; review the tasks.

Systematic reviews have not shown that lumbar supports prevent back pain or back injury in workers and NICE guideline NG59 advises against offering belts or corsets for managing low back pain. Belts are not an established protective measure for lifting (C) and giving them only to pickers with previous back pain does not make an ineffective control effective (A). The Manual Handling Operations Regulations 1992 point at the task: avoid, assess and reduce the handling risk. Training in lifting technique on its own has limited effect on back injury rates (B) and spinal X-rays do not predict who will injure their back (D).

Question 6 (chemical hazards): blood-lead levels for a young person

Blood-lead action and suspension levels under the Control of Lead at Work Regulations for a young person under 18

Which of the following statements is correct?

A  A young person is subject to exactly the same blood-lead levels as an adult employee
B  No blood-lead monitoring is needed for an employee under eighteen, however significant the exposure
C  The action level is 40 micrograms per decilitre and the suspension level is 50 micrograms per decilitre
D  The employer may not employ anyone under eighteen in any work that involves lead at all
E  Young persons are suspended only once the blood-lead level reaches 60 micrograms per decilitre

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The answer is C: The action level is 40 micrograms per decilitre and the suspension level is 50 micrograms per decilitre.

The Regulations set lower blood-lead levels for a young person than for other employees, with lower levels again for a woman of reproductive capacity (A). For a young person the action level is 40 and the suspension level 50 micrograms per decilitre; 60 is the general suspension level for other employees (E). Medical surveillance applies to any employee, young persons included, whose exposure to lead is significant; what differs for a young person is the lower action and suspension levels, not the definition of significant exposure (B). Young people may do lead work, although specified activities in lead smelting and refining and in lead-acid battery manufacture are closed to them (D).

Question 7 (sickness absence): the right to request flexible working

Regarding the statutory right to request flexible working in Great Britain:

Which of the following statements is true?

A  Employees need 26 weeks of continuous service before they are able to apply
B  It is a day-one right that needs no minimum period of prior service
C  Only one statutory request may be made in any 12-month period
D  The employer has three months to decide, including any appeal
E  The employer may refuse a request for any reason it chooses

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The answer is B: It is a day-one right that needs no minimum period of prior service.

Since 6 April 2024 an employee may make a statutory flexible working request from the first day of employment. A, C and D are the old rules: the 26-week qualifying period has been removed, two requests may now be made in any 12-month period and the employer must deal with a request, including any appeal, within two months unless the employee agrees to an extension. The right is to request, not to have, but the employer must consult before refusing and may refuse only on one of eight statutory business grounds (E).

Question 8 (principles of occupational health): a manager’s request about a urine sample

At his pre-placement assessment a warehouse applicant gives a urine sample for glucose testing. The manager then asks the OH nurse to send the same sample for a drugs screen because the company is worried about cannabis use.

What is the most appropriate response?

A  Advise that a drugs test needs his specific consent
B  Carry out the drugs screen and tell him about it afterwards
C  Decline, because drug testing is unlawful before placement
D  Send the sample, since he agreed to give urine for testing
E  Test the sample but report only a positive result to the manager

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The answer is A: Advise that a drugs test needs his specific consent.

Consent is specific to its purpose: agreeing to a urine glucose check is not agreement to a drugs screen (D), which carries very different consequences. Telling him afterwards does not create consent (B). Reporting only a positive result still means testing without consent and would disclose sensitive information to the manager without his agreement (E). Drug testing before placement is not unlawful in itself (C): it should follow a written policy that applicants know about in advance, with informed consent, a properly collected sample, confirmation of any non-negative screen and interpretation by a Medical Review Officer.

Question 9 (occupational lung disease): asbestos fibre types

Asbestos fibre types

Which of the following statements is true?

A  Amosite is the form of asbestos commonly known as white asbestos
B  Chrysotile could still be newly installed in UK buildings until 2010
C  Chrysotile is an amphibole with straight needle-like fibres
D  Chrysotile is more potent than crocidolite in causing mesothelioma
E  Crocidolite (blue) and amosite (brown) are both amphibole forms of asbestos

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The answer is E: Crocidolite (blue) and amosite (brown) are both amphibole forms of asbestos.

Chrysotile (white asbestos) is the only serpentine form, with curly, flexible fibres (C). Crocidolite (blue), amosite (brown) and the less common tremolite, actinolite and anthophyllite are amphiboles with straight, needle-like fibres, so amosite is not white asbestos (A). Amphiboles, especially crocidolite, are much more potent causes of mesothelioma than chrysotile, largely because they persist in the lung, although chrysotile is not safe (D). The UK banned the import and use of blue and brown asbestos in 1985 and of white asbestos in 1999 (B).

Question 10 (mental health): NICE guidance on PTSD

Regarding NICE guideline NG116 on treating post-traumatic stress disorder in adults:

Which of the following statements is true?

A  Benzodiazepines are recommended to prevent PTSD after a trauma
B  Counselling without a trauma focus is the first-line treatment
C  Drug treatment is preferred to trauma-focused psychological therapy
D  EMDR is a recommended option for PTSD following non-combat trauma
E  Trauma-focused therapy should wait until a year after the event

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The answer is D: EMDR is a recommended option for PTSD following non-combat trauma.

NG116 recommends eye movement desensitisation and reprocessing for adults with PTSD related to non-combat trauma, alongside trauma-focused cognitive behavioural therapy, the main first-line treatment. Non-trauma-focused counselling is not first line (B). NICE does not recommend drug treatment, including benzodiazepines, to prevent PTSD (A). Psychological therapy is preferred (C): venlafaxine or an SSRI such as sertraline can be considered for adults who prefer drug treatment. There is no requirement to wait a year: trauma-focused CBT can be offered within the first month to people with acute stress disorder or clinically important symptoms (E).

How this fits the platform

The DOccMed package has just over 800 questions in this short format and the longer scenario format, three fixed 80-question papers, a random timed mock and a viva trainer. Free sample questions are on the same page. The Core Tools are free interactive revision tools.

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