Embarrassing Question

[bkkphantom]

I have a rather embarrassing question to ask, and before I ask it I'd like to just say that I'm not the typical sexpat that spends his nights at nana or with as many women as I can cram into a week. I don't need lectures or judgement, just an honest answer.

In March I was diagnosed with secondary syphilis. It has been treated and the doctor has said I'm fine now. However, syphilis tests can remain positive for years (sometimes indefinitely) even after the disease itself has been cured. My question is about a work permit. Several hospitals in BKK have said getting a work permit should be fine seeing as I never had stage 3 syphilis to begin with and that a doctor could determine my treatment was successful despite a positive blood test. Contrary to the hospitals' claim that I would be ok, I'm aware that many schools require blood tests.

If anyone has any insight to post (or pm) it would be greatly appreciated!

[Mario2008]

Syphilis test is for stage 3, not stage 2.

[bkkphantom]

Syphilis test is for stage 3, not stage 2.

Yes, but the blood test isn't really able to differentiate between the stages... that part must be done by a doctor. That's why the requirement of actual test results is so perplexing

[Colabamumbai]

When you go for a physical for a W.P. the employer can ask that the test include blood and urine. Some of the forms can ask for tests for Elephantatis, Syphillis stage 3, T.B. etc

I have applied for 4 work permits, the fourth yesterday. All require a medical certificate do not be afraid. 3 were for teaching positions, schools and one as hotel manager.

Only once did I have to provide a blood and urine sample and I think that this was because I was being given insurance by my employer. More than not the doctor asks how do do you feel? You tell him fine and he signs and stamps the certificate. Don't worry.

[Sateev]

Syphilis test is for stage 3, not stage 2.

No, it's not. There are two types og test for syphilis: treponemal antibody tests, and non-treponemal tests. Of these, the treponemal antibody test is more specific, but less indicative of active infection; the antibodies can be present for many years after successful treatment.

The non-treponemal test measures evidence of active disease, e.g., a cardiolipin which is released when the spirochete damages a cell. It is fairly labile, and not persistent, so after successful treatment, it will drop off quickly.

Whether or not the doctor/clinic treating this condition is doing the proper test(s) is the question. So discuss this with the doctor: tell him you know that antibody tests can remain positive for a long time, but ask if there is another test that will turn negative after successful treatment. If he knows what you are talking about, get the test. If not, seek more competent care.

[Mario2008]

Syphilis test is for stage 3, not stage 2.

No, it's not. There are two types og test for syphilis: treponemal antibody tests, and non-treponemal tests. Of these, the treponemal antibody test is more specific, but less indicative of active infection; the antibodies can be present for many years after successful treatment.

The non-treponemal test measures evidence of active disease, e.g., a cardiolipin which is released when the spirochete damages a cell. It is fairly labile, and not persistent, so after successful treatment, it will drop off quickly.

Whether or not the doctor/clinic treating this condition is doing the proper test(s) is the question. So discuss this with the doctor: tell him you know that antibody tests can remain positive for a long time, but ask if there is another test that will turn negative after successful treatment. If he knows what you are talking about, get the test. If not, seek more competent care.

I was stating the official requirement, which is a check for stage 3 and not 2.

Any doctor can visually see that if one has stage 3.

[QED]

My experience with working here: you will be offered a job subject to medical. This will be a very thorough medical, and failing that will invalidate your job offer.

Once you have the job, then you need a medical for the work permit - this is the one that talks about syphillis, elephantiasis, insanity etc. My experience in the last 4 years is I go to the local clinic, the Dr asks if I am OK, then signs the work permit certificate 2 minutes later for 100 baht fee.

I work in oil and gas where medical fitness is very important, your industry may differ. But from my experience it is the work medical rather than the WP medical that you need to worry about. Good thing about that is that the work medical will normally be conducted in a large private hospital, where you can sit down and discuss everything with the Dr.

Good luck!

[bkkphantom]

Syphilis test is for stage 3, not stage 2.

No, it's not. There are two types og test for syphilis: treponemal antibody tests, and non-treponemal tests. Of these, the treponemal antibody test is more specific, but less indicative of active infection; the antibodies can be present for many years after successful treatment.

The non-treponemal test measures evidence of active disease, e.g., a cardiolipin which is released when the spirochete damages a cell. It is fairly labile, and not persistent, so after successful treatment, it will drop off quickly.

Whether or not the doctor/clinic treating this condition is doing the proper test(s) is the question. So discuss this with the doctor: tell him you know that antibody tests can remain positive for a long time, but ask if there is another test that will turn negative after successful treatment. If he knows what you are talking about, get the test. If not, seek more competent care.

Yes, the VDRL has dropped significantly enough so that any doctor will be able to look at my records and clearly see I am cured. However, it can take over a year for the non-treponemal tests to become negative again. My test is low, but not low enough to become neg in the next few weeks. As Super Member suggested, I think it is the actual employers that are wanting the blood tests and not necessarily the labor office. Even so, I highly doubt a school would hire someone based upon a failed blood test (even if a doctor has said it has been cured)... It isn't really a conversation I look forward to having with potential employers either.

[bkkphantom]

My experience with working here: you will be offered a job subject to medical. This will be a very thorough medical, and failing that will invalidate your job offer.

Once you have the job, then you need a medical for the work permit - this is the one that talks about syphillis, elephantiasis, insanity etc. My experience in the last 4 years is I go to the local clinic, the Dr asks if I am OK, then signs the work permit certificate 2 minutes later for 100 baht fee.

I work in oil and gas where medical fitness is very important, your industry may differ. But from my experience it is the work medical rather than the WP medical that you need to worry about. Good thing about that is that the work medical will normally be conducted in a large private hospital, where you can sit down and discuss everything with the Dr.

Good luck!

Were you renewing your exisiting WP or getting a new one each time? I'm not worried about a "real" medicial check as I'm super healthy and free from everything else. I am just worried because I know how inconsistent things can be here in Thailand and I read something on one of the boards about a girl having her job offer retracted after failing the blood test.

[Mario2008]

You just go to a(nother) government hospital for the health check, which would not cost very much.

It is the labour office that insist on the check, it is one of their official requirement.

[Dork]

If you are worried because you can't be sure what the test result is going to be, why not go to any random private hospital and have the test done yourself - even under an assumed name? You can do that easily. Then at least you will know what the next step should be. If negative, fine. If positive then go and see a Doctor and explain your predicament. I'm sure you could find a sympathetic one that would know what to do.

What exactly is the Labour Departments requirement regarding the certificate? Does it specify the exact type of test? Also, does it specify from which hospitals/clinics the certificate must come from?

[Mario2008]

Requirement for the test depend on the labour office in question. Some now inist on the blood test, while others still accept the old form without blood check. (Shame is that for stage 3 a blood check is not really needed, it is easily detected that someone is sick).

[bkkphantom]

What exactly is the Labour Departments requirement regarding the certificate? Does it specify the exact type of test? Also, does it specify from which hospitals/clinics the certificate must come from?

I guess this is the question of the day. According to the hospitals I spoke with I can get a work permit without any trouble because it's visibly obvious I don't have stage three syphilis. Bumrumgrad even said over the phone that no blood check was needed. But there is a lot of anecdotal evidence of schools requiring bloodwork results. Which, if this is the case, why aren't they actually checking for more significant things?

[bkkphantom]

Requirement for the test depend on the labour office in question. Some now inist on the blood test, while others still accept the old form without blood check. (Shame is that for stage 3 a blood check is not really needed, it is easily detected that someone is sick).

This makes sense (as much sense can made of it anyway) I didn't realize there were that many labour offices in BKK. And since the blood tests aren't REALLY able to differentiate the stages all that well, how is it that it can trump a doctor's opinion (the original checklist)? I thought it was a silly thing before, but now that it's something I'm having to deal with, I find it even sillier.

[Dork]

What exactly is the Labour Departments requirement regarding the certificate? Does it specify the exact type of test? Also, does it specify from which hospitals/clinics the certificate must come from?

I guess this is the question of the day. According to the hospitals I spoke with I can get a work permit without any trouble because it's visibly obvious I don't have stage three syphilis. Bumrumgrad even said over the phone that no blood check was needed. But there is a lot of anecdotal evidence of schools requiring bloodwork results. Which, if this is the case, why aren't they actually checking for more significant things?

But the certificate is required by the Labout Department, not the employer. Unless your employer has their own rules but then that is another story. If Bumrungrad will give you the certificate (without blood test) then I would just go with that. I think it is unlikely they would be wrong. They must process these things on a daily basis.

As for your question why? God only knows who thought that one up. And what has it got to do with whether someone works or not? As far as I know the only work that can spread syphilis is one that foreigners with work permits are unlikely to be doing. Frankly, it's moronic.

[guru]

I can confirm that bumrungrad gave me the certificate 3 weeks ago with just a visual test for stage 3 syphillis and no blood test.

My work permit application is in process so can't confirm yet if the generic bumrungrad wp medical certificate will be accepted this year but it certainly was 2 years ago.

[Dork]

I can confirm that bumrungrad gave me the certificate 3 weeks ago with just a visual test for stage 3 syphillis and no blood test.

My work permit application is in process so can't confirm yet if the generic bumrungrad wp medical certificate will be accepted this year but it certainly was 2 years ago.

Apart from (lack of) Syphilis, what else is mentioned in the certificate? So far I have never had to do the Labour Dept medical.

[maxman71]

I have had 6 physicals for WP's. Some were done at hospitals on the outskirts of BKK that were more "indigenous Thai" in nature. They were very perfunctory; no blood test, maybe checked my blood pressure/heartrate, maybe checked my weight, poked in my ears and thoat, and asked if I was feeling OK. Bam, I got the letter.

Then the last two years I went to an International Hospital clinic in BKK (BNH) and they were much more thorough; chest X-ray, blood test, weight check, heart rate, blood pressure check, vision and color blind test. Still not a comprehensive western style physical, but more complete than the non-international clinics.

Takeaway here is if you want to try and avoid the 3rd stage syphillis test, try a clinic on the outskirts of BKK. Maybe you'll get lucky.

[Dork]

It has just occurred to me that this seemingly bizarre requirement for Syphilis testing must be related to the Social Security medical cover since that is administered by the Labour Department. So perhaps it isn't quite as ridiculous as I previously thought. Duh!

But this begs the question, is Syphilis really so prevalent that it could potentially cost the SS fund a lot of money? I would have thought that there are lots of other diseases/conditions that would present a much higher risk to the fund but which aren't specifically tested for.

I just looked up the statistics for Syphilis in my own country and the incidence is tiny. What gives? Does anyone know?

[QED]

My experience with working here: you will be offered a job subject to medical. This will be a very thorough medical, and failing that will invalidate your job offer.

Once you have the job, then you need a medical for the work permit - this is the one that talks about syphillis, elephantiasis, insanity etc. My experience in the last 4 years is I go to the local clinic, the Dr asks if I am OK, then signs the work permit certificate 2 minutes later for 100 baht fee.

I work in oil and gas where medical fitness is very important, your industry may differ. But from my experience it is the work medical rather than the WP medical that you need to worry about. Good thing about that is that the work medical will normally be conducted in a large private hospital, where you can sit down and discuss everything with the Dr.

Good luck!

Were you renewing your exisiting WP or getting a new one each time? I'm not worried about a "real" medicial check as I'm super healthy and free from everything else. I am just worried because I know how inconsistent things can be here in Thailand and I read something on one of the boards about a girl having her job offer retracted after failing the blood test.

This was both for new and renewal for the last 3 times. I use a small clinic not a hospital, and they have standard forms they complete for the labour office. As the forms are standard I don't think it is down to the labour office or your employer as to whether you have the blood test, I think it is down to the hospital trying to get some more money out of you. I pay 100 baht, but a full medical like one poster described would run into thousands.

[QED]

I can confirm that bumrungrad gave me the certificate 3 weeks ago with just a visual test for stage 3 syphillis and no blood test.

My work permit application is in process so can't confirm yet if the generic bumrungrad wp medical certificate will be accepted this year but it certainly was 2 years ago.

Apart from (lack of) Syphilis, what else is mentioned in the certificate? So far I have never had to do the Labour Dept medical.

Leprosy, acute tuberculosis, elephantiasis, narcotic addition or habitual alcoholism.

How they can tell all that by looking at me and asking if I feel alright, I don't know

[edwardandtubs]

How much is the standard work permit medical at Bumrungrad Hospital?

[moe666]

I can confirm that bumrungrad gave me the certificate 3 weeks ago with just a visual test for stage 3 syphillis and no blood test.

My work permit application is in process so can't confirm yet if the generic bumrungrad wp medical certificate will be accepted this year but it certainly was 2 years ago.

Apart from (lack of) Syphilis, what else is mentioned in the certificate? So far I have never had to do the Labour Dept medical.

Leprosy, acute tuberculosis, elephantiasis, narcotic addition or habitual alcoholism.

How they can tell all that by looking at me and asking if I feel alright, I don't know

Lepraosy no fingers coming off, TB not coughing up blood, elephantiasis, you do not look like the elephant man. Narcotic addiction, no needle in arm, habitual alcoholism, no beer in your hand while being checked.

[philw]

It has just occurred to me that this seemingly bizarre requirement for Syphilis testing must be related to the Social Security medical cover since that is administered by the Labour Department. So perhaps it isn't quite as ridiculous as I previously thought. Duh!

But this begs the question, is Syphilis really so prevalent that it could potentially cost the SS fund a lot of money? I would have thought that there are lots of other diseases/conditions that would present a much higher risk to the fund but which aren't specifically tested for.

I just looked up the statistics for Syphilis in my own country and the incidence is tiny. What gives? Does anyone know?

The medical requirement is aimed at the Burmese but the regulation affects everybody.

Incidence of the S quite high there.

More interesting I can't see how someone would seek advice on a public forum about this.

I think this thread is a wind up.

[Dork]

My experience with working here: you will be offered a job subject to medical. This will be a very thorough medical, and failing that will invalidate your job offer.

Once you have the job, then you need a medical for the work permit - this is the one that talks about syphillis, elephantiasis, insanity etc. My experience in the last 4 years is I go to the local clinic, the Dr asks if I am OK, then signs the work permit certificate 2 minutes later for 100 baht fee.

I work in oil and gas where medical fitness is very important, your industry may differ. But from my experience it is the work medical rather than the WP medical that you need to worry about. Good thing about that is that the work medical will normally be conducted in a large private hospital, where you can sit down and discuss everything with the Dr.

Good luck!

Were you renewing your exisiting WP or getting a new one each time? I'm not worried about a "real" medicial check as I'm super healthy and free from everything else. I am just worried because I know how inconsistent things can be here in Thailand and I read something on one of the boards about a girl having her job offer retracted after failing the blood test.

This was both for new and renewal for the last 3 times. I use a small clinic not a hospital, and they have standard forms they complete for the labour office. As the forms are standard I don't think it is down to the labour office or your employer as to whether you have the blood test, I think it is down to the hospital trying to get some more money out of you. I pay 100 baht, but a full medical like one poster described would run into thousands.

I think you may have hit the nail on the head.

So the answer is go to a hospital/clinic, tell them you need a WP medical certificate but that you're not going to pay for any blood tests. If they refuse, say thanks & walk away. Then go somewhere else.

[therealmrbrightside]

I heard that the reason why they check for stage 3 Syphilis was because this was another way of diagnosing HIV in it's early stages??. I also did the WP medical and got checked for Elephantitis, Leprosy etc etc, but as this is Thailand a quick 500thb under the table and the doc gave me the certificate..Now I am happily teaching at a school in Rayong - I'm the teacher with no fingers or toes and a pair of gigantic <deleted>.