Brentwood Fire Department did not have medical examination for its fire fighters beyond the most basic medical examination required of all city employees. The city required each fire fighter to pass a physical performance appraisal (PPA) twice a year to remain employed. Two problems revolved around the limited medical examination. 1. Were fire fighters physiologically prepared to complete the PPA (and ultimately their job)? 2. The city also had inadequate baseline medical information for each employee. The purpose of this research was to investigate medical examination standards. Evaluative research was used to answer the following questions: 1. What are the current national consensus standards, relevant Tennessee laws, or national laws relative to medical examinations? 2. What consensus standards, if any, are other fire departments in Tennessee utilizing? 3.What components do physicians in Tennessee believe are required for medical examinations? 4. What components should the new medical examination for the Brentwood fire fighters contain? The procedures included a literature review of the relevant literature. A survey of fire departments in Tennessee was conducted to ascertain what standards they were utilizing. A survey was also given to physicians to determine what components they felt were necessary for a fire fighter medical examination. The results revealed that firefighter medical standards must be identical for the incumbents and applicants. The majority of Tennessee fire department are unable, at the current time, to comply with NFPA 1582. Physicians agree that the guidance in NFPA 1582 is very strict and should ensure that a fire fighter should be able to perform the essential duties contained in the job description.It was recommended that the Brentwood Fire Department continue with implementation of its new medical examination. Incumbents are currently subject to random drug screening, so therefore it is only included in an applicant examination.