🚗 Driving and Medical Conditions — What Every Emergency Doctor (and FRCEM Candidate) Must Know

Introduction

The Final FRCEM exam on 30 September 2025 featured a question about driving advice following a medical condition — a topic many candidates underestimate.
Yet, in real NHS practice, patients ask us daily, “Doctor, when can I drive again?” Whether it’s a professional driver with chest pain or a retired patient after a fracture, the implications are huge.

In this blog, we summarise the most commonly tested driving-related medical conditions from the DVLA 2025 Guidance, highlighting fractures, syncope, epilepsy, TIA, and cardiac disease, with practical take-home points for the Emergency Department and the Final FRCEM SBA.

1️⃣ Fractures and Musculoskeletal Injuries

Functional ability, not radiology, determines fitness to drive.

• Simple wrist or forearm fractures (e.g. displaced Colles’ fracture reduced in ED) — patients may not drive until they can safely control steering, gear, and handbrake without pain or restriction.
• Lower-limb fractures (tibia, ankle) — typically no driving until full weight bearing and able to perform emergency stop safely.
• Plaster casts or splints that limit joint movement = unfit to drive.
• Post-operative orthopaedic fixation — driving when cleared by the treating surgeon and when physical control of vehicle is unimpaired.

🧩 Recent FRCEM SBA (Sept 2025):
A 56-year-old medical secretary drove to work after manipulation of a right-wrist fracture. She asked whether she could continue driving.
Answer: She must not drive until she can control the car safely and has confirmation from her clinician; DVLA notification is not required for a temporary injury.

🔗 Internal link: Trauma & Orthopaedics SBA Category

2️⃣ Syncope and Blackouts

Understanding the underlying cause is crucial for both management and driving advice.

Type of SyncopeGroup 1 (cars/motorcycles)Group 2 (lorries/buses)Vasovagal (with clear trigger) | May drive once cause identified & treated, no restriction. | 3 months off; notify DVLA.
Arrhythmic or cardiac syncope | Must not drive 4 weeks (min) after treatment if cause identified and controlled; 6 months if unexplained. | 12 months off driving.
Unexplained recurrent syncope | 12 months off; notify DVLA. | Permanent bar until cause found.

🔗 Internal link: Cardiovascular SBA Section

3️⃣ Epilepsy and Seizure Disorders

• Single unprovoked seizure: No driving for 12 months (Group 1) and 10 years (Group 2).
• Provoked seizure (e.g. alcohol withdrawal, metabolic): Driving may resume 6 months after full recovery.
• Ongoing epilepsy: Must be seizure-free ≥ 12 months with treatment compliance before resuming Group 1.

🔗 Internal link: Neurology SBA Category

4️⃣ TIA and Stroke

• Stroke or TIA with full recovery: No driving 1 month (Group 1) if no residual deficit; DVLA notification not required.
• Persistent deficit > 1 month: DVLA must be notified.
• Group 2 drivers: 1 year off minimum, mandatory notification.

🔗 Internal link: Neurology – Cerebrovascular Section

5️⃣ Cardiac Conditions

ConditionGroup 1 (cars)Group 2 (lorries/buses)STEMI / NSTEMI (no complication) | Stop 1 week; may resume if clinically stable. | 6 weeks off + DVLA notification.
Elective PCI | 1 week off if no angina or heart failure. | 6 weeks off; notify DVLA.
CABG surgery | 4 weeks off minimum. | 3 months off; DVLA notification.
Stable angina | May drive if symptom-free at rest and not provoked by driving. | Must notify DVLA; licence withdrawn if angina at wheel.
ICD (secondary prevention) | Stop 6 months; DVLA notification. | Permanent bar.
Pacemaker implant | 1 week off; notify DVLA if symptoms persist. | 6 weeks off + DVLA notification.
Cardioversion for AF | 48 h off if sinus rhythm maintained. | 4 weeks off + notification.

🔗 Internal link: Cardiology SBA Category

6️⃣ Commonly Tested FRCEM Scenarios

1. Vasovagal syncope vs unexplained collapse:
   Know the difference between provoked and unexplained causes.
2. ICD implantation:
   Group 1 = 6 months ban (secondary prevention). Group 2 = permanent bar.
3. Post-PCI lorry driver:
   At least 6 weeks off + DVLA notification required.
4. Stroke with residual hemiparesis:
   DVLA notification mandatory; cannot drive until approved.
5. Fracture after manipulation:
   Must not drive until control of vehicle is fully safe; no notification needed for temporary injury.

7️⃣ StudyZone Strategy for SBA Candidates

At FRCEM StudyZone
, our consultant-written SBA questions replicate these real exam patterns:

• Realistic stems set in busy EDs (e.g. “see-and-treat clinic” or “major’s resus bay”).
• Distracting details (pain control, triage pressure) to mirror exam stress.
• Guideline-based explanations referencing DVLA 2025, RCEM Curriculum 2021, and GMC Public Safety guidance.

Try our Mock Exam Simulator (30–120 min) — experience true RCEM timing, detailed analytics, and downloadable certificates to track your progress.

Conclusion

Driving advice is not merely a formality; it is a matter of patient safety and public protection.
 The DVLA 2025 guidance is a living document every Emergency Physician should know, and it remains a high-yield Final FRCEM topic.

So next time a patient asks, “When can I drive?” — you’ll have the answer, and possibly an extra mark on your exam.