Item 39. Anus

Anus exam (visual anal or digital rectal exam [DRE]) is not required unless indicated by past medical history (PMH) or symptoms.  It may be performed at the discretion of the examiner and applicant.     

• If PMH or symptoms do not warrant examination of these items, the AME should mark “normal” in AMCS and annotate in Item 60 that the exam was not indicated and not performed.
• If PMH or symptoms warrant examination of these items, the AME should mark “abnormal” in AMCS and annotate in Item 60 the reason exam was performed and any findings.