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BackgroundMany specialists encounter issues related to fitness to drive in their practices. We sought to determine the attitudes and practices of Canadian specialists regarding the assessment of medical fitness to drive in older persons.MethodsWe present data from a postal survey of 842 physicians certified in cardiology, endocrinology, geriatric medicine, neurology, neurosurgery, orthopaedic surgery, physical medicine and rehabilitation, or rheumatology regarding their attitudes and practices relating to the assessment of their patients’ fitness to drive.ResultsOverall response rate was 55.1%. Except for rheumatologists (18%), most specialists reported that fitness to drive is an important issue in their practices (68%). Confidence in the ability to assess fitness to drive was low (33%), and the majority (73%) felt they would benefit from further education. There were significant differences (p < .05) in responses between physicians from different provinces, owing to reporting policies. More geriatricians than neurologists report drivers with mild Alzheimer disease to authorities regardless of reporting policy (mandatory 90.7% vs. 56.0%; non-mandatory 84.1% vs. 40.0%) (p < .05).ConclusionsCanadian specialists accept the responsibility of determining their patients’ fitness to drive but are not fully confident in their ability to do so. However, they are receptive to education to improve their skills in this area.