medical unfitness

means that currently and for the foreseeable future the member’s physical or mental condition is such that he or she cannot maintain a satisfactory level of performance or cannot perform his or her duties except with extreme pain and discomfort, or with treatment or medication that poses a risk to his or her health, and that subject to the member’s seniority and training, no reasonable alternative placement exists: Provided that this condition is of such a nature that the efficiency and effectiveness will be adversely affected for an unforeseeable period;