The priority of safety issues in ensuring the uninterrupted and accident-free movement of trains, the safety of cargo, the life, health, well-being of passengers and railway workers allows us to consider measures aimed at maintaining health, preventing occupational diseases, developing professionally significant physical, psychological and personal qualities enshrined in regulatory documents defining the procedure for professional inspections in railway transport as part of the technological processes of railway production (Development Strategy of the Russian Railways Holding for the period until 2030; section 5.5. Social block). An increase in information flows, changes in the organizational, logistics, technological, and technical foundations of transport production give rise to situations of high variability and danger. This challenge significantly increases the level of influence of risks of various natures, the implementation of which can lead to socially unfavorable consequences (the occurrence of errors, failures, failures, threats to the safety of cargo, the health and life of workers and passengers). This challenge actualizes the problem of developing the health care competence of railway transport specialists, which belongs to the universal competencies of the “Self-development and selforganization” category. Analysis of scientific and methodological literature and the results of applied research made it possible to summarize the essential characteristics of the concept of “health-preserving competence” and define it as an integrative personal education, the structure and content of which depends on the conditions for the implementation of professional activity, the main functions, actions and operations of the professional activity of specific specialists. The structure of the health-saving competence of railway transport specialists is represented by a set of components: motivational (readiness and attitude towards the implementation of competence), cognitive-activity (knowledge, cognitive skills, practical experience, level of physical fitness and psycho-emotional stability), reflective (self-analysis, selfdevelopment, formation of the self - concept). The logic of forming health care competence can be represented by a movement from a threshold level to a basic level and from there to a higher level - progressive.