Seafarer medical (ENG1)

What is a seafarer (ENG1) medical?

A seafarer medical, usually called an ENG1, is a health check that decides whether you are medically fit to work at sea on a UK-registered ship. It is required for crew on merchant ships and for anyone applying for a UK Certificate of Competency, and is widely used by yacht and superyacht crew. It is a statutory safety check, not a treatment or a general health MOT.

The examination is carried out by a doctor specifically approved by the UK Maritime and Coastguard Agency (MCA). The doctor assesses you against published medical standards (set out in Merchant Shipping Notice MSN 1886, which reflects international maritime and labour standards). The aim is to make sure that, in a place where medical help may be hours or days away and the work is physically demanding, you are not put at undue risk and do not put shipmates at risk.

The doctor checks things such as eyesight and colour vision, hearing, heart and lungs, mobility, and any conditions or medicines that could be dangerous at sea or in an emergency. You are told the outcome — fit, fit with restrictions, or not fit — and the certificate (if issued) is normally valid for up to two years.

An ENG1 medical can find a condition that affects certification. That can be unwelcome, but the standards exist to protect you and the rest of the crew in an environment where help is not close at hand.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

ENG1 vs ML5 (in brief)

Check with your employer, training provider or the MCA which certificate your job actually requires before booking.

Preparing for your test

• Check your employer or training provider actually needs an ENG1 (rather than ML5 or an accepted equivalent) and book an MCA-approved doctor.
• Bring photo ID and any previous seafarer medical certificate.
• Bring any glasses or contact lenses you use, and recent eye-test details if you have them.
• Bring a full list of your medicines and doses, including inhalers, insulin and anything bought over the counter.
• Bring details and letters about any conditions such as diabetes, epilepsy, heart problems, mental-health conditions or sleep apnoea.
• Be ready for vision, colour-vision and hearing tests, and a general physical examination.
• Answer honestly — leaving out a relevant condition can invalidate the certificate and is unsafe at sea.

What happens

The appointment is a structured assessment against the MCA standards, not a treatment. The approved doctor reviews your medical history and medicines, then examines you.

You will usually have your eyesight, colour vision and hearing tested, and your heart, lungs, blood pressure, mobility and general health checked. The doctor is thinking about how a condition might behave at sea, where help can be far away, and about your role in shipboard emergencies. Colour vision matters for some deck roles in particular.

The doctor then decides whether you meet the standard. You are told the outcome — fit, fit with restrictions (such as wearing glasses, or being limited to certain areas or duties), or not fit — and the reasons. If you are fit, the ENG1 certificate is issued, usually for up to two years. The doctor is impartial: their job is to apply the standard honestly, not to pass everyone.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The most important issues at sea are conditions that could suddenly worsen far from help — for example uncontrolled diabetes, heart disease, epilepsy, severe mental-health conditions or significant vision and hearing loss. The ENG1 is deliberately cautious because evacuation can be slow. If you think a condition may affect you, ask the approved doctor what the standard requires, whether a restriction or appeal is possible, and what you can do to meet the standard in future.

Published figures to discuss

There is no meaningful complication rate for this medical, because it is an assessment rather than a procedure. How often seafarers are found unfit or restricted varies widely by age, role and underlying health, and is not published as a single reliable figure. We therefore avoid quoting a percentage and describe outcomes in plain terms instead.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. 'Afterwards' is about the certificate, any restrictions, and what to do if a health issue is found.

• Being asked for an eye test, GP letter or specialist report before a final decision is common.
• A shorter certificate period for closer review is a normal outcome with some conditions.
• A restriction such as 'must wear glasses' is routine and still lets you work.
• Feeling anxious while waiting for the outcome is understandable when your job depends on it.

Aftercare

• Keep your ENG1 certificate safe and carry it as required for joining a vessel.
• If a restriction applies (for example glasses), always follow it at work.
• If a health problem was found, see your GP or specialist and follow the plan.
• Tell an approved doctor if your health changes in a way that could affect your fitness for sea.
• Diarise the expiry date and book your next medical in good time.
• Keep a copy of any report; you can usually see a report before it is shared and ask for factual corrections.
• If you are found not fit, ask about the review or appeal route rather than simply re-booking elsewhere.

• Photo ID
• Previous seafarer medical certificate
• Glasses or contact lenses
• Recent eye-test details if available
• Up-to-date medicines list
• Specialist or GP letters about relevant conditions
• A note of the certificate's expiry date

⚠ Get urgent help if…

• Sudden change or loss of vision, or double vision — get assessed before working at sea.
• Blackout, faint, fit or seizure — seek medical advice and do not join a vessel until reviewed.
• Chest pain, severe breathlessness or palpitations — seek urgent medical care.
• Symptoms of a stroke (face drooping, arm weakness, slurred speech) — call 999 immediately.
• New severe mental-health symptoms or thoughts of self-harm — seek help promptly; sea isolation can make these dangerous.
• Repeated very high or very low blood sugars if you have diabetes.
• Any condition a clinician says makes it unsafe for you to be at sea.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result means you meet the MCA seafarer standard and receive an ENG1, sometimes with sensible restrictions such as wearing glasses. The certificate is usually valid for up to two years and is widely accepted.

A medical cannot guarantee you will stay well throughout the certificate, and it does not remove the need to seek help if your health changes. If you are found not fit, this is often not permanent — many conditions can be treated or stabilised, and you can seek a review or re-examination. The approved doctor should explain exactly what would need to change.

An ENG1 is a snapshot. It is normally valid for up to two years (shorter for younger seafarers or where a condition needs closer review). A new or worsening condition can require an earlier reassessment. Renew in good time before expiry, because joining a ship without a valid certificate is not permitted.

Related tests, treatments or support

Seafarer medicals sit alongside required safety training (such as STCW courses) and, for some roles, additional checks. The ENG1 itself only certifies medical fitness; it does not cover competence or training, which are assessed separately.

Follow-up & long-term care

If you are fit, the next contact is your renewal before expiry. If more information is needed, the approved doctor will tell you what to provide. If a condition is found or you are restricted, you may be referred to your GP or specialist, and told about the review or appeal route.

• Keep long-term conditions such as diabetes, blood pressure and heart conditions well controlled and reviewed.
• Keep your eyesight and hearing checked, especially before renewal.
• Renew your ENG1 before it expires to avoid a gap that stops you working.
• Seek a reassessment if your health changes in a way that could affect fitness for sea.

Repeat, follow-on and what comes next

• Being asked for an eye test, GP letter or specialist report before a decision is common and is not a failure.
• A restriction (such as 'must wear glasses') or a shorter certificate is a frequent, sensible outcome.
• Many people found not fit can be certified later once a condition is treated or stabilised; a review/appeal route exists.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear explanation of the outcome, any restriction, and the certificate's expiry date.
• Honest advice on whether it is safe to go to sea while any condition is treated.
• Signposting to your GP or a specialist if a health problem was found.
• Information on the review or appeal route if you are found not fit.
• A copy of your report and the chance to correct factual errors before it is shared.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The approved doctor's fee, which the MCA caps for the standard ENG1 (extra tests may cost more).
• Whether additional tests are needed, such as detailed eye or hearing assessment.
• Whether the doctor needs to obtain records or specialist reports.
• How quickly you need the appointment and certificate.
• Whether you need a re-examination after illness, injury or a change in health.
• Whether your employer pays or you pay yourself.

• The fee for the ENG1 examination and the certificate.
• Whether vision, colour-vision and hearing tests are included.
• Any extra fee for additional tests or reports.
• What happens, and any cost, if more information is needed before a decision.
• What happens if you are found not fit or are restricted.
• Whether a follow-up or review appointment is included.

On the NHS? The ENG1 is a statutory occupational medical with a fee rather than NHS care; the NHS still treats any condition the medical uncovers.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Do I need an ENG1, an ML5, or an accepted equivalent for my role?
• Do I meet the vision, colour-vision and hearing standards, and will any correction be recorded?
• If I have a condition such as diabetes or a heart problem, what does the MCA standard require?
• If you cannot certify me as fully fit, could I be fit with restrictions, and how do I appeal?
• How long will my certificate last, and why?
• What information goes to my employer, and what stays confidential?
• If my health changes at sea or on leave, when should I be reassessed?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for seafarer medical (eng1)

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: GOV.UK — Seafarer medical certificates: overview (MCA) GOV.UK — Seafarers medical certification guidance (MCA) MCA — Approved Doctor's Manual: Seafarer Medical Examinations MSN 1886 (M+F) — Seafarer medical and eyesight standards (MCA) Faculty of Occupational Medicine — Good Occupational Medical Practice Access to Medical Reports Act 1988 (legislation.gov.uk)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.