Guidance

Your certificate of medical fitness questions answered

Updated 10 April 2024

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This publication is available at https://www.gov.uk/government/publications/certificates-of-medical-fitness-answering-fishermens-questions/your-certificate-of-medical-fitness-questions-answered

1. Why do fishermen need to have a medical certificate?

The working environment on a fishing vessel can be unforgiving and medical fitness is important. Here are just some of the main reasons why you need a medical certificate.

First and foremost, having a medical fitness certificate reassures you that you’re medically fit. A medical examination may identify a condition or risk you are not aware of, so treatment options can be explored at an early stage. You can take action to prevent things developing or worsening.

You may work a long way from medical facilities. This could suddenly put you at risk if you become ill at sea. Even working relatively close to shore, it may take more time to raise the alarm or access emergency medical treatment. If you become ill when working alone, you may not be able to call for help or reach medical assistance.

Some conditions will reduce your ability to undertake the strenuous physical activity involved in fishing, and a medical certificate will make you aware of those conditions. If you’re not able to perform your duties properly because you have been taken ill, others working on the vessel or the vessel itself may be put at risk.

The regulations do not apply to those whose work is not part of the routine business of the vessel and whose principal place of work is ashore. A person temporarily on board to complete a repair, maintenance or survey work is unlikely to need a medical certificate.

2. What are the two types of medical certificate available, and which one will I need?

To work on a fishing vessel you must have a medical certificate in either the form of an ENG1 (or accepted equivalent) or an ML5.

ML5

An ML5 can be used by those working on vessels under 24 metres, operating within 200 miles of the UK coast and for less than 72 hours at a time. To apply you can print a form from the Seafarers medical certification guidance on GOV.UK, and take it to your GP or a UK General Medical Council registered doctor. An ML5 is valid for a maximum period of 5 years or until your 65th birthday, or one year if you are 65 years or older.

ENG1

An ENG 1 or accepted equivalent is required for those who are on vessels at sea for more than 72 hours, or operating more than 200 miles from the coastline of the UK or beyond the Continental shelf, or are subject to inspection in a foreign port. An ENG1 must be completed by a Maritime and Coastguard Agency (MCA)-approved doctor. You can find a list of approved UK-based doctors on GOV.UK. An ENG1 is valid for a maximum period of 2 years.

If you fall into the criteria for an ML5, an ENG1 is also valid.

3. Who needs an ML5 certificate?

You need an ML5 certificate if you’re:

  • the Master of a passenger ship that does not go to sea (Class IV or V)

  • the Master of a commercial vessel that does not go to sea.

  • the Master or a crew member of a small commercial vessel certificated for Area Category 2 to 6 – no more than 60 miles from a safe haven.

  • a crew member or anyone else (for example catering staff) who normally works on a domestic passenger ship (Class VI or VIA) that goes to sea.

  • any fisher working on a fishing vessel that is over 10m but under 24 metres in length and does not normally remain at sea for more than 72 hours or operates further than 200 miles from the UK coastline.

  • a new entrant to the fishing industry working on a fishing vessel that is under 24 metres in length and does not normally remain at sea for more than 72 hours or operates further than 200 miles from the UK coastline.

You do not need an ML5 medical if you are exempt as per MSN 1915.

4. Who needs an ENG1 certificate?

You need an ENG1 certificate if you’re:

  • a seafarer
  • in charge of a ship
  • serving on a merchant ship or yacht
  • a fisherman on fishing vessels on voyages more than 72 hours, or operating more than 200 miles from the coastline of the UK or beyond the Continental shelf, or are subject to inspection in a foreign port

You can choose to have ENG1 certification if you need an ML5.

5. Why is this happening now?

These certificates are now required by international law. The International Labour Organization Work in Fishing Convention, known as ILO C188, introduced medical certification for fishermen, which came into force in the UK in 2018.

In the UK the decision was made to phase in the requirements for medical certification. This decision was made in consultation with representatives of fishing vessel owners and fishermen.

The phased approach means that fishermen require a medical certificate from 30 November 2023 – 5 years after the legislation came into force.

6. How much does the ML5 or ENG1 certificate and assessment cost and what happens with that money?

There is no set fee for an ML5 certificate, you will need to contact your local GP practice or other UK doctor offering ML5 certification for any charges they may impose. This fee is paid directly to the doctor performing the medical examination. It is not passed on to the MCA or government.

There are also online organisations offering ML5 medicals from £65, but you will need to travel to those locations.

If you decide to get an ENG1 medical certificate instead, the fee for this is currently set at £115. Like the ML5, this fee is paid directly to the doctor performing the medical examination. It’s not passed on to the MCA or government.

7. What if I do not have a doctor or access to a surgery?

Any doctor registered with the UK General Medical Council and with a valid licence to practice can complete the ML5 report.

If you’re not registered with a doctor or practice, or your normal doctor does not have availability, you can contact GP practices in your area for further guidance. There are also maritime medical centres located nationwide who can help.

For an ENG1 certificate, you will need to contact an MCA-approved doctor. A list of MCA-approved doctors in the UK is available.

8. What if when I ask for an ML5 medical my GP says they’ve never heard of it?

You can take along the ML5 report form to the appointment and all the instructions for the doctor are on the form. It may also be helpful to say it’s rather like the system for medical examination for commercial drivers, as doctors may be more familiar with that.

In addition, the MCA is sending out information to Clinical Commissioning Groups (Health Boards in Scotland) explaining about the ML5 medical examination and why fishermen now need it.

9. What happens if I fail the ML5 assessment?

If the doctor ticks the “Yes” box against any of the medical conditions listed, or writes any comments in section 9 of the form, the doctor will not issue the certificate.

This is not a “fail” of the medical assessment.

You will be referred to an MCA-appointed medical assessor for a decision. This will be based on your fitness to undertake your role, taking account of where you work and what you do, and the medical standards in MSN 1886.

10. What are Grandfather Rights (GFR), and are there GFR for existing medical conditions?

Yes – providing you apply for your medical certificate before 30 April 2024 you can be considered for GFRs.

GFRs ensures that, where you can do so without significant risk to your own or others’ health and safety, you are able to continue to work in your current occupation.

If you do not apply for your medical certificate before April, you will not be eligible for GFR. You will be classed as a new entrant that needs to meet the MSN 1886 medical standards.

The medical assessor will then have less flexibility to take into account your history of working with any medical condition.

11. Will this prevent fishermen from work? Will this cause a reduction of fishermen in the industry?

Introducing medical certificates is not to prevent existing fishermen from working.

This certificate provides fishermen with reassurance that they’re medically fit enough to do their work, without causing a risk to themselves or others.

GFR also means those who have a medical condition and may not meet the medical standards in MSN 1886, but do not pose an immediate risk to safety, can continue working. This is provided that the medical certificate is applied for before the 30 April 2024 deadline.

12. I’m colour blind/my eyesight without glasses or contact lenses does not meet the standard. Will I be able to get a medical certificate?

If you’re an existing fishermen who can show that you have worked with a colour vision deficiency or visual acuity which does not meet the unaided standard (for example, without glasses or contact lenses), GFR can be applied. This means that you will be able to continue to work in your current role.

You do however need to be able to meet the standard for visual acuity with glasses or contact lenses.

13. How will these certificates help against the risk of other incidents at sea?

Being medically fit may increase your chances of survival in the event of an operational accident or incident on board.

14. How is Body Mass Index (BMI) taken into account during the medical assessment?

There is no cut-off for BMI above which a certificate cannot be issued.

BMI is used only as a trigger for further investigation of medical conditions the risk of which statistically increases with a BMI above 35 and for the assessment of physical capability that reduces with an increasing BMI. At the initial medical examination for an ML5, the doctor completing the report form cannot issue a medical certificate on the day, but if the fisher goes to the next stage and submits their medical report to MCA for consideration by MCA-approved medical assessors (for which there is no additional cost to the fisherman), the assessor will consider other factors and can, and regularly do, issue medical fitness certificates to those with BMIs well above 35.

15. What is the difference between an ML5 and an ENG1?

ENG 1 ML5
• The ENG 1 medical examination fully meets the requirements of ILO 188 and STCW.-F and is in-line with the ILO/IMO medical fitness standards for seafarers, so can be used worldwide if applicable. • The ML5 is not compliant with ILO or STCW and therefore cannot be used internationally.
• The ENG 1 medical examination is conducted by MCA approved doctors, who have undertaken MCA training, they have the support of the MCA Medical Administration Team, Chief Medical Adviser and the Approved Doctor’s manual, this contains decision trees to aid with complex assessments. • The ML5 form can be completed by any doctor registered with the GMC and with a valid licence to practice in the UK. This allows a fisherman to ask their GP to complete the form.

If all questions are answered with a no then the doctor can issue the ML5 certificate.
• The majority of seafarers would get a decision on their fitness to work on the day of the examination. • Using the screening form, if there are any questions with a yes answer the ML5 will be referred to an ML5 Assessor. It may take the assessor up to 10 working days (once they have all the relevant information) to make a decision. So it may take about three or four weeks for the decision to be returned to the fishermen.
• The ENG 1 medical has an appeal system in place that can be used should the seafarer feel aggrieved by the decision made by the approved doctor. • If an ML5 is referred to an Assessor to review, their decision is final, there is no subsequent appeal process.
• The ENG 1 is transferable to use with Merchant Navy CoCs if applicable. • The ML5 is not accepted when applying for Merchant Navy CoCs.
• A maximum fee applies for an ENG 1 medical examination currently £115. (NB the future of the ENG1 fee is currently subject to ministerial decision).

• There is no additional cost to the fishermen if they appeal the decision.		 • There is no prescribed fee for the doctor completing the ML5 form. The fee is at the discretion of the doctor completing the ML5 form. (Anecdotal evidence would suggest that the fee can range from £80 to £250.)

• There is no additional cost to the fishermen if the ML5 is subsequently referred to an Assessor. If additional information is required to enable the assessor to make a decision, there may be a cost to the fisher for tests or reports.”
• The ENG 1 has a maximum validity of 2 years (1 year for under 18s) which does not reduce (unless on clinical grounds) with age. • An ML5 is valid for a maximum of 5 years or until your 65th birthday, or one year if you are 65 years or older.
• An applicant needs to present original, valid and in date photographic identification (passport, driving licence, seafarer’s discharge book/seafarer identity document or national identity document/citizen card are the accepted forms of ID). • ID needs to be checked but could include other documents at the discretion of the doctor.

16. There’s hardly any MAIB investigations where medical conditions have been the reason for the incident so what evidence is there that medicals are needed?

We accept that medical conditions are rarely cited as causes or potential causes of accidents and incidents in the MAIB reports. However, MAIB investigate the following (full definitions can be found in the Merchant Shipping (Accident Reporting and Investigation) Regulations 2012) :

  • marine casualties (death or serious injury to a person, loss of a person from a ship, material damage to a ship)
  • serious marine casualties (fire, explosion, collision, grounding, contact, heavy weather damage)
  • very serious marine casualties (total loss of a ship, loss of life or severe pollution)
  • marine incident (other than those listed above which has occurred directly in connection with the operation of a ship that endangered, or if not corrected would endanger the safety of a ship, its occupants or any other person or the environment.)

Royal National Lifeboat Institution’s taskings, His Majesty’s Coastguard helicopter taskings or calls to the Telemedical Advice Services in cases of illness on board are not included in MAIB statistics.

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