Guidance

MSN 1883 (F) Amendment 5 Work in Fishing Convention (No. 188): Medical examination and certification for fishers

Published 31 August 2024

1. Introduction

1.1      The Merchant Shipping (Work in Fishing Convention) (Medical Certification) Regulations 2018, (referred to in this Notice as “the Regulations”) came into force on 30 November 2018. They put into UK law the medical certification provisions of the International Labour Organization’s (ILO) Work in Fishing Convention (No. 188) (“the Convention”).

1.2      The medical fitness standards which fishers must meet to obtain a medical certificate under these Regulations are published in MSN 1886 (M+F).

1.3      The working environment on a fishing vessel can be unforgiving and medical fitness is important because:

• Fishers may work a long way from medical facilities which could put them at risk if they become ill while at sea; even when working relatively close to shore, it will take more time to reach emergency medical treatment, compared to someone working ashore;
• A medical examination may help to prevent a fisher being taken ill when at sea, by identifying when a fisher has an increased risk of developing a medical condition or of sudden incapacity so that treatment can be obtained;
• If a fisher working alone is taken ill, they may not be able to call for help or reach medical assistance;
• Some medical conditions will reduce the fisher’s ability to undertake the strenuous physical activity involved in work in fishing;
• If one fisher is unable to perform their duties properly because they have been taken ill, others working on the vessel or the vessel itself may be put at risk.

1.4      The medical examination may also help to identify a medical condition, or risk of developing a medical condition, at an early stage so that action can be taken to prevent it developing or worsening.

2. Application general

2.1       The Regulations apply to UK-flagged fishing vessels wherever they may be, and for the purposes of inspection as a port State, to non-UK fishing vessels when in a UK port or UK waters. The requirement to hold a valid medical certificate applies to all fishers on those vessels.

2.2      The requirement to hold a medical fitness certificate will apply to those working on fishing vessels as follows:

	Vessel	Operating Pattern	Date Medical Certificate Required	Notes
(1)	FV of any length	Subject to inspection in a foreign port	30 May 2019	ENG1
(2)	FV 24m in length or over	At sea for more than 7 days	30 May 2019	ENG1
(3)	FV 24m in length or over to which (1) and (2) does not apply		30 November 2019	ENG1
(4)	FV under 24m in length	At sea for more than 72 hours	30 November 2019	ENG1
(5)	FV under 24m in length	Operating more than 200 miles from the coastline of the UK or beyond the Continental shelf	30 November 2019	ENG1
(6)	FV over 10m but under 24m in length to which (1), (4) and(5) do not apply		30 November 2023	ENG1[footnote 1]/ML5[footnote 1]
(7)	New entrants on Fishing vessels under 24m in length to which 1, 4 and 5 do not apply		30 November 2023	ENG1[footnote 1]/ML5[footnote 1]
(8)	Existing fishers on fishing vessels of 10m or less, to which 1, 4 and 5 do not apply		No medical required as of 27 March 2024	As per MSN 1915

2.3      “Normally remains at sea for more than 72 hours” means not returning to port within a 72 hour period.

2.4      “at sea”, “sea service” etc. includes work on a fishing vessel in categorised or other internal waters.

2.5      A fisher is every person including the skipper employed or engaged in any capacity on board any fishing vessel. This includes self-employed share fishers. It does not include pilots or fisheries protection officers or others whose role requires them to work on board a fishing vessel for a purpose other than fishing.

2.6        “Fishing vessel owner” means the owner of a fishing vessel or any other organisation or person such as the manager, agent or bareboat charterer who has assumed the responsibility for the operation of the vessel from the owner and who, on assuming such responsibility, has agreed to take over the duties and responsibilities imposed on fishing vessel owners in accordance with the Convention, regardless of whether any other organisation or person fulfils certain duties or responsibilities on behalf of the fishing vessel owner.

2.7      “Existing fisher” for this purpose is defined as those who can evidence that they have already been working on vessels of 10 metres and under for at least four weeks between 30 November 2021 and 30 November 2023 (as per MSN 1915).

2.8       Existing fishers will need to demonstrate they were working on a relevant fishing vessel via one or more of the following means:

• appropriately dated evidence of completion of SEAFISH Basic Health and Safety, or
• Sea service Testimonials e.g. from skippers/the fishing vessel owners/managers, or
• if you are the owner of the vessel, the registration document for the vessel including fishing vessel number, and your name on the document as the owner, or
• other relevant evidence, (as per MSN 1915).

3. Requirement for fishers to hold a medical fitness certificate (Regulation 5)

3.1      As defined in the table above those fishers working on a fishing vessel who need a valid medical fitness certificate must ensure that their medical fitness certificate is on board the vessel while they are working.

For any person working on a fishing vessel which:

• is 24m in length or over, or
• normally remains at sea for more than 72 hours, or
• operates more than 200 miles from the coastline of the UK or beyond the Continental shelf, or
• is subject to inspection in a foreign port

The valid medical fitness certification is:

(i) an ENG 1 issued by a medical practitioner approved by the MCA (known as an approved doctor – see paragraphs 4.2 and 4.3); or

(ii) a certificate of medical fitness issued by the Maritime Authority of any country which is recognised by the UK as equivalent to the UK certificate. The countries whose certificates are recognised as equivalent are listen in MSN 1815. The certificate must show key information in English.

For any person holding a certificate of competence as a skipper on a fishing vessel of 16.5 m and over, the valid medical fitness certificate is an ENG 1 or recognised equivalent as set out in 3.1 (ii) above.

3.2      For persons other than CoC holders working on fishing vessels, or those who are exempt as above and per MSN 1915 which:

• is under 24m in length; or
• does not normally remain at sea for more than 72 hours

The valid medical fitness certificate is either:

(i) an ENG 1 or recognised equivalent as set out in 3.2 above, or

(ii) an ML5 certificate (see section 7)

3.3       In either case, a certificate is only valid until the expiry date shown on the certificate. It must not have been withdrawn or suspended (see section 8).

3.4      It is an offence:          

• to work on a fishing vessel without a valid medical fitness certificate, unless you are exempt as per (MSN 1915);
• to work in a capacity or in a geographical area for which the medical fitness certificate is not valid by virtue of a restriction on the certificate (see paragraph 5.3)
• to work in such a way as to breach a condition, where the certificate has been issued subject to conditions (see paragraph 4.2)

3.5       It is also an offence to employ a fisher to work on a vessel without a valid medical fitness certificate, or in a capacity which is not compliant with a restriction or condition. However, the owner should also consider whether it is possible to accommodate any restrictions by making “reasonable adjustments” to the fisher’s duties or working environment, in compliance with the Equality Act 2010.

Exceptions

3.6 The exceptions

• A fisher whose medical fitness certificate has expired during the course of a voyage may continue to work until the next port of call at which a replacement certificate can be obtained, or for up to three months from the date of expiry of the certificate – whichever is the sooner. The validity of the certificate cannot be extended. A replacement medical fitness certificate must be obtained at the next port at which it is possible to do so.
• This exception should only be used where a certificate expires while in a location where it is impossible to obtain a valid medical certificate – e.g. in a foreign port where there is no UK approved doctor within reach and in a country from which the MCA does not accept the national medical fitness certificate or where this is not available to foreign nationals.

• In urgent cases, and with MCA’s express prior approval, a fisher who has no valid medical fitness certificate may exceptionally join a vessel for a period not exceeding three months, provided that their last medical fitness certificate:

• expired no more than one month ago; and
• was valid for a full 24 months (or 12 months if the fisher is under 18 years of age)

In such a case, the fisher must obtain a replacement medical fitness certificate at the next port at which it is possible to do so. Approval should be requested from MCA’s Medical Administration Team at the details at the end of this Notice.

3.7       A fisher required to hold a valid medical fitness certificate must produce the certificate on demand to a proper authority (for example, an inspector appointed under Section 258 of the Merchant Shipping Act 1995, or a Port State Control Inspector).

4. Statutory standards of medical fitness

4.1      The approved doctor’s decision on a fisher’s medical fitness and issuance of an ENG1 certificate, must follow the statutory medical and eyesight standards set out in MSN 1886 (M+F) The Notice also gives some information about factors the approved doctor will consider in reaching their decision. The Approved Doctors Manual provides further guidance on how to interpret and apply the standards.

4.2       Candidates for an ML5 medical certificate are also subject to the standards  of MSN 1886 (M+F) as assessed by an ML5 assessor if required. (See 7.4)

4.3       Grandfather rights were applicable for existing fishers who applied for their first medical certificate by 30 April 2024. Once a medical certificate has been issued under grandfather rights, the fitness decision and any associated restriction will be carried forward when the medical certificate is renewed, unless and until there is a significant change in the condition, or the fisher seeks to change the work that they do, or their area of operation, or obtain a new certificate of competency etc.

4.3.1   Grandfather rights were applicable for ENG1 and ML5 medical certificates.

4.3.2   Grandfather rights were not applied if a medical condition existed that would have seriously conflicted with maritime or navigational safety, or if the safety of others was reasonably foreseen to be at risk.

5. Application for an ENG 1 medical examination

5.1      A list of approved doctors with contact details is published on the MCA’s webpage.

5.2      For MCA approved doctor in the UK: MCA Approved Doctors UK based

5.3      For MCA approved doctors overseas: MCA Approved Doctors for overseas - GOV.UK (www.gov.uk)

5.4      Approved doctors should be able to offer an appointment for an ENG 1 medical examination within one week of request. Where this is not possible, for instance because of holidays, the approved doctor should normally be able to suggest alternative approved doctors in the vicinity.  However, sometimes the approved doctor who issues an ENG 1 may require the fisher to return to them for any renewal, because they need to monitor a particular medical condition. Fishers who are having difficulty in obtaining an appointment or feel there is a lack of availability in a specific area should notify the Medical Administration Team using the contact details provided at the end of this notice.

5.5      A fisher attending a medical examination will be asked for original, valid and in date photographic identification (passport, driving licence, seafarer’s discharge book/seafarer identity document or national identity document/citizen card) which will be checked by the approved doctor. Any previous medical certificate (ENG 1 or equivalent) or Notice of Failure or Restriction (ENG 3) if applicable, should also be brought to the examination. In addition, if the fisher has a medical condition on which they have received specialist advice, any medical information or reports from consultants should be brought if possible as they are likely to help the AD make a decision.

5.6      The approved doctor will charge a fee for the examination, which is set in legislation and published on the www.gov.uk website.  Where the fisher is employed or has an offer of employment, this cost should be met by the fisher’s employer or company.

About the ENG 1 medical examination

5.7      The approved doctor will ask about the fisher’s medical history, including whether they have had any previous medical examinations for an ENG 1, and the outcome of that examination. The fisher will be required to sign a declaration on the report of the medical examination confirming that the information they have given is correct.

5.8      The fisher should also inform the approved doctor of any medical condition they are aware that they have, or any medical treatment they are undergoing/medication they are taking at the time of the examination. Knowingly withholding such information may be considered as obtaining a certificate under false pretences, which is an offence under fraud legislation.

5.9       The approved doctor will carry out an examination, including testing eyesight and colour vision. See Annex A for further detail.

5.10    The approved doctor will upload full clinical notes of any medical examination, and records including a completed medical report form (known as ENG2) to the Approved Doctors’ Information System (ADIS) which will be retained for ten years. These records may be subject to clinical and administrative audit by the MCA to ensure that approved doctors are following the medical standards and procedures correctly. Information on how personal information is processed and held can be found in the privacy notice.

5.11     The MCA will obtain statistical information (containing no identifiable personal information) on examinations conducted and publish annual statistical returns.

6 Categories of ENG 1 medical fitness

6.1       The following ENG 1 categories are applied in assessing whether or not a fisher is fit in terms of the medical and eyesight standards:

• Category 1: Fit for sea service, with no restrictions.

• Category 2: Fit for sea service, but with restrictions.

• Category 3: Temporarily unfit  for sea service. The approved doctor must specify the duration of the period of unfitness.

• Category 4: Permanently unfit for sea service. This category will normally be considered to last for a minimum of five years and may only be changed at a later date if an approved doctor is presented with medical evidence of the reversal of the original medical condition. Review by a medical referee may also be required.

Restrictions

The approved doctor may issue a “Fit” certificate but specify restrictions on the geographical locations or duties in which the fisher is medically fit to work. This will require discussion with the fisher about their current role and the type of fishing they engage in. This restriction will be written on the face of the ENG 1 certificate, so that any employer, the skipper, owner, and the issuing authority for any Certificate of Competency issued can see it. It will not contain any medical information. Some restrictions may preclude the issue of certain certificates of competency. MCA will advise.

Conditions

Alternatively, the approved doctor may set conditions for the issue of a medical fitness certificate, formally notifying the fisher of measures that must be taken in order for their medical fitness to be maintained. This will be put in writing but will not be written on the ENG 1 certificate since it may contain confidential medical information. Sometimes however, the approved doctor will advise that the fisher must make their employer or skipper aware of the condition agreed, for example where the fisher is required to take regular medication which must be carried on board.

6.2      If the approved doctor issues a medical fitness certificate to the fisher with restrictions, or finds them temporarily unfit or permanently unfit, they will also issue a Notice of Failure/Restriction (form MSF 4106, known as the ENG 3) which the fisher can use to apply for a review of the approved doctor’s decision (known as an “appeal” – see section 9).

6.3      The approved doctor should normally explain to the fisher the medical reasons for the refusal of a certificate or the inclusion of a restriction, as this will help the fisher to understand whether to apply for a review of the decision. (The exception would be if the approved doctor considers that such disclosure would be harmful to the fisher’s health.)

Replacement certificate

6.4      The ENG 1 certificate is the property of the fisher. If a certificate is lost or damaged, the fisher may ask the approved doctor to issue a replacement certificate. This will be at the approved doctor ’s discretion. The replacement certificate will be valid for the remaining validity of the original certificate. An administrative fee may be charged.

6.5       However, if a significant period of time has passed since the medical examination was carried out, the approved doctor may consider that a new examination is required so that they can issue a new certificate, which may be valid for up to two years, in which case the statutory fee for a medical examination will be payable.

6.6      Only the approved doctor who issued the original certificate can issue a replacement without conducting a full examination.

7.  Validity of ENG 1 (Regulation 7)

7.1      The medical fitness certificate will specify the date that the medical examination was carried out and the expiry date of the certificate.

7.2      The maximum validity period for any person of 18 years and over is 2 years, and for those under 18 years old, 1 year.

7.3      If there is a medical reason, an approved doctor may issue a certificate valid for a period of less than those in paragraph 7.2.

7.4      The fishing vessel owner, employer or skipper may at any time require a fisher who holds a valid medical certificate to obtain a new certificate if, as a result of illness, injury or other reasonable cause, they believe the fisher may no longer meet the medical fitness standards.

8. Suspension and cancellation of a certificate (Regulation 10)

8.1        An approved doctor  has the power to suspend or cancel a medical certificate if they have reasonable grounds for believing that:

• there has been significant change in the medical fitness of a person while holding a valid certification; or that

• the person is not complying with the terms of a condition of issue of the certificate; or that

• they did not have full details of the person’s condition at the time of examination, and if they had done so he could not reasonably have considered that the fisher met the required standards; or that

• the medical fitness certificate was not issued in accordance with the Regulations.

8.2        The certificate may be suspended until the person holding it has undergone a further medical examination, or for a specified period, or permanently cancelled, depending on circumstances. The approved doctor has the right under the Regulations to require the holder to surrender their medical certificate.

8.3        A fisher whose medical fitness certificate is suspended for more than three months or cancelled has a right of review (“appeal”) of that suspension or cancellation – see section 9.

9. Application for an ENG review (“appeal” – Regulation 11)

9.1        A fisher (including any fisher applying for their first ENG 1) may apply for a review of the ENG medical decision of the approved doctor if they are found:

• permanently unfit (Category 4), or

• temporarily unfit for more than 3 months (Category 3), or

• fit only for restricted service (Category 2), or

• if their certificate is cancelled or suspended for more than 3 months by an approved doctor

9.2        There is no right of review against a condition notified by an approved doctor or against a decision of temporary unfitness (Category 3) for three months or less or a time limited certificate.

9.3        To apply for a review the fisher should complete the application form which forms part of the Notice of Failure/Restriction (ENG 3) issued by the approved doctor and send it to the MCA’s Medical Administration Team at the details at the end of this Notice. The application should be made within one month of the date of the ENG 3 being issued.

9.4        In signing the application for review, the fisher is also giving consent for the approved doctor to release his or her ENG 2 report form and any other information provided to the approved doctor (including supplementary medical reports, GP letters, or any other information that led to the approved doctor’s decision) to the Medical Referee. If the applicant wishes to submit additional medical evidence in support of their application, they should arrange for this to be sent to the medical referee before the appointment date.

9.5       The MCA’s Medical Administration Team will then arrange for the case to be reviewed by a medical referee appointed by the Secretary of State for Transport. There are referees located in different parts of the United Kingdom and MCA will offer a choice of the most convenient location.

9.6       Before applying for a review, the fisher may wish to review MSN 1886 (M+F), which contains the medical fitness standards (the ENG 3 form will state which clause of the standards is relevant), seek independent medical advice from their GP, or perhaps from their federation/association or employer of fishing vessel owner. The cost of the review, and of any specialist reports required by the medical referee in order to make their decision, is met by the MCA. The fisher is responsible for their travel costs to their appointment, and if having agreed the appointment time with the referee they fail to attend without giving due notice, may be required to cover the cost of the missed appointment. Some reviews may be able to be conducted remotely, depending on the condition/restriction being reviewed. This must be agreed by both the fisher and the referee.

9.7      Where a medical referee has determined that a fisher is permanently unfit to go to sea, MCA will not normally allow a further application for review from that person within five years of that determination.

9.8       The medical referee will normally reach a decision within 2 months of the date on which the review was lodged with the MCA. However, this may take longer if further medical information is needed to make the decision.

10. Application for an ML5 medical certificate

10.1     The application for an ML5 certificate (referred to as the ML5 report form) can be downloaded from ML5 medical report form and certificate (MSF 4112).

10.2    The ML5 report form can be completed by any doctor registered with the UK General Medical Council (GMC) and with a valid licence to practice in the UK. This allows a fisher to ask their GP to complete the form, or another doctor who meets the above criteria if preferred. 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.

10.3    The report form is designed in a question and answer format. If the doctor can complete the form with no ticks in any box indicating a medical problem, or any notes on medical conditions, the doctor may complete and issue the ML5 certificate.

10.4    However, 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, and the applicant will have to be referred to an MCA-appointed medical assessor for a decision. This review is the second step of the medical process for ML5 Medicals. The ‘appeal’ process as detailed in section 10 of this notice is for ENG 1 applicants only.

10.5    The MCA medical assessor will make a decision based on the seafarer’s fitness to undertake their role and the Medical Standards in MSN 1886 Amendment 2 MLC and ILO 188 medical standards. The ML5 referral is a paper based process that does not involve a face to face appointment.  In order to start the referral process the applicant should complete Part D of the ML5 Medical Report (MSF 4112), and send the entire ML5 Medical Report to MCA Medical Administration Team, at the details at the end of this Notice.

10.6    The applicant can provide further information regarding their fitness, this may include medical evidence from their GP, a specialist consultant or optometrist as appropriate. Medical evidence can be submitted with the ML5 form in an envelope marked “Private and Confidential” for forwarding to the MCA ML5 medical assessor.

10.7    Once the ML5 has been referred to the ML5 medical assessor, the assessor has 10 working days to determine whether or not they can issue an ML5 medical certificate based on the evidence provided. If not, they may request additional information be provided by the fisherman.

10.8 The possible outcomes following a ML5 Referral to an ML5 medical assessor are:

• Fit: The certificate has no restrictions placed on it, but may be limited in validity either due to the fisher’s age or if there is a clinical need.

• Fit with Restriction: An ML5 Certificate is issued and the assessor has decided that it is necessary to place restrictions on the seafarer’s area of operation or duties. It may also be limited in validity either due to the fisher’s age or if there is a clinical need.

• Unfit: If after considering all the information available to them, it is clear to the ML5 assessor that the fisher does not meet the medical standards they will be made unfit, and no ML5 certificate will be issued. A letter will be given to the fisher explaining the outcome.

10.9    The ML5 medical assessor will sometimes issue a compliance letter to the applicant to accompany their medical certificate. This is to emphasize that the certificate is issued on the basis of the applicant’s current medical status, including any treatment or monitoring to which they are subject under their GP or consultant. Any change to that treatment may require a review of their medical certification.

10.10   The fisher is not charged for a referral. In order to ensure that the referral is dealt with promptly, it is important to ensure that the medical assessor is provided with all available supporting information they may need to make their decision when the form is submitted.

11. Validity of ML5 Certificate

11.1     The medical fitness certificate will specify the date of issue and the expiry date of the certificate.

11.2     The maximum validity is 5 years for those under 65 years, and for those who are over 65 years old, 1 year.

11.3     If there is a medical reason, an ML5 assessor may issue a certificate valid for a shorter period.

12. Replacement ML5 medical fitness certificate

12.1    The ML5 certificate is the property of the fisher. If a certificate is lost or damaged, the fisher may ask for a replacement certificate. If the ML5 certificate was issued by an ML5 assessor please contact the MCA Medical Administration Team, at the details at the end of this notice. If it was issued by another doctor you will need to contact them directly.

12.2    The replacement certificate will be valid for the remaining validity of the original certificate.

12.3    Only the doctor who issued the original certificate can issue a replacement without conducting a full examination.

13. Reporting of medical conditions (Regulation 9)

13.1     If a fisher is absent from work for 30 days or more (or expects to be) because of illness or injury, they must report the reason as soon as possible to:

• For an ML5 Medical: Contact MCA Medical Administration Team on the details at the end of this Notice, to be advised of the next steps.

• For an ENG 1 Medical: Contact an MCA approved doctor (if practicable the one who issued their certificate). The approved doctor will advise whether a further statutory medical examination is required before the fisherman returns to work.

13.2     If a fisher develops a medical condition or suffers an injury which may affect their fitness to work at sea, they must report this to an approved doctor and, if advised to do so, attend for a medical examination for re-issue of their medical certificate. Likewise, if there is a significant change in treatment for a medical condition, e.g. starting treatment with insulin for diabetes, the fisher must report this as above.

13.3     In either case, once the reason for absence or medical condition is identified, the fisher’s medical fitness certificate is suspended until they have been advised by a medical practitioner whether they need re-examination, and if so have been re-examined.

13.4    Where a fisher on a UK fishing vessel holds a medical certificate issued on behalf of another maritime administration, they should consult the issuing authority. If that is not practicable, advice should be sought from the Maritime and Coastguard Agency, who may advise that the fisher undergoes an examination for an ENG 1 medical certificate.

13.5     A fisher may at any time be required by the fishing vessel owner, their employer or skipper, if in accordance with their terms and conditions, to obtain a new certificate where as a result of illness, injury or reasonable cause it is believed the fisher may no longer meet the appropriate minimum standards.

More information

Medical Administration Team
Maritime and Coastguard Agency
Bay 2/19
Spring Place
105 Commercial Road
Southampton
SO15 1EG

Telephone: +44 (0)203 81 72835

Email: medical@mcga.gov.uk           

Website: www.gov.uk/mca

Please note that all addresses and telephone numbers are correct at time of publishing.

Annex A

What is involved in an ENG1 medical examination?

Length of appointment: An appointment for a medical examination will normally be 30 – 40 minutes. The approved doctor (AD) may delegate some parts of the examination (measuring weight and height, blood pressure readings, vision test etc.) to another health professional in the practice, and the time spent with the AD may not be the whole appointment. The decision on fitness however will be taken by the AD.

Questions about medical history:It is important that the candidate is open and honest about any medical condition they are aware of, and any medication they take or have taken. This will help the AD to make a good decision about the candidate’s fitness to work at sea, including any restrictions on the work that they can safely do. Knowingly withholding information may invalidate the medical fitness certificate, and it is a criminal offence to work without a valid medical certificate. 

It may be necessary, with the candidate’s consent, for the AD to obtain information from the candidate’s General Practitioner or consultant or other doctor providing medical care to the candidate. When it is necessary to consult with other doctors, the usual ethical considerations about patient consent and medical confidentiality apply, but the decision on fitness for work at sea, in accordance with the required standards, rests with the approved doctor, subject to the review procedure (section 9 of this Notice).

Physical examination: The AD will normally want to see the candidate unclothed, at least down to underwear, to assess their physique and mobility. They may, with the candidate’s permission, need to move underwear aside in order to complete the examination. 

The AD will also be looking at –

• Posture, movement and gait
• Condition of skin, especially hands – including scars from past surgery or injury
• Clinical test of hearing, examination of external ear and drum, and mobility
• Clinical test of eye movements, pupil responses and visual fields
• Visual inspection of teeth, gums, mouth and tonsils; if necessary, the AD may ask for details of the candidate’s dentist regarding any recent dental appointments
• The examination of lungs and heart including auscultation and pulses
• Palpation of abdomen
• Standing examination of hernial orifices and leg veins
• Simple neurological screen – reflexes, sensory function, motor co-ordination in arms and legs

Routine tests

The following will be carried out at every full examination i.e. at least 2-yearly:

• Height and weight
• BMI (body mass index) calculated from height and weight
• Pulse rate
• Blood pressure
• Urine test with dipsticks for protein, glucose and blood
• Spirometry or peak flow measurement if the candidate has a respiratory problem
• Vision – distant, near and colour vision tests (Ishihara plate test)

Colour vision: if the candidate fails the Ishihara plate test, a supplementary test will be required for those with navigational lookout duties or engineers. See Appendix 1 to Annex A of MSN 1886 (M+F) Amendment 2 and instructions at the end of this Annex.

Additional tests: Depending on the candidate’s medical history and the findings of the routine test, the AD may require further information from the candidate’s GP or medical consultant. Alternatively, in accordance with international guidelines on medical examinations for seafarers, one or more extra medical tests or procedures may be required before they can make a decision on the candidate’s medical fitness:

• Additional vision test
• Chest X-ray
• Audiogram (hearing test)
• Physical fitness assessment
• Dental check-up and treatment

Some ADs may be able to do the additional tests themselves or they may refer the candidate to someone else who has the correct equipment.

Where requested by the fishing vessel owner, the AD may also undertake immunisations or anti-malaria treatment (for those intending to call at ports in areas with risk of infection) – this is not part of the statutory medical examination.

An additional charge may be made for some tests or for reports. The employer of fishing vessel owner is responsible for these changes (see paragraph 5.6 of this MSN)

Instructions for fishers attending a CAD testing centre for colour vision test

The fisher must take the following documents to the test centre:

A referral document, which can be any one of the following:

• An ENG 3 form (MSF 4106)
• A letter from the approved doctor
• An ML5 form (MSF 4112)
• Application for a seafarer vision test sight test form (MSF 4100) if visual acuity and the Ishihara test were conducted by an optometrist

The fisher will also need to take:

• Any normal glasses or contact lenses worn to correct for refractive errors (colour correcting lenses or glasses are not permitted)
• A statutorily issued form of photo identification document (ID) such as a passport, driving licence or seafarer discharge book. A photocopy or scanned copy is notacceptable.

Published: August 2024

1. Any holder of a Certificate of Competency “CoC” for a vessel of 16m or more requires an ENG 1 ↩ ↩² ↩³ ↩⁴