The ENG1 Medical: What It Tests, What Fails You, and How to Prepare

Every crew member on a commercially registered yacht needs a valid seafarer medical certificate. On a Red Ensign vessel that is the ENG1, issued by a doctor approved by the UK Maritime and Coastguard Agency (MCA). Without it you are not employable, no matter how strong your CV is.

What the ENG1 actually is

The ENG1 confirms you are medically fit to work at sea, where professional help may be hours or days away. It follows the medical standards set out in the Maritime Labour Convention 2006 and the MCA''s published fitness standards (see MSN 1886 on the MCA''s guidance pages at gov.uk). It is not a general health MOT and it is not a fitness test.

What happens in the appointment

Expect 30 to 45 minutes:

• Paperwork and history — previous illnesses, surgery, medication, mental health history. Answer honestly; a declared, managed condition is usually fine, an undeclared one that surfaces later is a serious problem.
• Vision — distance vision, and colour vision for deck and engineering roles.
• Hearing — conversational or audiometric, depending on role.
• Physical examination — height, weight, blood pressure, heart, lungs, abdomen, mobility.
• Urine test — checked for sugar and protein, screening for diabetes and kidney issues.

The outcomes

• Fit for sea service, unrestricted — valid up to two years (one year for under-18s).
• Fit with restrictions — for example, restricted to near-coastal waters, or requiring corrective lenses. Some restrictions still allow you to work; others will close doors.
• Temporarily unfit — a treatable issue, re-examined after a set period.
• Permanently unfit — rare, and appealable through the MCA.

What most commonly causes a problem

In practice, the issues that catch green crew out are:

1. Uncontrolled blood pressure. Turning up dehydrated, hungover or caffeinated inflates readings. Sleep well, drink water, skip the espresso.
2. Colour vision for deck roles. Colour deficiency does not stop you working, but it can restrict you out of deck and engineering. Get tested before you spend money on a deck pathway.
3. Undeclared mental health history. Depression or anxiety is not automatically disqualifying. Being stable, treated and honest is the standard the examiner is looking for. Concealment is what fails people.
4. BMI and mobility. There is no fixed BMI limit, but the examiner assesses whether you can climb, evacuate, and function in an emergency.
5. Medication that cannot be safely managed at sea. Bring a list of exact names and doses.

Practical booking advice

• Use only an MCA-approved doctor. The MCA publishes the official list of approved doctors worldwide at gov.uk; anything else is not valid.
• Expect roughly £90 to £130 in the UK, and comparable prices in Antibes, Palma, Fort Lauderdale and Cape Town.
• Take photo ID, glasses or lenses, and a medication list.
• Book it before your STCW course, not after. Discovering a restriction after you have paid for a week of training is an expensive way to learn.
• Diary the expiry. A lapsed ENG1 mid-season means you stop working that day.

If the flag state is not Red Ensign

Not every yacht is Red Ensign. Marshall Islands, Cayman, Malta and others accept equivalent seafarer medicals, and many accept the ENG1 directly. The ENG1 remains the safest single certificate to hold because it is the most widely recognised across the fleet.

What we do with this

Every Career Roadmap we build sequences the medical before training spend, checks it against the flag states you are realistically targeting, and diarises the expiry so a renewal never costs you a contract.

Sources: UK Maritime and Coastguard Agency seafarer medical guidance (gov.uk); Maritime Labour Convention 2006, Regulation 1.2.