ENG1 Medical Test: What Happens, and Can You Fail It?
You've booked your ENG1 medical test and now you want to know what actually happens in the room. You might also be quietly worried about your eyesight, a medication you take, or something in your medical history.
This post goes through the exam in order and explains what each possible result means. If you haven't booked yet, or you want to know about cost, validity and renewal, start with our ENG1 medical certificate guide.
It's general information, not medical advice. If you have a specific condition, read the official guidance or ring the approved doctor's practice before your appointment. They would much rather hear about it in advance than on the day.
What to bring to your ENG1 medical
The gov.uk "how to apply" page lists what you need:
- An accepted form of photo ID, such as your passport
- Your previous medical certificate, if you have one
- Your own doctor's name, address and contact details
- Any medication you're taking
- Your glasses or contact lenses, but not colour-correction lenses
The MCA's medical certification guidance also asks you to bring spare glasses or lenses, and any reports or letters from your GP if you've recently been in hospital or under a consultant. If you have an ongoing condition, take the paperwork. A specialist's letter showing that your condition is stable and well managed can be the difference between a decision on the day and a delay while the doctor chases the information.
Most ENG1 medicals happen in an ordinary clinic room like this one, at an MCA-approved doctor's practice. Photo: Harrison Keely, CC BY 4.0.
What does an ENG1 medical consist of?
The MCA's guidance describes the same core steps for everyone, and none of them is a fitness test. Expect a normal GP-style appointment.
1. Medical history
The doctor or a practice nurse will go through your medical history with you. Be completely honest, especially about any previous ENG1 that was failed or restricted, or any exam with another approved doctor that you didn't finish. The MCA warns that leaving these out can be treated as "doctor shopping" and could invalidate your ENG1. A certificate can also be suspended or cancelled if the doctor didn't have full information when they examined you (MSN 1886 Amendment 3, para 4.1).
2. Height and weight
You'll be weighed and measured. This matters more than people expect. In the MCA's ENG1 annual report for 2025, obesity was one of the most common reasons for a restriction or unfit result.
3. Urine sample
You'll be asked for a urine sample. Some clinics ask for it as soon as you arrive, so it helps to turn up without having just been to the toilet.
4. Eye test
Your distance and near vision are tested, one eye at a time. You need to meet a higher standard with your glasses or contacts if you wear them, and a minimum standard without them (MSN 1886, para 3.4).
Eyesight is checked one eye at a time on a letter chart, with your glasses or contacts if you wear them. Photo: Beendy234, public domain.
5. Hearing test
Your hearing is tested too. The hearing problem the MCA's guidance lists is "severe deafness or difficulty communicating by radio or telephone."
6. Physical examination
Finally there's a physical examination, for which you undress to your underwear. The doctor is checking that you have no condition that working at sea could make worse, and none that would put you or the rest of the crew at unacceptable risk. If you pass, you'll usually get your certificate the same day. If the doctor needs more medical information first, you'll have to wait for it.
ENG1 colour vision test: why it matters for deck crew
Colour vision is screened using Ishihara plates, the circles of coloured dots with a number hidden inside (MSN 1886, para 3.4). This is the part of the exam with the biggest effect on your career, and it mainly affects people who want to work on deck.
An Ishihara plate, the standard colour vision screen at an ENG1. Deck crew who can't read the plates need to pass a further lantern or CAD test, or carry a lookout restriction. Photo: Shinobu Ishihara, public domain.
If you fail the Ishihara test, the restriction depends on your department (MCA guidance):
| Department | Restriction |
|---|---|
| Deck | "Not fit for lookout duties at night. Not eligible for MCA CoC or rating certification." |
| Engineering | "Not fit for work with colour coded cables or equipment," and not fit for lookout duties |
| Interior / catering | "Not fit for lookout duties." |
Deck crew still have a route. You can be reconsidered if you pass the HWB lantern test or the CAD (Colour Assessment and Diagnosis) test. The CAD test is done at an MCA-approved centre, which charges its own fee that you pay directly (MSN 1886, para 3.4). If you plan to work up through the deck tickets, sort this out early. Don't wait until you've paid for an OOW course.
Does the ENG1 medical test for drugs?
Neither the MCA's guidance for seafarers nor MSN 1886 includes a drug screen in the exam steps. Neither says what the urine sample is tested for. The guidance does list alcohol or drug addiction problems among the conditions that can affect your fitness, as well as medication with side effects that reduce performance or alertness. Answer the questions about drugs, alcohol and medication truthfully.
How can you fail an ENG1 medical?
Not many people do. In 2025, 88% of ENG1 exams ended with an unrestricted certificate, 6% were restricted, 5% were temporarily unfit and fewer than 1% were permanently unfit (ENG1 annual report 2025).
The most common reasons for a restriction or unfit result were obesity, high blood pressure and mild mood disorders. Diabetes, eyesight and colour vision, hearing, heart problems, cancer, asthma and allergies also came up. The MCA's guidance also names heart attack, insulin-treated diabetes, epilepsy, stroke, mental health conditions and substance addiction.
Having one of these conditions doesn't automatically mean you fail. The doctor is judging whether your condition is controlled and safe at sea, which is why the letters from your GP or specialist matter.
ENG1 results: the four outcomes and the ENG3
Every exam ends in one of four categories (MSN 1886, para 3.5):
| Category | Result | What you get |
|---|---|---|
| 1 | Fit, no restrictions | ENG1 |
| 2 | Fit with restrictions (e.g. limits on certain duties or areas) | ENG1 with restrictions, plus an ENG3 |
| 3 | Temporarily unfit, for a period the doctor specifies | ENG3 if longer than three months |
| 4 | Permanently unfit, normally for at least five years | ENG3 |
The ENG3 is the Notice of Failure/Restriction. It explains the decision and how to ask for a review. A period of temporary unfitness can be anything from a few weeks to a year or more.
Failed your ENG1 medical? Asking for a review
If you get an ENG3 and think the decision is wrong, you can ask for a review by an independent medical referee:
- Who can apply: anyone given a restriction, found permanently unfit, or found temporarily unfit for more than three months. Temporary unfitness of three months or less can't be reviewed.
- Deadline: apply to the MCA within one month of the date on the ENG3. Use the address on the form, and don't contact the referees directly.
- Cost: the MCA pays for the review. You pay your own travel.
- What happens: the referee examines you and may ask for further tests or specialist opinions. They should reach a decision within two months, and that decision is final.
Bring up-to-date letters from your GP or consultant. A review won't overturn the original decision just because you asked for one. You need evidence.
After your ENG1 medical test
Keep a clear photo of your certificate, because you'll be asked for it constantly. If you're getting yours outside the UK, see our guides to getting an ENG1 in Fort Lauderdale and the USA and ENG1 equivalent certificates.
Once you have it, upload it to your Radius profile along with your STCW and CV. Verified crew show up on the map captains use to find dayworkers nearby, so you're not relying only on dockwalking and Facebook groups.