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Maritime and Coastguard Agency

Guidance

Seafarers: medical certification guidance

How to get an ENG1 or ML5 medical certificate.

Contents

• Overview
• What is a 'seafarer'?
• Seafarers and other crew members: which medical certificate do you need?
• ENG 1 and Maritime Labour Convention (MLC) compliance
• Seafarers getting an ENG1: find an MCA AD to carry out your ENG1
• Seafarers getting an ENG1 equivalent: find countries whose certificates are accepted on UK flag vessels
• ENG1 ADs for companies and healthcare providers
• Your ENG1 or ML5 medical: what to take with you
• Your ENG1 medical: What it covers and what happens
• Your ENG1 medical results
• What to do if you're found 'permanently unfit' for your ENG1
• If you want to have an independent medical review
• ENG1 additional colour vision tests
• The cost of an ENG1 or ML5
• Guidance for seafarers and other crew getting an ML5 certificate
• What happens if your doctor can't issue your ML5 certificate
• Seafarers with ENG1s who also need UK Oil and Gas (UKOG) medical certificates
• Seafarers who need both UKOG certificates and ENG1s
• Further information
• Contact MCA´s seafarer services

The Maritime and Coastguard Agency (MCA) collect and retain personal information provided on the medical examination of seafarers report form (ENG 2) the seafarer medical examination notice of failure/restriction (ENG 3), the certificate of medical fitness (ENG 1), and any seafarer medical report forms (ML5), which are referred to MCA for assessment.

We will use this information to fulfil our duties as stated in the Merchant Shipping (Maritime Labour Convention) (Medical Certification) Regulations 2010 (which implement the UK's international obligations under Maritime Labour Convention, 2006), the ILO Work in Fishing Convention (C.188) and the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978, as amended (STCW).

To find out more about how the MCA looks after personal data, your rights and how to contacts our data protection officer please go to the MCA personal information charter page.

Overview

As a seafarer, it's important that you are fit for the job you are doing on a day-to-day basis, and during emergencies.

A medical examination will find out if you have a health condition that could result in you needing urgent treatment, or potentially put fellow crew or passengers' lives at risk.

If you are employed on a ship, and it's your normal place of work, then regulations require you to have a medical examination. This is to prove that you are in good enough health and fitness to carry out your duties.

This guide tells you which of the two medical certificates you need, how to get it, and where to find a doctor to carry out a medical fitness examination. It also tells you what to do if you fail, and want to get your result reviewed.

What is a 'seafarer'?

The Maritime Labour Convention (MLC) states:

• 'A seafarer is any person, including a master, who is employed or engaged or works in any capacity on board a ship and whose normal place of work is on a ship.'

Seafarers and other crew members: which medical certificate do you need?

You need a seafarer medical certificate (ENG1) if you are:

• in charge of a ship, e.g. ship's captain
• serving on a merchant ship
• a seafarer
• working on a fishing vessel over 24m in length
• working on a fishing vessel less than 24m in length, but are at sea for more than 72 hours or are operating more than 200 miles from the coastline of the UK or beyond the continental shelf
• working on a fishing vessel of any size that is subject to inspection at a foreign port

Any seafarer on board a ship must have an ENG1 (or equivalent) to work on a merchant vessel, or for any UK Certificate of Competency (CoC).

You need an ML5 medical report and certificate if you are:

• master of a non-seagoing passenger ship (Class IV or V)
• master of a commercial non-seagoing vessel
• master and crew of a small commercial vessel (under 24 metres, carrying no more than 12 passengers, going no more than 60 miles from shore)
• crew or other employee (like a steward, security guard, caterer) on a domestic seagoing passenger ship (Class VI or VI(A)).
• working on a fishing vessel under 24m in length that is not subject to inspection in a foreign port, at sea for more than 72 hours or operating more than 200 miles from the coastline of the UK or beyond the continental shelf, and are not exempt as per MSN 1915.

This has to be your normal place of work.

You don't need either certificate if you are employed:

• on a non-commercial pleasure vessel
• on an offshore installation while on its working station
• on-shore as your normal place of work

and/or working during a voyage on a short-term, one-off or temporary basis in roles like:

• a guest lecturer
• a research scientist
• riding crew
• a pilot
• a trainee or a volunteer on a sail training ship (carrying out non safety-critical role)

ENG 1 and Maritime Labour Convention (MLC) compliance

The ENG 1 has been MLC compliant since 2010, when the medical standards were changed. A new merchant shipping notice (MSN) was then published.

STCW requires a doctor to check the Identification Document (ID) at the time of the medical examination but does not require the document number to be entered on the ENG 1. From the end of May 2018, MCA Approved Doctors will not enter ID details on the ENG 1 medical certificate.

MSN 1886 is the most current notice.

This notice also applies if you want to have an independent medical review after failing the ENG1.

MCA are satisfied that the ENG1 is MLC compliant, because the medical examination and certification system meets the MLC's requirements of:

• appointing and training approved doctors (ADs)
• validity of certificates
• your right to appeal the AD's decision if you're unhappy with it
• checking your ID
• the scope of the medical, such as checking your colour vision and (as of 2010) your hearing

Read the 'Merchant Shipping (Maritime Labour Convention) (Medical Examination) Regulations'.

Seafarers getting an ENG1: find an MCA AD to carry out your ENG1

Search MCA's current list of ADs in the UK.

Search MCA's current list of ADs overseas and in international territories.

Search MCA's current list of Doctors who were previously approved.

All lists are updated regularly.

Seafarers getting an ENG1 equivalent: find countries whose certificates are accepted on UK flag vessels

Each country has a list of its own ADs. To get a certificate that's been assessed as equivalent to ENG1, you must contact the relevant country's own maritime authority. They'll give you the locations of their own ADs.

The list updates annex A of MSN 1815 Amendment 6, which lists the countries that can issue equivalent certificates. It's updated as and when medical standards and systems have been assessed for equivalency.

If you are based overseas and are not in of one of the countries above, you could obtain a statutory seafarers medical fitness certificate from one the countries with a 'List of Approved Doctors attached'. These maritime administrations have doctors based overseas that can issue statutory seafarers medical certificates that are equivalent to an ENG 1. Please note the certificate issued will not be an ENG 1 certificate.

For example Norwegian Maritime Authority have approved doctors in Italy, USA, Nigeria and more, who can issue a Norwegian Seafarers Medical Fitness Certificate.

The Netherlands Maritime authority have approved doctors in Russia, Saint-Martin, Indonesia and more, who can issue a Dutch Seafarers Medical Fitness Certificate.

*The Bermuda Maritime Authority seafarer medical certificate is only acceptable if issued by a doctor appointed for Carnival UK or Princess Cruises. Medical certificates issued by these doctors are valid until expiry/unless otherwise invalidated even if the seafarer leaves the company.

**The Malta Maritime Authority has confirmed that the list of duly qualified medical practitioners available in Malta for seafarer medical certificates is the list officially issued by the Malta Medical Council (see below link) which is the official Authority responsible for issuing licences to medical practitioners in Malta's territory.

Please note that a Malta seafarer medical certificate will only be accepted as equivalent to the UK ENG 1 medical certificate if it was completed by a qualified medical practitioner licenced by the Malta Medical Council (see link) and the seafarer medical examination was conducted in Malta's territory. No Maltese seafarer medical certificates issued outside Malta's territory will be accepted. However, from the date of publication of this notice, there will be a grace period of 3 months to allow seafarers already holding such certificates to obtain acceptable medical certificates as listed in this notice.

ENG1 ADs for companies and healthcare providers

See the list of ADs at healthcare providers who carry out seafarer medical examinations for employers.

MCA is legally obliged to publish the providers' and the doctors' names.

Find ENG1 ADs for companies

This list of company ADs is for any seafarer employed by one of the companies listed, and needs to have an ENG1 medical.

Your ENG1 or ML5 medical: what to take with you

Although you'll be told what to take when you make your appointment, don't forget:

• your current ENG1 certificate or equivalent
• any medication you're taking
• any glasses or contact lenses you're using, and spares
• the name and telephone number of your doctor (general practitioner; GP)
• any reports or letters from your GP, if you've recently been to hospital or under a consultant
• current and valid photo ID: passport, driving license, national ID or citizen's card, discharge book/seaman's card

It's important that you tell the approved doctor
if:

• you have failed the ENG1 examination
• you have been issued with restrictions
• you failed to complete an ENG1 examination with another AD

If you don't, it can be seen as 'doctor shopping' - and could invalidate your ENG1.

Your ENG1 medical: What it covers and what happens

The ENG1 medical fitness certificate standards are based on these international guidelines:

• Standards of Training, Certification and Watchkeeping for Seafarers (STCW)
• MLC
• Internal Maritime Organization (IMO)/International Labour Organization (ILO) guidelines on medical examinations of seafarers

The most important conditions that can affect fitness are:

• heart attack (coronary thrombosis)
• problems with the heart rhythm
• Some forms of heart surgery
• heart or artery disease
• lung disease causing shortness of breath
• diabetes treated with insulin (Type 1 or 2)
• stroke
• unexplained loss of consciousness
• epilepsy
• severe head injury or brain surgery
• treatment for mental or nervous problems
• alcohol or drug addiction problems
• severe deafness or difficulty communicating by radio or telephone
• eyesight or colour vision that does not meet standards
• transplants: heart, kidney or other organs; joint replacement; limb prostheses
• conditions that can cause sudden incapacity
• conditions that put you at increased risk of illness while in charge of a vessel (remote from assistance)
• conditions that limit mobility and stamina (under normal and emergency conditions)
• medication with side effects that reduce performance or alertness - and can cause complications while in charge of a vessel

During your ENG1 medical you'll be:

• asked about your medical history by the doctor or a practice nurse
• weighed and measured
• asked to provide a urine sample
• tested on your hearing and sight (for distance, colour and near vision)
• given a physical examination (you will be asked to undress to your underclothes)

Your ENG1 medical results

At the end of the ENG1 examination, the AD will issue you with a certificate of fitness. This can certify you as:

• fit without restrictions (unrestricted)
• fit with restrictions (e.g. limiting your work to certain jobs or locations),
• temporarily or permanently unfit

If you pass the ENG1, you'll get your certificate usually on the day of the examination.

You won't get your ENG1 certificate on the same day if the doctor has any concerns about your fitness, and needs to get additional medical information

You'll get a 'temporarily unfit certificate' if there's likely to be a delay in the doctor's final decision.

What to do if you're found 'permanently unfit' for your ENG1

A 'permanently unfit' result stands for at least five years.

If you want or need to have another ENG1 medical in the next five years, you must show clinical evidence proving the condition that caused this result has been reversed.

The AD will give you a 'notice of Failure/Restriction (ENG 3)' form if:

• you are found unfit, or
• your ENG1 is restricted

The ENG 3 will tell you what to do if you want to have an independent medical review.

If you want to have an independent medical review

You must contact MCA Seafarer Health and Safety Branch within one month of the ENG3 being issued.

MCA will cover the cost of your review - but you will have to pay your own travel expenses.

You will be examined by an independent medical referee.

What you need to take to your independent medical review:

• a passport or discharge book
• job description for your current or most recent job
• your restricted ENG1, if you have been issued one
• the medical paperwork relevant to your current condition or state of health, especially letters from your consultant(s) or GP

To help the referee decide if the original decision of fitness was sound, they can also ask for:

• additional testing to be done
• additional specialist opinions

The referee will take all of this information into account, and make a final assessment of your fitness.

Please note: the referee has a level of discretionary power above the AD's, but they're still bound by the medical fitness standards in MSN 1886.

If all the evidence supports it, the referee can issue you with a revised ENG1 certificate.

Their decision is final - they won't overturn the AD's original decision just because you have asked for a review.

List of MCA medical referees

ENG1 additional colour vision tests

Seafarers: what happens if you fail an Isihara plate screening

Deck department:

The MCA has made the decision to stop conducting lantern testing. If you have evidence that you have previously passed a MCA Holmes Wright B lantern test, you do not need to take a further CAD test.

The new colour vision test is the Colour Assessment and Diagnosis (CAD) test which measures the severity and type of colour vision loss, and reliably detects congenital deficiency. The CAD test was developed by City University in conjunction with the UK's Civil Aviation Authority (CAA) and is being used by the aviation industry worldwide.

See MIN 564 and MSN 1886 for

• a list of CAD test centres,
• information a seafarer will need to take to the CAD test
• to arrange a CAD test, contact the Centre directly. Please note there is a charge for the test that will need to be paid to the CAD centre directly.

The AD will normally wait for the result to come back before completing the ENG1 certificate.

You'll be issued an unrestricted ENG1 if:

• you pass the CAD test
• and have no other medical conditions that can affect your fitness to work at sea

If you fail the CAD test you'll be issued an ENG1 with the restriction "Not Fit for lookout duties at night. Not eligible for MCA CoC or Rating certification" and the certificate will be ticked 'not fit for lookout duties'.

You'll get a letter from the CAD test centre to confirm this result. Take this with you to your next and future examinations.

New entrant deck candidates:

If you do not pass the CAD test, you'll be unable to get a CoC as a deck officer. If you decide, after career advice, not to pursue another seafaring career, you'll be issued with an ENG3 Cat 4 'permanently unfit'.

Engineering department:

Your AD will need to arrange a City University or Farnsworth D15 colour vision test for you.

If you pass either the City University or the Farnsworth D15 colour vision test you'll be issued an unrestricted ENG1. This is if you have no other conditions that can affect your fitness to work at sea.

If you fail the City University or Farnsworth D15 colour vision test you'll be issued an ENG1 with the restriction 'not fit for work with colour coded cables or equipment'. It will be ticked 'not fit for lookout duties'.

Other departments such as catering or hotel

If you fail the colour vision test you'll be issued an ENG1 with the restriction 'not fit for lookout duties'. It'll be ticked 'not fit for lookout duties'.

Maritime security guards: read the guidance for maritime security guards and their employers.

The cost of an ENG1 or ML5

The cost of an ENG1

The current fee for an ENG1 is £115.

If you are employed in the UK, your employer will pay this.

The limit is set in UK regulations.

If you need any extra tests (like a step test), the approved doctor can charge more. This must be agreed with whoever is paying for the ENG1 before you have the test(s).

The cost of an ML5

There is no set price for the ML5.

It isn't regulated by MCA, as it's considered a private transaction.

Ask your doctor how much the ML5 will cost before they complete your report.

Guidance for seafarers and other crew getting an ML5 certificate

You don't need an AD to carry out your ML5 medical. You can print the ML5 form and certificate, or also get your form from:

• the Royal Yachting Association (RYA)
• your local Marine Office.

Take the ML5 report form to any doctor registered with GMC (General Medical Council), and with a valid licence to practice.

The doctor will complete your ML5 certificate if:

• there are no ticks in the 'yes' box (this shows there might be a medical problem)
• there are no other notes on medical conditions

You can then send this with your application for issue or revalidation of a boatmaster's licence (BML) or RYA commercial endorsement.

You won't get an ML5 certificate if you're found, during the medical examination, to have any type of condition which may make you unfit for service - and the box is ticked to show this.

The completed report and blank certificate will be returned to you.

What happens if your doctor can't issue your ML5 certificate

If you are applying for your ML5 due to the change in fishing regulations or you want to continue with your BML or commercial endorsement application, you´ll need to complete part D of the ML5 report.

You will then need to send your completed ML5 report to one of the below:

• BML applications - to your local marine office or to the Registry of Shipping and Seamen in Cardiff (depending on who may be processing your application).
• RYA commercial endorsements - the ML5 should be included within your application direct to RYA.
• Fishing - the ML5 can be sent by email to medical@mcga.gov.uk or post to;

Maritime Coastguard Agency
Medical Administration Team
Spring Place
105 Commercial Road
Southampton
Hampshire
SO15 1EG

This will then be reviewed by an MCA medical assessor. They’ll issue your ML5 certificate if they find you fit for sea service, but this certificate may be subject to restrictions.

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. The assessor may also decide if it is necessary to place restrictions on the seafarer’s area of operation or duties.

Seafarers with ENG1s who also need UK Oil and Gas (UKOG) medical certificates

A UKOG medical certificate isn't equivalent to an ENG1, as they are two separate medicals which serve two different purposes:

UKOG is an employer's medical. Its medical standards have been produced to meet the needs and requirements of the employer.

ENG1 is statutory - it's required by law for all seafarers working on board a UK flagged vessel.

Seafarers who need both UKOG certificates and ENG1s

If you need to have both the ENG1 and the UKOG medicals, check MCA's list of ADs before making your appointment.

You could find one doctor to carry out both at the same time.

Further information

Health and safety on ships

Contact MCA´s seafarer services

UsA DataErol.