Fitness-for-duty medical standards by flag
Comparative reference for seafarers evaluating flag-state contracts. Medical, pension, and taxation regimes differ substantially by flag and materially affect take-home pay, family security, and long-term financial planning. Every seafarer must renew a fitness-for-duty medical certificate at least every 2 years under STCW Regulation I/9. The specific thresholds — colour vision, best-corrected visual acuity (BCVA), hearing thresholds, BMI cutoffs — vary by flag administration. This table compares the 15 major flag states with substantial seafarer intake.
| Flag | Certificate | Colour vision | BCVA | Hearing (dB) | Cost USD |
|---|---|---|---|---|---|
| China | MSA (Maritime Safety Administration) Medical Certificate | Ishihara required for deck | 6/6 corrected | 30 dB at 500-2000 Hz | $45 |
| Croatia | Ministry of Sea Medical Certificate | Ishihara required for deck | 6/6 corrected | 30 dB at 500-2000 Hz | $50 |
| Denmark | DMA (Danish Maritime Authority) Medical Certificate | Ishihara required | 6/6 corrected | 30 dB at 500-2000 Hz | $180 |
| Greece | HRMM (Hellenic Ministry of Maritime) Medical Certificate | Ishihara required for deck | 6/6 corrected | 30 dB at 500-2000 Hz | $80 |
| India | DG Shipping Medical Certificate (Form MS-1) | Ishihara — pass 15/15 for deck; 12/15 for engine | 6/6 corrected for deck; 6/9 for engine | 30 dB at 500-2000 Hz | $30 |
| Japan | MLIT (Ministry of Land, Infrastructure, Transport and Tourism) Medical | Ishihara required | 6/6 corrected | 30 dB at 500-2000 Hz | $120 |
| Marshall Islands (RMI) | RMI-approved medical certificate (any state-issued STCW-compliant certificate accepted) | Ishihara required for deck (STCW compliant) | 6/6 corrected | 30 dB at 500-2000 Hz | $100 |
| Norway | SDIR (Sjøfartsdirektoratet) Medical Certificate | Ishihara; deck OOW must pass | 6/6 corrected | 30 dB at 500-2000 Hz | $200 |
| Panama | AMP-approved medical (STCW compliant) | Ishihara required for deck | 6/6 corrected | 30 dB at 500-2000 Hz | $80 |
| Philippines | MARINA Certificate of Medical Examination | Ishihara test — pass all 15 plates for deck; 12/15 for engine | 6/6 corrected, or 6/12 uncorrected for deck (glasses permitted) | 30 dB at 500-2000 Hz | $40 |
| Poland | Polish Maritime Office Medical Certificate | Ishihara required | 6/6 corrected | 30 dB at 500-2000 Hz | $60 |
| Russia | Rossvyazlkhoz Medical Certificate | Ishihara + Rabkin plates for deck | 6/6 corrected | 30 dB at 500-2000 Hz | $60 |
| Ukraine | MRA (State Service of Maritime and Inland Water Transport) certificate | Ishihara + Farnsworth for deck | 6/6 corrected | 30 dB at 500-2000 Hz | $25 |
| United Kingdom | MCA ENG-1 (Seafarer Medical Certificate) | Ishihara; Farnsworth D-15 for borderline cases; watchkeepers must pass | 6/6 corrected, 6/60 minimum uncorrected (deck OOW) | 27.5 dB better ear at 500-2000 Hz | $120 |
| United States | USCG Medical Certificate (46 CFR 10.302) | Ishihara + Farnsworth D-15 for deck; lantern test acceptable | 20/20 corrected; 20/50 uncorrected minimum (deck) | 30 dB better ear at 500-2000 Hz | $250 |
China — MSA (Maritime Safety Administration) Medical Certificate
- BMI
- BMI <35 preferred
- Cardiovascular
- ECG mandatory over 40
Croatia — Ministry of Sea Medical Certificate
- BMI
- No hard cap
- Cardiovascular
- ECG mandatory over 40
Denmark — DMA (Danish Maritime Authority) Medical Certificate
- BMI
- BMI <35 preferred
- Cardiovascular
- ECG mandatory over 40
Greece — HRMM (Hellenic Ministry of Maritime) Medical Certificate
- BMI
- No hard cap; medical officer judgement
- Cardiovascular
- ECG mandatory over 40
India — DG Shipping Medical Certificate (Form MS-1)
- BMI
- BMI 18.5-30 preferred; medical review 30-35
- Cardiovascular
- ECG mandatory over 40; treadmill test over 50
Japan — MLIT (Ministry of Land, Infrastructure, Transport and Tourism) Medical
- BMI
- BMI <35 preferred
- Cardiovascular
- ECG mandatory over 40
Marshall Islands (RMI) — RMI-approved medical certificate (any state-issued STCW-compliant certificate accepted)
- BMI
- No specific requirement beyond STCW
- Cardiovascular
- Standard STCW medical exam
Norway — SDIR (Sjøfartsdirektoratet) Medical Certificate
- BMI
- BMI <35 preferred
- Cardiovascular
- ECG mandatory over 40
Panama — AMP-approved medical (STCW compliant)
- BMI
- No specific requirement beyond STCW
- Cardiovascular
- Standard STCW medical exam
Philippines — MARINA Certificate of Medical Examination
- BMI
- No hard cap; medical officer judgement above BMI 35
- Cardiovascular
- ECG mandatory over 40; blood pressure <150/90
Poland — Polish Maritime Office Medical Certificate
- BMI
- BMI <35 preferred
- Cardiovascular
- ECG mandatory over 40
Russia — Rossvyazlkhoz Medical Certificate
- BMI
- BMI <35 preferred
- Cardiovascular
- ECG mandatory over 40
Ukraine — MRA (State Service of Maritime and Inland Water Transport) certificate
- BMI
- BMI 18.5-30 preferred
- Cardiovascular
- ECG mandatory over 40
United Kingdom — MCA ENG-1 (Seafarer Medical Certificate)
- BMI
- BMI <35 preferred; case-by-case for BMI 35-40
- Cardiovascular
- ECG mandatory over 50; treadmill for symptomatic candidates
United States — USCG Medical Certificate (46 CFR 10.302)
- BMI
- No hard cap; case-by-case with fitness-for-duty exam
- Cardiovascular
- Full physical over 40; treadmill for symptomatic