Fees for seafarer examinations and medical referee

Guidance and fees for doctors on issuing certificates confirming fitness to be at sea.

Location: UK
Audience: Occupational health doctors Consultants
Updated: Wednesday 1 May 2024
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There are two medical certification schemes, which is required depends on the vessel where the seafarer works.

Under the Merchant Shipping (Maritime Labour Convention) (Medical Certification) Regulations 2010: '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 (a seafarer), subject to certain exclusions, must hold a medical fitness certificate (and ENG1) which is still valid and is not suspended.' This includes staff and entertainers on passenger vessels.


Getting approval to issue ENG1 medical certificates

Only medical practitioners approved by the secretary of state may issue the ENG1 medical certificates. The approval is by the MCA (Maritime and Coastguard Agency) medical team and its senior medical adviser.

Vacancies are advertised locally by CCGs. MCA keeps a file on those who have expressed an interest who are then invited to apply to make sure of fair and open competition. Details can be found on the MCA’s website.


Payment of fees

ENG 1 Seafarer medical exam £80.00
Medical referee (per review) £280.00
Medical referee for attending casework meeting £400.00

The fee for the examination and issue of the certificate may be paid either by the seafarer or the employer.

Receipts should be issued and the seafarer may wish to claim the cost from an employer. The fee is limited by the Merchant Shipping (Fees) Regulations 2018.

Additional fees may be charged for any extra tests (like a step test). This must be agreed with whoever is paying for the ENG1 before they have the test(s).



The MCA appoints medical referees who are senior occupational health consultants located around the UK, to carry out reviews of decisions made by appeals doctors, where a seafarer is dissatisfied.

The MCA is responsible for paying referees for undertaking this work.


The second certification

The second scheme for certification applies to those working on specified smaller vessels mostly inshore or non-seagoing.

This may be carried out by any registered medical practitioner with a licence to practice.

The fee is not limited, but should be agreed in advance to avoid dispute if the certificate required additional ratification by the MCA or Royal Yachting Association.