Fitness, Vision and the Medical Flag
A 17-year-old applicant for a marine cadetship presents for the pre-sea medical. He wears glasses for distance vision and reads 6/9 in the right eye and 6/12 in the left with correction; unaided he is 6/60 in both. He has mild asthma, using a reliever inhaler about twice a month, with no hospital admission in the last five years. His BMI is 29. He has had no recent illness. He plays football weekly. The examining doctor must decide whether to pass him fit, pass with conditions, or refer, and the cadet wants to understand what each outcome means for his place.
1. Identify which findings are likely to require referral or conditions and which are likely to be acceptable, and explain the reasoning.
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Vision - likely a condition or referral. Corrected acuity of 6/9 right and 6/12 left is below the usual standard for seafaring roles, which commonly require around 6/6 in the better eye and a defined minimum in the worse eye, with unaided vision also relevant for emergency situations (e.g. losing glasses at sea). Unaided 6/60 in both eyes means he cannot function safely without correction. Realistic outcome: pass with conditions (spare corrected spectacles carried on board) or referral to an optometrist/ophthalmologist for a formal assessment against the applicable standard.
Asthma - likely acceptable, possibly conditional. Reliever use twice a month with no admission in five years suggests good control. Many standards accept mild, well-controlled asthma; some require a documented exercise test or a period free of oral steroids. Outcome: pass, possibly with a review date.
BMI 29 - a flag, not usually a bar. It warrants advice and a fitness plan rather than rejection, unless accompanied by other findings.
Overall: most likely pass with conditions pending the eye assessment.
2. The cadet asks whether he can simply not mention the inhaler. Explain the consequences of non-disclosure.
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No - non-disclosure is a serious matter.
Why it matters practically: the medical exists to establish that he can work safely in an isolated, physically demanding environment where medical help may be hours or days away. An undeclared condition can become a safety issue for him and for the crew.
Consequences of concealment:
- The medical declaration is a formal document; a false answer can invalidate the certificate.
- If discovered later, it can lead to withdrawal from the course or termination of a contract, regardless of how well he performs.
- It may affect insurance and his own entitlement to care if he falls ill at sea.
- It damages the trust on which a sea career depends.
The better route: declare the inhaler, bring the prescription record, and let the doctor assess control. Mild asthma is often acceptable; concealment never is. Being honest gives him a defensible position rather than a hidden risk.
3. Explain what "pass with conditions" means in practice and what the cadet should do next.
Read the worked answer
"Pass with conditions" means fit for training, subject to specific requirements being met and maintained. It is not a rejection and it is not an unconditional pass.
Typical conditions in this case:
- Carry a spare pair of corrected spectacles on board at all times, and possibly a current prescription.
- Attend a follow-up eye assessment by a set date.
- Declare the asthma and keep the reliever inhaler with him, with a written asthma plan.
- Possibly a review in 6–12 months, or evidence of weight management.
What the cadet should do next:
- Ask the doctor to write the conditions down so there is no ambiguity.
- Book the eye assessment promptly - this is the item most likely to decide his place.
- Keep a record of inhaler use so control can be demonstrated at review.
- Tell the training provider what conditions apply, so arrangements (e.g. spectacle policy) are in place before he joins.
Key point: conditions are manageable. Missing them is what costs a place.