Definition and Overview

A certified medical examination for an overseas worker is a medical procedure that is required for all individuals who are seeking work opportunities abroad. The purpose of the exam is to make sure that the individual is fit to work, and does not have any serious medical illness. The exam can be taken either before departing for the destination country or within a set amount of time upon arrival. The results of the test will determine whether the applicant will be granted a work permit. If the applicant fails to pass the exam, he or she may be advised to undergo additional testing or may be sent home.

Who Should Undergo and Expected Results

A certified medical examination is a necessary step in applying for an overseas work permit. It is a common requirement across all destination countries and is performed for the benefit of both the worker and the country he is seeking to enter.

At the end of the exam, the applicant will either receive a medical clearance followed by an approved work permit, a denied medical clearance, which may delay or cancel his work permit, or recommendations to address certain medical issues detected during the exam. For example, if a person has dental issues, he will be advised to undergo dental treatments before he will be granted a license to work overseas. In some cases, the foreign worker may be required to undergo some procedures, such as biopsies, spinal taps, booster vaccinations, or even minor surgery to meet the medical requirements of the host country.

Most denied applications are due to infectious and chronic non-infectious diseases, such as:

  • HIV/AIDS
  • Hepatitis B
  • HCV reactive
  • Malaria
  • Leprosy
  • Tuberculosis
  • Granuloma
  • Pleural effusion
  • PTB, including active, past, or healed cases
  • Skin diseases
  • Chronic renal or heart failure
  • Diabetes
  • Arthritis
  • Cancer, especially colon and breast cancer
  • Epilepsy, or a history of seizures
  • Hypertension
  • Obesity
  • Psychiatric and neurological conditions
    Other factors that may cause a denied medical clearance include physical disabilities such as blindness or deafness.

How Does the Procedure Work

In most countries, certified medical examinations for overseas workers need to be performed by physicians who are certified or accredited by the government, and cannot be performed by the worker’s own physician. Some countries, on the other hand, may allow the pre-employment test to be performed in the applicant’s country, but the physician will need to follow strict guidelines in performing the exam.

The manner in which the tests are performed is based on the nature of the work the person is applying for. For example, the medical standards required for seafarers may differ from those required for land-based workers, and host countries tend to impose stricter regulations on individuals planning to work for a longer time.

The required components of the medical exam as well as the expected results may also vary per country, as some countries have special medical requirements. Generally, however, the certified medical examination for overseas workers typically involves the following:

  • Review of medical history
  • Routine physical exam
  1. Height and weight measurement
  2. Body mass index
  3. Eye exam
  4. Hearing test
  5. Dental exam
  6. Nose and sinus exam
  7. Blood pressure test
  8. Kidney function tests, such as blood urea nitrogen test or creatinine test
  9. Liver function tests, such as total protein, total bilirubin, direct and indirect bilirubin, alkaline phosphatase, albumin levels, and globulin levels, among others
  10. Pulmonary function tests or spirometry
  11. Pancreatic function tests
  12. Lipid tests
  13. Treadmill exercise test
  14. Ultrasound and x-rays
  15. ECG
  16. Abdominal echo
  17. Fecal and urine tests
  18. Blood tests
  19. Pregnancy test for women
  • Psychological testing
  • Drug and alcohol testing
  • Infectious disease screening
    Aside from the pre-employment medical exam, foreign workers are also required by their host countries to undergo regular physical examinations. The recommended frequency and schedule of these exams may differ from each country, but most require at least one exam every six months. The workers also need to undergo a physical exam every time they renew their work permit. The results of the test are usually released between one and two weeks after the medical exam.

Possible Risks and Complications

If a person fails to pass a medical exam, his or her job offer will be cancelled, resulting in deportation. Thus, it is important for overseas workers to prepare for the said test. Applicants are advised to get a good night’s rest the night before the medical exam and to refrain from smoking and drinking alcohol and caffeinated beverages, which may adversely affect the accuracy of test results. They may also be given pre-exam fasting guidelines that enumerate the kinds of foods that they need to avoid prior to the exam. Strenuous activities and excessive exercise should also be avoided. These factors may cause liver function, kidney function and blood sugar tests to produce inaccurate results.

Applicants are also advised to bring their eyeglasses, contact lenses and a list of the medications they are currently taking. If they are currently under treatment, they should take their medications as normal.

Another consideration to think about is the cost of the procedure. If the patient fails during the first exam and wishes to give it another try, he or she will have to pay for the second exam.


Reference:

  • Simel DL. Approach to the patient: history and physical examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 6.
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