A crew member has shared details of the gruelling medical tests they have to take before stepping onboard, and it’s way more intense than you ever imagined.
With contracts for the food and beverage team usually lasting around eight months, cruise lines are extremely stringent when it comes to making sure that crew members are fit for the job.
So if you’d like a peek behind the curtain into what that entails, read on, as one cruise ship waiter has shared her medical forms on social media,
A Full Day of Medical Tests
The medical exam for cruise ship crew isn’t something you can pop in and out of on your lunch break. It usually takes a full day, as there’s so much to get through.
Because several tests require fasting, crew are often told not to eat or drink anything except water for 8 to 10 hours before their appointment. So, most start early in the morning, stomach rumbling, and spend the day moving from one floor to another for each stage of testing.
That means arriving early in the morning, hungry and ready to start the medical marathon.
1. Blood Tests
As many of these require fasting beforehand, these are done first. Blood is taken and tested for
- FBS (Fasting Blood Sugar) – Measures glucose levels to screen for diabetes or other blood sugar issues.
- BUN (Blood Urea Nitrogen) – Checks how well the kidneys are working.
- Creatinine – Looks for signs of kidney damage.
- Cholesterol (With Fasting) – Measures total cholesterol to assess heart health.
- Triglycerides (With Fasting) – High levels can indicate a higher risk of heart disease.
- HDL (High-Density Lipoprotein) – The “good” cholesterol that helps remove excess fat from the bloodstream.
- LDL (Low-Density Lipoprotein) – The “bad” cholesterol that can clog arteries.
- SGOT and SGPT (Liver Enzymes) – Show how well the liver is functioning and detect possible liver disease.
- CBC (Complete Blood Count) – Gives a detailed look at red and white blood cells to check for anaemia, infection, or immune problems.
- Blood Typing – Determines the person’s blood group in case of emergency transfusions.
- HBsAg (Hepatitis B Surface Antigen) – Screens for Hepatitis B infection.
- HEPA C Test (Hepatitis C) – Checks for signs of Hepatitis C, which can cause long-term liver issues.
- HIV/AIDS Test – Detects HIV infection, which affects the immune system.
- RPR (Rapid Plasma Reagin) – Screens for syphilis, a sexually transmitted infection.
- Salmonella Test – Detects exposure to salmonella bacteria, which can cause severe food poisoning.
2. Ultrasound
Before crew can even think about breakfast, they’re sent for an abdominal ultrasound, which is also done on an empty stomach.
This scan checks all the major internal organs, including the liver, kidneys, gallbladder, pancreas, and spleen.
It helps doctors spot gallstones, liver problems, kidney disease, and other hidden issues that could cause trouble. Because the test requires a clear view of the organs, fasting ensures there’s no food or gas in the stomach to block the images.
3. Specimen Tests
After finishing the fasting procedures and grabbing a much-needed snack, the crew member moves on to what’s politely called the specimen tests. This means providing both urine and stool samples. It’s not exactly the most glamorous part of the day, but it’s an an important one.
The urinalysis checks for signs of infection, dehydration, kidney problems or high sugar levels that could point to diabetes. Even traces of blood or protein can reveal early warning signs of illness that might otherwise go unnoticed.
Then there’s the fecalysis, or stool test. This screens for parasites, bacteria and other digestive issues, making sure the crew member isn’t carrying anything that could spread in the close quarters of a ship’s galley or dining room.
It may sound unpleasant, but these tests are essential for maintaining strict hygiene standards at sea and ensuring that everyone handling food is completely healthy before boarding.
4. Drug and Alcohol Screening
Next comes one of the strictest parts of the medical exam – the drug and alcohol tests. Every crew member, no matter their role, must prove they’re completely free from illegal substances before joining the ship.
A urine sample is tested for traces of amphetamines, barbiturates, cocaine and marijuana (THC). Even a small positive result for illegal substances means automatic disqualification.
There’s also an alcohol test, which checks for recent drinking. While having a glass of wine at home is fine, turning up to a medical with alcohol in your system is a definite fail. Cruise lines have a zero-tolerance policy for substance use, so this step ensures every crew member boards fully sober, safe and ready to work.
5. X-Ray
Once all the lab work and samples are out of the way, the crew member heads to radiology for their chest X-ray. This is one of the most important parts of the exam. It checks for tuberculosis (TB), pneumonia or any other lung or heart abnormalities that could make life onboard unsafe.
If the X-ray shows anything suspicious, the crew member would need to see a specialist or undergo further testing before being cleared to work. Otherwise, it’s a quick in-and-out procedure – one deep breath, one snapshot – and then it’s on to the next test.
6. ECG
The ECG (Electrocardiogram) measures the electrical activity of the heart. Small sensors are placed on the chest, arms, and legs to record the heartbeat and rhythm.
This test can detect irregularities such as arrhythmias, high blood pressure effects, or other heart problems that might not show any symptoms yet.
7. Lung Function Test
Next comes spirometry, a simple but crucial lung function test. The crew member blows into a special tube connected to a machine that measures how much air they can exhale and how quickly.
This checks for conditions like asthma or reduced lung capacity, both of which could affect endurance or breathing in physically demanding roles.
8. Hearing Test
The audiometry test checks hearing levels by playing a series of tones at different pitches and volumes through headphones. The crew member presses a button every time they hear a sound, helping to identify even slight hearing loss.
Clear hearing is crucial on a ship, whether it’s listening for alarms, safety announcements or guests placing orders in a noisy dining room.
9. Eyesight Test
The visual acuity test measures how well the crew member can see at various distances. If they wear glasses, they will take the test both with and without their glasses, to make sure that the eyewear that they have is suitable.
There’s also an Ishihara test, which checks for colour blindness. If someone is severly colour blind they may not be approved for work on a ship, even as a waiter, as they may need to be able to distinguish colours for safety reasons.
10. Dental Examination
As part of the physical assessment, every crew member undergoes a dental exam. With limited access to dentists during the contract, cruise lines want to be absolutely sure every crew member’s teeth and gums are healthy before they step on the ship.
During the check-up, the dentist looks for cavities, gum disease, infections, or broken fillings, and checks that the crew member’s bite and jaw are normal. X-rays may be taken.
If the dentist finds any dental work that needs doing, the crew member must have it completed before being cleared as “fit to work.” The clinic will hold their medical file until a dentist signs off that the problem’s been treated.
11. Pregnancy Test
For female crew members, a pregnancy test is mandatory before they can be declared fit to work.
The test is quick urine sample and results are usually available within minutes. If it’s positive, the crew member will be placed on hold until after pregnancy and recovery, at which point they can reapply for a new contract if they wish.
12. Physical Examination
The last stage of the medical is the physical exam, where a doctor gives the crew member a full head-to-toe check-up. This part ties everything together, confirming that all systems are working as they should before anyone is declared fit for duty.
It starts with the basics, height, weight, BMI, blood pressure and pulse.
Then, there’s a general physical inspection. The doctor checks for things like hernias, varicose veins or skin conditions that could worsen during long contracts at sea.
Finally, there’s the Digital Rectal Exam (DRE). It’s not the most comfortable moment, but an important one. It allows the doctor to check for any abnormalities that could signal more serious health issues.
By this point, the crew member has been examined inside and out, ensuring they’re genuinely healthy and ready for life on board.
What Happens Next
After completing what feels like a full body MOT, the final step is waiting for the results, which are usually available with a couple of days.
Once every test has been reviewed, the clinic compiles everything into one crucial document: the Fit to Work certificate.
If all results are normal, the crew member is cleared and ready to travel. But if something shows up, perhaps high cholesterol, a dental issue, or an infection, they’ll need to get treatment and repeat the relevant test before clearance can be issued.
Only when that final signature is added does the crew member officially pass their medical. So the next time you see your waiter smiling through dinner service, remember – before they ever stepped onboard, they’d already passed one of the toughest exams of their life.
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Jenni Fielding is the founder of Cruise Mummy. She has worked in the cruise industry since 2015 and has taken over 30 cruises. Now, she helps over 1 million people per month to plan their perfect cruise holidays.
