Diving and medical fitness assessment

Why medical background is important for scuba diving?

By going underwater, divers exposes themselves to the force of hydrostatic pressure or simply said the weight of the water on their bodies. On land, unless at altitude, we do not expose ourselves to changes of pressure like we do in diving. This change has effects on the human body and could cause decompression sickness. Some medical conditions are known to increase drastically the chances of such sickness occurring.

How do I know if I am fit for diving?

This is a question that often comes to mind of people who start or want to start diving. Good news is you do not have to be an athlete to dive and most people are considered fit for it.

In most places in the world this is determined by a medical questionnaire. The outcome determine if a physician examination and clearance is required. This medical questionnaire can be found at a local dive shop or center or given by an instructor. Another way to get it is to download it from the website of the agency you are interested in.

In some countries like France, medical clearance from a physician is required for any in-water scuba diving activities.

Just remember the goal is not to see if you are fit enough for diving but to keep you safe doing it. It might seems to be overwhelming but it is for good reasons. It should not be an overlooked part of scuba diving.

There are medical conditions known to be incompatible with diving. Some of them could be depending on the medication taken to treat symptoms. Or for surgeries and other physical injuries how long it’s been and how healed it is.

Medical questionnaire

Here is a list that represent the most likely asked questions by training agencies prior to in water activities. It is not a complete list and should not be used as a final diagnostic. The appropriate action is to visit a dive shop or center and ask about it. Also some agencies provides their medical forms online. You can see the list of agencies to get to their website.

Have you ever had…

  • Cardiac problems, heart diseases or attacks?
  • Angina or blood or heart vessels surgery?
  • Lung diseases, pneumothorax or collapsed lung?
  • Asthma, emphysema, wheezing when breathing?
  • Perforated eardrum, ear or sinus surgery, ear disease, problems with balance?
  • A back surgery or recurrent back problems?
  • Diabetes?
  • A stroke, brain damage or nervous system injury?
  • Hernia?
  • Colostomy or chest surgery?
  • A diving accident or other pressure related accident?
  • Seizures, convulsions, epilepsy and take medicine to prevent them?
  • History of blackouts, fainting, loss of consciousness, coma?
  • History of ulcers or ulcers surgery?
  • History of bleeding or other blood disorders or diseases?

Do you currently have…

  • A cold, sinusitis, ear infection or other sinus or ear problem?
  • Bronchitis or other lungs problems?
  • Abnormal blood pressure and take medication to control it?
  • Behavioral problems, dementia, schizophrenia?
  • Allergies that affects breathing such as hayfever or other severe attack of allergies?
  • Other important medical considerations
  • Do you take prescriptions drugs excluding contraceptive pills or malaria medication?
  • Are you trying to be pregnant or are you pregnant?

What about my answers?

If you answered yes to any or many of these question you will likely be asked to see a physician before you can go in the water.

Even more physiologic and psychologic concerns

Some other conditions that may cause concerns but are not incompatible with diving. They can be mostly prevented or avoided with some guidelines.

Some more questions

  • Do you have seasickness?
  • Do you have vertigo?
  • Do you have gastric reflux often?
  • Claustrophobia or agoraphobia?

Seasickness or motion sickness

If you have seasickness there are a few things you can do to prevent it. One of them is to dive from shore. Another is to take over the counter medications for the relief of motion sickness. Be aware that such medications can have adverse effects with diving. For more information you can read this article from Divers Alert Network.

DAN – Motion Sickness https://www.diversalertnetwork.org/medical/articles/Motion_Sickness


Vertigo can be a concern for people that experience very strong reaction from it. When diving in really clear waters the mind can be tricked into thinking that it will just fall into the abyss. It can also happen when diving over a thermocline if the bottom cannot be seen. Ways to avoid these situation is to start in shallow waters and see progressing to deeper water with time. Learning about and to control buoyancy is another way to overcome this feeling.

Gastric reflux

If you are afraid of getting gastric reflux while diving. You can avoid acidic food like coffee. You can also use over the counter medicine as they have no or very little side effects. If it still happens underwater just remember divers can cancel dives at any time for any reason.

Claustrophobia or agoraphobia

As these conditions are very hard to quantify it might be a good idea to give it a try in a very controlled environment such as a pool with a professional. Taking it further as level of comfort increase. In the end, diving should be a fun thing and not some task to overcome.

Does it hurt to get medical clearance?

No there is no intrusive painful medical test for diving. What we mean is that it might be a good idea to see a physician anyway. It does not hurt to do it.

There are also possibilities that some conditions went unnoticed because they do not cause symptoms in everyday life. A good example is a PFO which cause no problem so they usually do not test for in common medical examination. But it can be of a big concern for scuba diving activities.

When should I do it?

The sooner the better. For the reasons above, it might be a good idea to go see a physician when you think you might eventually be diving. Even days or few months before as physician clearance will usually be accepted up to two years after being given.

It is a good idea to do it at the beginning of the course or even at the moment of booking if you start a course at a later time or another day. This way you make sure that you will not get bad surprise after you already spent some time on a course.

And once certified or if I do a new course?

For certified divers it is their responsibility to see if their medical condition changed so that it could be a problem with diving. It is recommended to see a physician every 2 years to keep track and up to date. Age is also a consideration in the frequency.