The distinction that actually matters
There are two completely separate ways a certificate other than a "standard" UK ENG1 can get you signed on to a commercial vessel, and conflating them is the single most common mistake crew make when researching this.
- An MCA-approved doctor based abroad issues the actual UK ENG1 certificate. The doctor happens to be in Antibes, Palma, or Fort Lauderdale rather than the UK, but the document they issue is identical to one issued in Plymouth: it's an ENG1, full stop. See our full list of MCA-approved doctors worldwide →.
- An equivalent certificate is a completely different document: that country's own national seafarer medical certificate, which the MCA has separately assessed and agreed to accept in place of an ENG1. It isn't an ENG1 at all, it just does the same job for UK purposes.
These two lists don't overlap the way you'd expect. Malta, for example, is on the equivalent-certificate list below, but doesn't currently appear on the MCA's list of approved doctors issuing ENG1s abroad. Spain and France appear on both, for different reasons entirely. Always check which list you actually need before assuming coverage.
How equivalent certificates work
This is governed by MSN 1815 (M+F) Amendment 7, "countries whose seafarer medical certificates have been assessed as meeting international requirements and are acceptable for use on UK ships." In practice: if you hold a valid, in-date seafarer medical certificate issued under one of the 43 countries listed below, by that country's own recognised process, the MCA will accept it as equivalent to an ENG1 for service on a UK-flagged vessel. You don't need to separately obtain a UK ENG1 on top of it.
Two entries on the list carry specific conditions, so check these carefully if they apply to you:
Bermuda: only accepted as equivalent if the certificate was issued by a doctor nominated by Carnival Corporation & PLC, not any Bermudian medical certificate. A certificate issued by one of those doctors stays valid until it expires, even if you go on to work for another company.
Malta: only accepted if completed by a medical practitioner licensed by the Malta Medical Council, with the examination physically conducted in Malta's territory.
The full list
Source: Annex 1 of MCA MSN 1815 (M+F) Amendment 7, published 13 August 2026, which replaced Amendment 6 on the same date. Note that the MCA's separate seafarers medical certification guidance page still cited Amendment 6 when this page was checked on 9 September 2026, so the two disagree. The notice is the authority. This list changes periodically, always confirm the current version directly with the MCA before relying on it for a specific job or flag-state requirement.
What to do if your country isn't listed
If your own national medical certificate isn't on this list, you'll need an actual ENG1, either from a doctor in the UK or from one of the MCA-approved doctors based abroad. See our full list of MCA-approved ENG1 doctors worldwide →, which covers the UK plus major crew hubs including Antibes, Palma, Fort Lauderdale, Antigua, the BVI and Monaco.
Track whichever certificate you actually hold.
Whether it's a UK ENG1 or an accepted equivalent, YachtSync tracks the expiry and reminds you before it lapses. Free, forever.
Get YachtSync freeFree for crew: unlimited certificates, expiry reminders, instant sharing. No card required.
Frequently asked questions
What does it mean for a medical certificate to be "equivalent" to the ENG1?
It means the UK Maritime and Coastguard Agency (MCA) has formally assessed that country's own national seafarer medical certificate as meeting the same fitness standard as the UK ENG1, and will accept it in its place for a seafarer working on a UK-flagged commercial vessel. This is governed by MSN 1815 (M+F) Amendment 7.
Is an equivalent certificate the same as seeing an MCA-approved doctor abroad?
No, these are two different mechanisms. An MCA-approved doctor abroad issues the actual UK ENG1 certificate, using the UK's own standard, regardless of what country they're based in. An "equivalent certificate" is a completely different document, that country's own national medical certificate, which the MCA has separately agreed to accept as good enough. Don't assume a country on the equivalent list also has MCA-approved doctors, or vice versa.
Which countries are on the equivalent certificate list?
43 countries as of the current MSN 1815 (M+F) Amendment 7, including Australia, Canada, France, Germany, Italy, Ireland, South Africa, Spain and New Zealand. Two entries carry conditions: Bermuda (only if issued by a doctor nominated by Carnival Corporation and PLC) and Malta (only if completed by a practitioner licensed by the Malta Medical Council, examined in Malta).
Related: ENG1 medical certificate guide → · Full list of MCA-approved doctors → · Best ENG1 examiners in the main crew hubs →
Where to train for this
- Find an MCA approved ENG1 doctor: searchable by town, with contact details.