A Simple Guide To The Firefighter Medical Exam | FirefighterNOW (2023)

Part of becoming a firefighter is have a medical exam. But, if you’ve ever wondered what to expect during a firefighter medical exam, you’re not along.

In this article, I want to give you a quick run-through ofsome of the different aspects of the physical exam in the hiring process. Thiscan help you prepare for what is to come. I will also talk about some otherexpectations and medical disqualifications. Finally, I want to talk about thelikelihood of ongoing physicals while working at your new fire department.

Basic Requirements of a Firefighter Medical Exam:

  • Vitalsigns
  • Visiontest
  • Hearingtest
  • Bloodwork
  • Urinalysis
  • ChestX-ray
  • Pulmonarytests
  • Treadmilltest (stress test)
  • Functionalmovement screening
  • Generalmedical history

Many departments willadd a physical exam to their healthcare package for new employees. In mostcases, it is a way to help them with their health and well-being in dangerousoccupations.

Most will also use physical exam when hiring to be sure that candidates are right for the role. Firefighting is one such profession and, as you might expect, the physical is pretty extensive because of the stress and dangers of the profession.

When you apply for a role in the fire service and pass your initial application process and interviews, a medical assessment isn’t far behind. This is an essential screening measure to make sure that applicants are fit enough to proceed. The test typically consists of 10 key processes.

While differentdepartments may have different requirements, this list gives you a good idea ofwhat to expect. Let’s further break downwhat to expect with each exam.

Vital Signs

This one is pretty straightforward. They need to know yourvital signs, such as your blood pressure, heart rate and oxygen level (pulseox) as an indication of your general fitness level. Poor results here couldindicate poor physical fitness but also underlying health issues that may needmedical intervention.

Physicians and department officers need to decide whetherthose issues could harm your performance on the job.

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Another vital sign that some departments may look at is bodycomposition. They need to know your body mass index (BMI) and will use skinfoldtests for a ratio of fat to muscle. Not only does this indicate the physicalfitness of a candidate at the time of hiring them, but physicians can also seeimprovements over the years.

Vision Test

Good vision is essential in firefighting for dealing withincidents with poor visibility or night-time work. Many departments will allowfirefighters to sign up if their vision can be corrected to appropriatestandards with no impairment on the job.

There can be a disqualification for those with monochromatic vision, far visual acuity that is less than 20/40 binocular vision or a peripheral vision less than 110 degrees.

Hearing Test

Recruits need to hear instructions and indications ofdangers on the scene in loud, confusing situations. Therefore, the hearing testis essential.

The test is simple with a series of responses to stimuli ina soundproof room. Those that underperform at the different frequencies maystruggle on-site. There are also disqualifications for conditions that couldprove dangerous, such as uncorrected tinnitus, Meniere’s syndrome orlabyrinthitis.

Blood Work

You will have blood taken 48 hours before the physical examso that doctors can have the results ready. The blood work is vital in highlightingpossible health risks.

Doctors can look at white and red blood cell counts as wellas glucose levels. These can indicate diseases that are perhaps undetected orpoorly managed. It is also a good way to test alcohol levels for substanceabuse.


You might think that the urinalysis is primarily for drug tests. Fire departments will have strict policies on the use of drugs – especially those in states with legalized marijuana. But, there is more to this test. The compounds and consistency of the fluid can indicate major diseases and small infections.

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Chest X-Ray

A chest x-ray gives doctors an up-close look at the healthof your lungs and heart. This means checking the lungs for damage orobstruction, spotting potential problems with the heart and looking at themajor blood vessels. This is the perfect chance to locate something small thatcould end up being a ticking time-bomb.

Pulmonary Tests

It isn’t enough to see inside your lungs for visibleindicators of disease. Breath tests with spirometers determine a candidate’slung function through inhalation and exhalation. A poor rate could be dangerousin a smoke-filled room even with a mask on.

Hiring officers may not be interested in hiring those withasthma or those with any other reactive airways disease that has requiredbronchodilator or corticosteroid treatment for more than 2 months in the past 2years.

Treadmill Test (Stress Test)

This one is a classic that never seems to go out of fashion.The treadmill is the perfect way for physicians to gauge the cardio andrespiratory function of their new applicants. This one is as much aboutendurance as anything else. Can you maintain the right heart rate andperformance for your age during long tasks?

Functional Movement Screening

Functional movement essentially means the way that your bodycan move with the range of motion of the limbs, flexibility of the joints andperhaps also the strength of the muscles. The tests involved can vary between departments,so it is best to practice a lot of exercises and get your range of motion andflexibility up to the right standard.

Flexibility is essential in the hamstring muscles, lowerback, and shoulders. It helps firefighters move around dangerous areas andhandle equipment with less risk of injury.

There are different ways to test this. Participants can bemade to sit against a wall with their legs and knees flat. They then reach outtoward their feet to see how far they can get. There are also leg raises,hurdle step-overs, deep squats and other tests.

General Medical History

Finally, the physician will want to go over your medicalhistory and run some additional tests as needed. This is the final phase whereall of the numbers, samples and red flags come together.

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They will get to know your previous medical history andrisks within the family. This could help them analyze the samples and resultsand make their recommendations. It is important to be honest at this point whenanswering all the questions. Failure to do so could put you and your crew atrisk.

This list is a good starting point when hiring applicants. But, the NFPA has high standards and additional clauses.

The NFPA has a list of 1582 medical requirements forfirefighters to make the grade. This may sound excessive, but we have toremember how physically demanding the role is.

I can’t go into full details about each of the 1582requirements here. Just be aware that many additional disabilities andillnesses could prove to be a reason for disqualification.

For example, there are neurological conditions that would not be tested for in this physical. Any neurological condition that could affect the safety of others, concentration on the job or short-term physical ability is an issue. Anyone with epilepsy is expected to have had it under complete control for at least 5 years.

Firefighter Medical Exams Shouldn’t End There…

Ideally, your fire department should also have the fundingand support to provide regular medical screenings on the job. Regular screeningcan help medical professional spot any signs of disease caused by theprofession.

This means a more general physical examinationof the body, limb function and response. But, there should also be screenings for cancer and chest x-rays.

This is another reason why those tests forvital signs and stats from the previous tests are so important. The informationgathered in the hiring procedure does just highlight current physicality fornew recruits. It can also highlight declines in health later on.

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For example, doctors may a drop in some vital signs,chest function or on the treadmill test year on year. The stats can also flagup any sudden changes in x-rays, vision and hearing tests or the blood workthat may require further help.

Unfortunately, fire departments don’t all workto the same standards and practices.

The problem is that there is no nationalstandard here where every department has to conform to the same procedures.Some states will go out of their way to ensure that recruits and crew membersundergo regular, thorough medical testing. Others won’t.

This is a concern in a professional that is sodangerous with so many cancer risks. Firefighters are urged to seek out regulartesting either on the job or through their own healthcare provider. Tell yourown doctor about your profession and any recent incidents and exposures as aprecaution.

I hope this article gave you an idea of what toexpect during a firefighter medical exam. There is a lot to prepare forwhen you enter the hiring process and a lot of physical tests. But, each one ofthese procedures is essential for both you and the department.

They can highlight risk factors that youweren’t aware of that may have an impact on your ability to work as afirefighter. Failure to do so could put you and those in your crew at risk.

If you know that you have underlying medicalissues, be honest during the firefighter medical exam, and try and show thatthey won’t be an issue. If doctors disagree, respect that decision for the goodof the department. If you know that you aren’t quite fit enough yet, work onthat fitness before you apply to improve your chances.


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