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It is imperative that you have a clear and valid medical certificate, completed in full and signed by one of the ships cleared private doctors before you join ship.
By this I mean; the ship will have a list (very short one) of approved private medical practitioners in each country. You will need to visit such place in order to be medically examined for ship approval.
You will have a thorough medical examination including blood samples, weight measurements, chest x-rays, a full prehistorical health questionnaire, vaccinations, (for girls) a boob exam along with pelvic and abdominal exams. And, if you have pre-existing medical conditions, then you are to have approval from your general GP along with a letter with more in depth information regarding this condition.
Once approved, you must take all original documentation to the ship for the medical staff to look into this and keep your files on board.
You are required to take this originals to every ship, and your validity of your medical certificate should last around 2 years. After this 2 years, you will need to arrange another medical, either at the same place, a pre-approved medical facility in another country if you are on ship, or sometimes the medical facility on board can also renew this for you.
An average medical certificate exam can cost around $400+ depending on where you live and where you go.
On board is $100+
Good luck and I hope this helps.