There are two main groups of medical practitioners who assess fitness to dive. UKDMC approves Diving Medical Referees and the Health and Safety Executive maintains a register of its Approved Medical Examiners of Divers.

Diving Medical Referees

Diving Medical Referees are doctors who assess the medical fitness of members of the public who wish to undertake sport diving. The Diving Medical Referees are listed by county after clicking on the Medical Referees link at the website

To become a Diving Medical Referee a doctor must meet the following requirements:-

  1. Undertake an approved Diving Medicine Course suitable for first time entrants.
  2. Qualified to BSAC Dive Leader level or equivalent
  3. Registered with the General Medical Council with a licence to practise (or the overseas equivalent if not based in UK)
  4. Have adequate medical insurance
  5. Undertake annual appraisal
  6. Have suitable premises to undertake the medicals.
  7. Have access to the UKDMC Diving Medicine Forum (invited to join this once approved)

Some medical practitioners who do not have an appropriate diving qualification but work in hyperbaric medicine facilities are approved as medical referees due to their knowledge of diving medicine and the fact that a significant proportion of their work is with members of the recreational diving community who attend for treatment.

The doctor applies to the UK Diving Medical Committee to be approved. The point of contact for this is –

Dr Margaret Clamp
Phone: 07776 995 273 Email:

To continue as a Diving Medical Referee the doctor has to undertake a UKDMC approved refresher course (usually two days) at least once in every six years and also to continue to satisfy criteria 2 – 7 as above.

Refresher courses are organised every other year by the UK Diving Medical Committee, again contact being as above. Other suitable courses are run at DDRC Healthcare in Plymouth – frequently, the Institute of Naval Medicine, Gosport – less frequently and at The Hyperbaric Unit, Aberdeen Royal Infirmary – infrequently.

BSAC (British Sub Aqua Club), SAA (Sub Aqua Association) and SCOTSAC (Scottish Sub Aqua Club) are recreational diving organisations which require that diving medicals for members are undertaken by a Diving Medical Referee on the list, as indicated above.

Sport diver training can also be undertaken under the PADI system (Professional Association of Diving Instructors). PADI does not insist on training in diving medicine for medical practitioners who assess candidates for dive training. However, many doctors prefer not to do these assessments because they feel they are not sufficiently experienced in Diving Medicine. Ideally the assessment should be undertaken by a medical practitioner with appropriate training in diving medicine. If an untrained medical practitioner undertakes the medical, it is recommended that they should at least seek the advice of another who is appropriately trained. Medical practitioners should be aware that their medical defence organisation may not cover them for undertaking work for which they are not qualified.

Approved Medical Examiners of Divers (AMEDs)

The second type of medical practitioner that assesses fitness to dive is an Approved Medical Examiner of Divers (AMED). AMEDs assess the fitness of working divers, including recreational diving instructors, in accordance with the Diving at Work Regulations 1997. Approval as an AMED is obtained from the Health and Safety Executive. The list of AMEDs can be found at

The requirements are:-

  1. The doctor has to undertake a Diving Medicine Course suitable for first time entrants – the course needs to be approved by the HSE (courses as described above for the initial training of medical referees are usually acceptable)
  2. Be registered with the UK General Medical Council with a licence to practise
  3. Have adequate medical insurance
  4. Undertake annual appraisal
  5. Have suitable premises to undertake the medicals
  6. For new applicants from 1 October 2015, to have an Occupational Medicine qualification (Diploma acceptable)

In other words, an AMED , unlike a Medical Referee, does not have to be a diver but does need an Occupational Medicine qualification (for all approved since October 2015) and must be licensed to practise in UK.

Visit the HSE AMED approval and review process page for more information on how to apply.

To remain an AMED the doctor needs to undertake a Diving Medical Refresher Course approved by the HSE at least once in five years and must continue to meet points 2 to 7 as above.

There is no mandatory requirement for an AMED to be on the UKDMC Diving medicine forum but many of them are. If they are not they will need to satisfy their appraiser that they have other means to get advice with regard to cases or learn from other diving medicine physicians.

A Medical Referee or an AMED can apply to Dr Phil Bryson on the Committee (contact details on and will be permitted to join the Diving Medicine Forum. This Forum is only accessible by diving medical doctors who have been given permission to join and any cases that are posted on the Forum are totally anonymised. Most postings are cases but sometimes general medical diving issues are also discussed.

Through this Forum doctors can obtain advice about difficult cases but also learn from other cases as they will automatically receive emails of all new postings and can access the forum to look at old postings.

Writing up case reviews where they have obtained advice from the forum and reflected on what they have learnt, how it has changed their practice and helped to deal with a diver safely would be an acceptable quality improvement project.

Other possible examples of quality improvements projects that could be acceptable are audits of their work, discussion of cases with other Diving Doctors, reading with reflection resulting in action to improve service/care of divers or significant events relating to diving medicine.

If any responsible officer or appraiser wishes to have advice about any of the above the point of contact is:-

Dr Margaret Clamp (as the appraiser and revalidation lead on the committee) at:-
Phone: 07776 995 273 Email: