A football transfer can look complete long before a player pulls on his new club’s shirt. The fee may have been agreed, personal terms settled and a contract prepared, but there is still one important hurdle before the paperwork is completed: the medical.
For supporters, the phrase “subject to a medical” is familiar. What is less obvious is what actually happens when a player walks into a club’s medical facility.
A modern football transfer medical is far more than a quick check of a player’s fitness. It can involve cardiovascular screening, blood tests, musculoskeletal assessments, neurological checks and detailed imaging, depending on the player and the concerns identified by the club’s medical team.
The purpose is not simply to establish whether a player is fit enough to play next weekend. A buying club is trying to understand the player’s current health, injury history and potential medical risks over the length of the contract.
That can become particularly important when a club is committing tens of millions of pounds to a player.
Why do football clubs conduct medicals before transfers?
There is no general legal requirement for a player to undergo a medical before completing a transfer. However, clubs use medical assessments to make an informed decision about the risks attached to signing a player.
The buying club has access to the player’s medical history, but it will normally want its own doctors and specialists to assess the player rather than simply relying on information supplied by the selling club.
That distinction matters because a footballer’s value is closely connected to his availability.
A club signing a player for five years is not merely asking whether he is healthy on the day of the transfer. It wants to know whether previous injuries, surgery or an underlying condition could affect his ability to train and play consistently during the contract.
In that sense, a transfer medical is effectively a risk assessment.
A medical does not necessarily produce a simple “pass” or “fail” result. The medical team reports its findings to the club, and the club then decides whether the identified risks are acceptable. A transfer can still proceed despite an issue if the club believes the risk can be managed.
How long does a football medical take?
The length varies considerably depending on the player and the club.
A straightforward assessment may be relatively quick, while a comprehensive examination can take several hours. Some transfer medicals can take around six hours when multiple tests and specialist assessments are required.
The process can also become longer when doctors discover something that requires further investigation.
That is one reason why a player being photographed outside a medical centre does not necessarily mean that a transfer announcement is imminent.
The club’s doctors may need to wait for laboratory results, review scans or seek an additional specialist opinion before giving the football department their assessment.
What tests are included in a football transfer medical?
There is no single universal checklist that every club follows. The exact examination depends on the club, the player’s position, age, medical history and previous injuries.
However, several areas are commonly examined.
1. General physical examination
The process normally begins with basic measurements and a general assessment of the player’s health.
Doctors can check factors such as:
- Height and weight
- Blood pressure
- Resting heart rate
- General physical condition
- Previous medical history
- Previous operations and injuries
The medical team will also review information about the player’s injury record.
For a player who has undergone significant surgery, for example, the club will want to understand not only what happened but also how well the player has recovered and whether there are any lingering limitations.
2. Cardiovascular screening
The heart is another important part of a professional football medical.
Elite football places enormous demands on the cardiovascular system, so clubs need to identify potential abnormalities before committing to a long-term contract.
Cardiovascular screening can include an electrocardiogram (ECG), which records the electrical activity of the heart. Depending on the player’s circumstances and the medical protocol being used, further cardiac assessment can include echocardiography and other investigations.
This area of football medicine has received particular attention because sudden cardiac arrest, although uncommon, remains a serious concern in sport.
A 2026 FIFA consensus on cardiac screening in adult professional football specifically examined how football can improve cardiovascular screening and emergency planning for players.
The aim is therefore not simply to determine whether a player can run for 90 minutes. It is to identify potential cardiovascular risks and ensure that the player is medically suitable for elite competition.
3. Blood and laboratory tests
Blood tests can provide doctors with a broader picture of a player’s health.
Depending on the club’s protocol, laboratory testing can help assess factors such as blood count, metabolic markers and other indicators relevant to the player’s overall health.
The results can also provide useful information for the club’s sports-science and medical departments.
This is particularly valuable because professional football clubs increasingly treat medical information as part of a wider performance-management process rather than viewing the medical as an isolated hurdle.
4. Musculoskeletal assessment
For most professional footballers, this is one of the most important parts of the examination.
Football involves repeated sprinting, changes of direction, jumping, tackling and kicking. The lower limbs consequently receive enormous physical stress.
Doctors and physiotherapists may examine:
- Knees
- Ankles
- Hips
- Hamstrings
- Quadriceps
- Calves
- Groin
- Achilles tendons
- Shoulders and other joints
They may assess strength, flexibility, mobility, stability and movement patterns.
Previous injuries are particularly important.
If a player has previously suffered an ACL injury, for example, the medical team will want detailed information about the reconstruction, rehabilitation and current function of the knee.
The same applies to recurring hamstring problems, ankle injuries or previous operations.
The question is not necessarily “Is the player injured?”
It can be much more complicated:
“What is the probability that this player’s previous injury history will affect his availability during the contract?”
That distinction explains why apparently healthy players can sometimes create concerns during a transfer medical.
5. MRI and other imaging
When doctors need a closer look at a particular body part, imaging can provide information that cannot be obtained through a physical examination alone.
MRI scans are particularly useful for examining soft tissues, including muscles, tendons, ligaments and cartilage.
This can become crucial when a player has a history of significant injuries.
A scan may reveal evidence of previous damage or changes that require further investigation even if the player is currently playing without obvious problems.
Importantly, the discovery of an abnormality does not automatically mean that a transfer will collapse.
The medical team has to interpret what the finding actually means for that particular player.
The Ederson example shows why medicals matter
A recent example illustrates how a transfer medical can change the course of a major deal.
Manchester United had agreed a deal with Atalanta for Brazilian midfielder Éderson, but the transfer did not proceed on the original terms after concerns emerged during the medical process.
Reports said United had initially agreed a package worth around £37.8m, but subsequent examinations raised concerns surrounding the player’s knee. The club ultimately decided not to proceed at the agreed price and structure.
The situation also demonstrated an important point about football medicals: the two clubs do not necessarily have to reach the same conclusion.
Atalanta disputed United’s assessment and maintained that Éderson was fit. The Brazilian subsequently remained at the Italian club and signed a new contract through 2031.
That is why describing a player as having simply “failed a medical” can sometimes be misleading.
The more accurate description is that the buying club identified a medical risk it was unwilling to accept under the agreed terms.
Can a player actually “fail” a medical?
This is one of the biggest misconceptions surrounding transfer medicals.
There is no universal football-medical pass mark that every player has to achieve.
A medical team assesses the evidence and provides its professional opinion to the club.
Imagine two clubs are interested in the same 28-year-old defender who has undergone knee surgery.
One club might believe the player’s current condition presents an acceptable risk and offer a four-year contract.
Another club might conclude that the same medical history represents too much risk for a four-year commitment and walk away.
Neither medical team necessarily has to be “wrong”.
The decision ultimately depends on the club’s assessment of the player’s medical condition, the financial commitment involved and the level of risk it is prepared to accept.
What happens if doctors find a problem?
There are several possible outcomes.
The club can proceed normally.
The medical finding may be considered insignificant.
The club can seek more information.
Doctors may request additional scans, tests or specialist opinions.
The club can renegotiate.
A medical concern could lead the buying club to seek a lower transfer fee or different contractual terms.
The club can abandon the transfer.
If the perceived medical risk is considered too high, the club can decide that the deal is no longer worthwhile.
This is particularly significant for expensive transfers.
The larger the financial commitment and the longer the contract, the more carefully a club has to consider the possibility that an injury could significantly reduce the player’s availability.
Why clubs take medicals so seriously
Football clubs have invested increasingly heavily in medical and sports-science departments because player availability has a direct effect on performance.
FIFA’s medical strategy explicitly places player health and wellbeing at the centre of football medicine, while its research programme aims to ensure that health-related decisions in football are increasingly guided by scientific evidence.
For a club spending £50m, £80m or even £100m on a player, the medical is therefore much more than a formality.
The transfer fee buys the player’s registration. The contract commits the club to his wages for several years.
The medical helps the club understand what it is actually buying.
The final hurdle before the shirt presentation
That is why the familiar phrase “subject to a medical” carries more weight than it might appear.
A player can have completed negotiations, agreed personal terms and even arrived at the club’s training ground, yet the transfer can still change direction.
Behind the scenes, doctors may be checking the heart, analysing blood results, examining joints and muscles, reviewing previous injuries and studying scans.
Most of the time, the process passes without drama.
But when a medical raises a significant concern, it can force a club to reconsider one of the biggest financial decisions it makes.
For supporters waiting for a new signing to be unveiled, the medical may feel like a final formality.
For the club’s doctors and executives, it can be the moment when a £50m transfer is either confirmed, renegotiated or abandoned.
Read more – Tottenham close in on Tosin and Mudryk double deal
Also see – Enzo Fernández to Manchester City close as Chelsea line up replacement
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