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Should you need a Medical Certificate to Run a Marathon?

Apr 4, 2018 | Running, Running Advice, Wellness | 31 comments

Should you need a medical certificate to run a marathon?

Did you see my recent plea on Instagram for a Doctor willing to sign my Paris Marathon medical certificate?

Incase you didn’t, let me explain…

To run any race in France or Italy, you need to have a medical certificate signed by a doctor to say that you’re medically fit to take part. This includes 5Ks, 10Ks, half, full and ultra marathons.

This is a bit of a faff, and in the UK costs £££ to get it signed. How much cash you’ll need to stump up for that signature really depends on your GP’s surgery… I was quoted £200! However, most doctors I’ve heard of charging between £20-50 for the medical certificate.

Not only does it add extra cost to the whole international race trip, but getting an appointment is a bit of a nightmare, especially when you’re working full time. I literally couldn’t even get an appointment until two days before the marathon if I had been prepared to stump up £200! And what if they hadn’t signed me off…

A big problem is people forging their medical certificates. The number of instagram messages I got telling me that the officials wouldn’t actually check my certificate or to just sign it myself was crazy. I totally thought about it (especially as I am working at a hospital right now, with a stamp!)

Luckily, I was able to find a GP who didn’t charge me to sign the certificate, but I’m now getting a lot of messages from other Paris marathoners who are stressing about their medical sign off. One even said that their GP refused to sign (after making the appt and agreeing to pay) and that they had been told they would need to go private for the signature. And this isn’t a one off, apparently some practices have a policy not to sign them.

So where can you get your marathon medical certificate signed? 

Luckily there are some private clinic options that seem to charge around £50-55, I’ve been recommended the London Doctors Clinic by a couple of friends.

On the flip side… 

I do think that having medical certificates are important for big events, like the Marathon des Sables, or any events where you’ll be going through extreme conditions and having a medical emergency would put you and others at risk.

I even wondered whether having a medical certificate for races such as Ride 100 might be a good idea to encourage more athletes to have their health checked over more regularly? Or would there just be more irritated riders/runners and more forgeries?

If it did become more commonplace in the UK, would doctors be more open to signing them after a quick questionnaire/check up? My GP said they would have to go through my entire medical file in order to clear me for the race…is that really necessary? According to some on instagram it is but I feel like perhaps that is an exaggeration (having looked at a LOT of medical notes over the past few weeks, most of them summarise relevant past medical history, although perhaps that is only hospital notes?!)

Would love to know what you think? Ever required a medical certificate for an event? 


  1. Sarah

    Really interesting post. I was going to run Paris, but the medical certificate put me off. I’m now doing Manchester instead.

    • charlotte

      Wow that’s interesting! I hadn’t thought about it being the deciding factor… Good luck in Manchester!

      • Sarah

        THank you- good luck in Paris!


    Oh gosh, this scares slightly! I’m doing the Disneyland half in September, and whilst I know I have to get a medical certificate signed, I hadn’t realised it could be difficult to do! How soon would you recommend getting it done? Disney themselves have a certificate template – wondering if that helps with costs.

    • charlotte

      Unfortunately that probably won’t help – Paris has a template too! I’d get it done sooner rather than later so that you can find a doctor willing to sign (and hopefully without spending a fortune!)


        Gah, thank you! Glad I spotted your post as I didn’t realise it would be so difficult! Hoping my doctor is kind haha.

        • charlotte

          Fingers crossed!

  3. Cathryn

    I shall try to leave my comment calmly without letting my inner fury boil over.

    I was in the same situation a few weeks ago as I’m running the Annecy HM later this month. I took my certificate to the doctor and he refused to sign it. It’s practice policy as they think it would open them up to legal action if anything went wrong and they’d signed someone healthy to run. Whilst I was annoyed and frustrated on my own behalf, I entirely agree with them and understand their situation – it’s a waste of their time and puts them in an awkward position.

    I also think that we are entirely responsible for our own choices. We choose to train, or not. We choose to race.

    In the end, I got mine online via CycloSport Medical Certificates. You fill in a questionnaire and it arrives in your inbox the next day for the princely sum of £65. That’s a LOT of money but I felt I had to do things honestly, as I’m trying to teach my little boy that the right, honest decision isn’t always the easiest one. Darn it!

    The whole palaver has definitely put me off running races in these countries in the future!

    • Laura Lucas

      I completely agree – it’s a way to attempt to take responsibility from the race organisers. At the end of the day you can never predict who may or may not have problems during a marathon. I’m not sure why they don’t just have runners sign a specific waiver like in obstacle races if they want to remove responsibility. It’s also very poorly monitored so I bet half the medical certs aren’t even real/valid anyway!

  4. Emily @ Always Emily H.

    This seems like such a waste of time! Especially for 5k, 10k and half marathon distances. I’ve always wanted to run races internationally (I’m from the US) but now this is putting me off a bit.

    Good luck to everyone who needs signatures!

  5. Laura

    I had a letter from my doctor saying I was fit to run but because it didn’t have the exact words in they wanted I had to rush to visit a doctor in Paris the day before the marathon to get another medical certificate – ironically that only cost about €30 which is cheaper than most quotes in the UK! I do think it’s a bit ridiculous as just because you are deemed healthy doesn’t mean you won’t have a problem (I.e. cardiac arrest) out on the course – it can happen to anyone! x

  6. Cathy Robertson

    It seems to vary significantly. My husband and I needed certificates for the Florence Marathon last year. My GP took my BP and pulse, listened to my heart, pronounced me fit, and signed for no charge. My husband’s GP (at the same practice) refused to sign without lots of investigations. He ended up just going to the race expo the day before and self certifying that he was fit to run.

  7. Linda Wright

    I ran Paris marathon in 2016, my GPs practice wasn’t very accommodating about the medical certificate for the race. One of the Drs did sign it and even asked me how far is a marathon??!!
    She charged me £30, then at the Paris Expo they didn’t check it and popped it into a pile with hundreds of other certificates!!
    So yes an interesting topic. All that said Paris is a fabulous marathon. Good Luck and enjoy. Look forward to your post marathon blog. Linda

  8. A Mac

    I am a GP, I also run marathons! As a GP , our medical indemnity DOES NOT cover us for signing marathon certificates. So when you ask your GP to sign, what that that means is that if you collapse and have a cardiac arrest on the course, your loved ones can then sue the GP, the GP then loses their job/livelihood/ license to practice, and even can get a criminal conviction ! So your GP is not being awkward about signing these forms, it’s not about the money, we don’t want the money, we don’t want to be put in that situation of refusing to sign a form for our patient. This is about th3 Marathon organisers trying to absolve themselves of any responsibility. None of us can predict the future and as a marathon runner , you know the risks, please do not put your GP’s career , license and livelihood on the line by asking them to sign these certificates. We are not insured to do so.

  9. Tim

    The main question here is what does fit to run actually mean and how do you test that? I am a GP. I could from reading your records and speaking with you, find that you are well, without significant health problems. I could tell from examining you that your bmi was in the normal range, that your resting pulse and blood pressure were normal and your heart sounds normal. But how does any of that show how you will fare running 26miles? People still die playing sport. Often young, seemingly ‘fit’ individuals particularly from heart conditions that may cause you no symptoms until you collapse in cardiac arrest like the footballer Fabrice Muamba. Things like HOCM, ARVD, things that may only be apparent by specialised testing with ECG, echocardiogram and more dynamic exercise testing. Things generally well outside the realm of your average GP.

    If I were to sign your form and something like this happened where would that leave me? I said you were fit, turns out you weren’t from something possibly diagnosable with the correct testing. If it went to court I wouldn’t have a leg to stand on and a large payout would almost certainly be made to you or whoever brought the case. Historically we made judgment calls and signed these forms on the basis of what we knew about you and our examination findings. But we live in different and far more litigious times and it is for this reason that really GPs should not be doing this work at all. Some still do but they are walking a dangerous tightrope. The situation is very different in Europe, GPs can’t be sued in the same way or for as much as in this country hence their different approach. I have no idea how these online providers do it either. I presume via massive disclaimers absolving themselves of any liability.

    Personally if I was doing a lot of high intensity or distance running I would want to have at least had a normal ECG interpreted by someone used to looking for these cardiac anomalies as a minimum.


    • Tim

      Perhaps I should also say that I have written letters for patients stating that they have no known or previously documented health problems that should preclude them taking part. However this is usually not what these race organisers or certificates want which is an explicit yes you are fit to take part to absolve themselves of the responsibility. Personally I think it is a ridiculous and onerous requirement that almost certainly is unnecessary as shown by the majority of races worldwide not requiring such information.

  10. Gabrielle

    Wow, I had no idea that some doctors charge to sign the forms! I got mine signed by my GP in London last year at a regular check-up with no problems. My friend in Paris told me that she just gets a new generic one signed every year since they don’t have to be race-specific and just have to be signed within the past year (of race date).

  11. Heidi

    I had no problem getting mine from my GP when I did Paris. I just asked him to sign it while I was there for another matter, so it cost me $ but not specifically as I had to pay for the visit anyway. It seems to be a bit redundant if people are forging them and it’s common knowledge this is happening. As everyone else has said, anything can happen on the way whether you have a certificate or not.

  12. Joyce CRAWFORD

    My GP practice signed a medical certificate for me to compete in a 24 hour event in France last year without a charge or even an appointment….I just handed in the form and collected the following day!

  13. Annelies

    I had to get a sport medical check to even join the local atlethic club since I moved to Italy. The medical was very basic, lasts one year and cost me 66 euros. As I am a pilot I already get a work medical which is more extensive every year. So to me this whole sport check seems like a waste. Never needed it before. If you have to get these for races, the whole race becomes quite expensive. At least I use mine a lot I guess.

  14. Andrew D

    I think these would be a good idea but not at £200 per time from your GP…also can see some GPs may be nervous to sign these in case something happens.

  15. Denise

    I don’t understand why they want the medical certificate because like you said, anything can happen, and the seemingly healthiest athletes can drop dead during an event. I think signing a waiver releasing the race organizers from any responsibility should be enough. Having said that I have worked the medical tent at Disney and Tinker Bell marathons and some people should not be running a marathon. I had a couple runners show up at the tent needing to be 911’d out and knowing they had a cardiac history.

  16. Lana Tena

    In Russia you need certeficert for every 5k+ race. So Paris didn’t surprise me. Most of runners here are buying there certificates on the internet, because it’s cheaper than going to the doctor, even with insurance.
    For me this is kind of stupid thing: doctors don’t do any serious tests, they just check blood pressure and heart rate, so this paper has no connection to my fitness level. And if you are a serious runner going for a marathon – you will do the tests and talk to your doctor or coach yourself.

  17. Chiswickmum

    All very interesting – and what about your travel insurance? Some travel insurance policies do not cover marathons, so please check before you run overseas.

  18. Erin

    I’ve never needed a medical certificate to participate in an event, but my kids need them for summer camps. They are always a pretty basic physical- check to see they are up to date on Immunizations, check heart rate, blood pressure, breathing, etc. Ask few questions for the history. It costs about $80 (that’s like 50 pounds?) But usually the doctor will sign for all the camps/school sports for 6 months with just that one check – up – this is also assuming you go regularly to well-child appointments which cost a whole lot more. It’s a pain. I can see the benefit and it releases liability on the camp or school. I don’t think adults need babying the way children do. Adults are also likely to lie. I do think adults don’t use preventative care often enough either. Maybe a quick listen to the heart beat might prevent one person from dying on a course, but who knows. Doesn’t seem likely to me, but what do I know?

  19. maureengetsreal

    I understand the logic behind needing a medical certificate. But what about all of the stories you hear about someone who had been to the doctor, nothing was wrong and then all of a sudden they drop dead from a hidden heart problem? The body can be perfectly healthy one minute and then an emergency happens. What if a problem happens due to extreme heat? There’s a ton of variables so I don’t know how I feel about needing one.

    • Maddy

      I completely agree with you MAUREENGETSREAL. I also don’t find a point in this, rather than making some doctors richer by a couple of $

  20. Maddy

    WOW!!! £200!!!. That’s insane. Where I come from, this is around 16K, which is a lot of money

    One thing that escapes my mind is, how is any medical certificate is of value, if it is purchased at a price.
    The organizing body is aware of this fact. Then why do they insist on a MC? I mean what’s the point?

    I think, there should be some initiative that the Marathon organizing body should take, rather than asking the participants to get the MC.

  21. LS

    I work in GP- we don’t have time to be doing all these extra forms. They are not part of our contract, hence are private and done at our discretion. It depends on how the form is interpreted, if we just look at your notes and sign then it won’t be too expensive but if you require a full check up then that will take longer and will be charged more.

  22. Nicoletta

    Hello there, I know that the process of going to find a doctor who signs a medical certificate is a pain.. but the point is ( I am Italian so I know a bit the system) that the organization would like your doctor to take the responsibility of the tests you need to perform ( before they sign you the certificate) which involves spirometry ( capacity of your lungs to keep /release oxygen), exercise stress test ( to check your heart under effort) and urine tests/blood tests. Very often during marathons we lose a lot of people due to congenital deseases they did not know they had or for not evaluating good enough the effort they can endure and this is a sort of certificate-warning for your doctor to judge if you are fit to run the distance. I was in Rome ( Marathon) yesterday and I needed to pull off at 30km because the heat and the effort ( hills) was such that I felt like fainting a couple of times ( and I did in the end but I was already out of the race).. It was such a bad moment, when you know you need to pull out even if you want to continue! I imagine that if I would have continued I might have got some worse condition …but a lot of people make different decisions when they feel their body is failing .. so while it sucks to find a doctor and everybody could just use a self assessment form/ take his own responsibility for the race I understand where this comes from .. hugs and well done you!! Nicoletta

  23. Ken

    It’s nothing to do with the race organisers, it’s law in France. You should all direct your anger elsewhere. It’s clear in the rules when you sign up, and if you don’t like them or agree with them, don’t enter.


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