Transfer deadline days often bring last-minute drama, and few moments carry as much tension as the medical examination a player must complete before a move is finalised. While fans may assume this is a formality, the process is in fact an exhaustive, multi-stage assessment that can take up to six hours and, on occasion, derail a transfer entirely.
The examination typically covers five broad areas: physical exams, cardiovascular health tests, laboratory work, musculoskeletal assessments and neurological evaluations. Physical exams measure basic vitals such as height, weight, blood pressure and heart rate, alongside checks on muscles, joints and bones. Cardiovascular testing goes further, using electrocardiograms, echocardiograms and stress tests to examine heart function in detail.
Blood work forms another key pillar, giving doctors a full blood count as well as insight into liver function, while urine and drug tests are also standard. To assess a player's physical condition more thoroughly, clubs use full-body MRI scans, X-rays and ultrasounds to study motion, strength, posture and movement. Neurological testing, meanwhile, examines balance, coordination and psychological wellbeing, including concussion assessments.
Once completed, the results are forwarded to the buying club's medical staff for analysis. Crucially, a player does not simply "pass" or "fail" a medical — instead, the findings inform a judgement call by the club on whether to proceed with the signing despite any potential risks uncovered.
Dr Charlotte Cowie, who formerly headed medical departments at Tottenham and Fulham, likened the process to a risk-benefit calculation rather than a strict pass-fail system. "One man's fail is another man's pass," Cowie told BBC News. "It really depends on where the player is injury-wise, what the manager and the club want from that player and what it's going to cost. It's a risk-benefit analysis."
History offers several examples of medicals influencing — or halting — transfers. Ruud van Nistelrooy's move to Manchester United in 2000 was delayed following his medical, and within a week he suffered a ruptured anterior cruciate ligament. In 2013, Peterborough United's George Boyd saw his switch to Nottingham Forest collapse after an eye test returned an inconclusive result, despite the forward continuing his career elsewhere without issue. More recently, West Ham defender Kurt Zouma's proposed 2024 move to UAE club Shabab Al-Ahli fell apart following his medical examination. In January 2026, Crystal Palace striker Jean-Philippe Mateta's deadline-day transfer to AC Milan was similarly called off after concerns arose during his medical.
Behind the scenes, facilities that carry out these examinations must operate with significant flexibility, particularly during the frantic transfer window period. The Manchester Institute of Health and Performance (MIHP), which conducts medicals on behalf of clubs, says its staff must remain highly responsive at all times. "We have to be as responsive as possible during the transfer window to medical requests from clubs - this includes working after hours and weekends," said MIHP clinical lead Sarah McDermott.
Despite the pressure of tight deadlines, McDermott insisted that standards are never compromised, with every player receiving "the same attentive care and a comprehensive evaluation". Francesca Bagshaw of MIHP's performance team added that departments work together to provide "fast, high‑quality service under tight timelines".
Turnaround times vary depending on the complexity of the tests required, though MIHP aims to deliver verbal reports to clubs on the same day, with blood results typically available within four hours. McDermott also noted that players react differently to the process itself: "All players are different and approach medicals with a range of attitudes, some are relaxed and some are more apprehensive."
Based on reporting from BBC Sport.