A pre-employment medical is a narrow question asked properly: is this person fit to do this specific job safely? Done well, it protects the employee, the employer and everyone working alongside them. Done badly, it becomes an expensive ritual that satisfies a file and tells nobody anything.
This guide covers what a proper fitness-to-work assessment includes, what it should never include, and how organisations in Nigeria can run one that stands up to scrutiny.
What the assessment is actually for
A pre-employment medical has three legitimate purposes. It confirms a candidate can perform the essential functions of the role safely. It establishes a health baseline at the point of hire. And it identifies whether any reasonable adjustment would let a candidate do the job safely where they otherwise could not.
That third purpose is often forgotten. The assessment is not a filter for finding reasons to reject people. A well-run process frequently returns fit with adjustment, which keeps good candidates in roles they can do.
The baseline function matters more than most employers realise. If a worker later develops a condition potentially linked to the workplace, a documented baseline from the point of hire is the only way to establish what changed and when.
What a proper assessment includes
Content should follow the job's hazards. A desk-based analyst and an industrial plant operator do not need the same assessment, and giving them the same one wastes money on one and misses risk on the other.
- Medical history and a structured clinical examination.
- Vision assessment, essential for driving, machinery operation and safety-critical work.
- Audiometry where the role involves noise exposure.
- Spirometry, or lung function testing, where dust, fumes or respiratory hazards are present.
- Baseline laboratory work, typically a full blood count, blood sugar and basic chemistry.
- Infectious disease screening where the role involves patient contact or food handling.
- Cardiac assessment such as ECG for safety-critical and physically demanding roles.
- Musculoskeletal assessment where the job involves manual handling.
For food handlers, screening requirements are specific and should be confirmed against the applicable public health requirements for the role.
What it should not include
Some things belong nowhere in a pre-employment assessment. Genetic testing has no place in a fitness-to-work determination. Pregnancy testing should not be performed as a hiring screen. And detailed clinical findings unrelated to job fitness are not the employer's information to receive.
The reporting model matters here. The candidate receives their own full results, confidentially, as their own medical information. The employer receives a fitness determination: fit, fit with specified adjustments, or not fit for this role, with only the reasoning that is directly relevant to the job.
Running the process well
- Define the role's hazards first, then design the assessment around them.
- Apply the same assessment consistently to every candidate for the same role.
- Obtain informed consent, with the candidate understanding what is tested and what the employer will receive.
- Schedule efficiently. Onsite screening days for volume hiring cost far less in lost working hours than sending people out individually.
- Turn results around quickly. A hiring process stalled waiting on medicals loses good candidates to faster employers.
- Store records securely and retain them in line with your data obligations.
For candidates: what to expect
Attend well rested and hydrated, and follow any fasting instruction you are given. Bring identification, your medication list and any relevant previous results.
Answer the medical history honestly. Concealing a condition that later causes an incident at work is far more damaging than disclosing it, and disclosure often leads to an adjustment rather than a rejection.
Ask for your own results. They are yours, they are useful, and a baseline set of numbers you keep is genuinely worth having regardless of the job.
