Step 4. Medical assessment

Conditions of firefighting are unique and physically and psychologically demanding. Fire and Rescue NSW has a duty of care to individual firefighters, their colleagues and the public and to this end, firefighter candidates are medically assessed to ensure:

  • they can carry out essential tasks without significantly increasing their personal risk of injury or illness, and
  • they are unlikely to place others at risk, and
  • they meet the medical standards for heavy vehicle operations.

A risk assessment approach is used for candidates at this stage of recruitment to ensure they are medically suitable to undertake the job of a firefighter. The medical process is comprehensive in nature due to:

  • high physical, cardiorespiratory and psychological demands of the job,
  • work undertaken in hazardous environments,
  • the safety critical nature of the job – an impairment or sudden incapacity can impact the safety of not only the individual, but their crew and the community.

Candidates who progress to the medical assessment stage will be required to undergo a detailed standardised pre-employment health assessment with a FRNSW Occupational Physician. Prior to this appointment candidates will need to:

  • Have FRNSW referred blood, urine and spirometry tests and ECG at the candidate’s cost;
  • obtain historical medical documentation relating to previous hospitalisations, surgeries or other significant health conditions;
  • obtain current status reports from treating doctors where indicated (further information is provided to candidates progressed to the medical assessment).

The results from the pre-employment blood and urine tests and ECG are sent to FRNSW for review by its Health and Safety team, including the Occupational Physicians. All information received is assessed by FRNSW against the demands of the job. In general, FRNSW is concerned about:

  • conditions carrying a risk of sudden incapacity or impairment;
  • conditions which could affect functional capacity for performing firefighting tasks;
  • conditions which could be aggravated by firefighting duties.

If a candidate has/has had a specific condition or injury, FRNSW, after initial review, may require the candidate to provide further information or undergo further assessment. Costs associated with any additional testing for pre-existing conditions requested by FRNSW for the purpose of suitability to the role, will in the majority of cases, sit with the candidate. All candidates should ensure that information from treating doctors/specialists relating to any pre-existing medical conditions is submitted prior to or at a minimum is available at the time of their pre-employment health assessment. This will allow timely assessment and avoids delaying the processing of their application.

If you have had any questions regarding a significant medical condition or injury, please feel free to email FRNSW at Please note, while FRNSW may be able to provide general advice, it is unable to provide ‘pre-assessment’ of individual cases. Examples of conditions generally considered not compatible with unrestricted operational firefighting duties include, but may not be limited to: previous heart attack, implantable defibrillators, diabetes requiring insulin, hearing aids, permanent need for blood thinning medications (anticoagulants eg warfarin, apixaban), joint replacement surgery.

Medical conditions can be complex, and in some instances, after appropriate case assessment, may ultimately be found to be incompatible with unrestricted firefighting duties. Candidates must satisfy all FRNSW medical requirements to progress.