Marathons In Europe That Require A Sports Medical Certificate
Only a small number of European countries make a doctor’s medical certificate a condition of entering a marathon, and the rules changed significantly in France. Italy is now the clearest case: its competitive races require a sports medicine certificate backed by an ECG and other tests. France replaced the certificate with an online health pass in 2024. Most of the other major European marathons, including Berlin, London, Amsterdam and Barcelona, ask only for a health declaration.
This page states what each named race publishes in its own entry rules, and it is honest about the two places where a UK doctor cannot help. A remote UK consultation cannot produce an Italian competitive sports certificate, because that certificate depends on tests carried out in person. It also cannot replace the French health pass, which is issued by the French athletics federation and not by a doctor. Always read the entry rules for the specific edition you are entering, because organisers revise them each year.
Sports Medical Certificate: Online, GMC-Registered Doctors
For events that accept a certificate from your own doctor, MedicalCert issues a sports fitness certificate after an online consultation. Check your event’s published entry rules first, because French and Italian races have their own national requirements that a UK certificate does not replace.
What Each Major European Marathon Publishes In Its Own Entry Rules
Every entry below is taken from the organiser’s own published rules or health information page, with the edition it refers to. Where an organiser has not published a medical requirement, that is stated as such rather than presented as a positive rule.
| Marathon | Country | Doctor’s certificate required? | What the organiser actually publishes |
|---|---|---|---|
| Schneider Electric Marathon de Paris | France | No, a federation health pass instead | The organiser’s health certificate page for the April 2026 edition states that the Health Prevention Course, its English name for the FFA Pass de Prévention Santé, is mandatory and that the medical certificate has been replaced since 2024. The French version of the same page gives the alternative of uploading an FFA licence. The pass number must be entered on the entrant’s Time To dashboard up to seven days before the race |
| Run In Lyon | France | No, a federation health pass instead | The organiser’s medical certificate page states that the PPS issued by the FFA has cost 5 euros and been valid for one year since 15 January 2026, and that the number is entered on the participant dashboard. An FFA licence is accepted instead. Non-licensed entrants under 18 complete a health questionnaire and need a doctor’s certificate only if they answer yes to any question |
| Run Rome The Marathon | Italy | Yes for the competitive race, no for the non-competitive entry | The official rules for the March 2027 edition require, for non-Italian citizens living outside Italy, a FIDAL RUNCARD plus a medical certificate on FIDAL’s own form, uploaded to ENDU.net by the tenth day before the race. Separately, foreign citizens living abroad may enter as non-competitive runners by accepting a disclaimer on ENDU.net, with a time but no ranking position and no prizes |
| Wizz Air Milano Marathon | Italy | Yes for the competitive race, no for the sport tourism entry | The official rules for the April 2026 edition require foreign athletes residing abroad to hold a RUNCARD and to show, in original, a certificate of eligibility for competitive athletics, either from their own country meeting the Italian tests or on the organiser’s downloadable health form. Foreign residents abroad may instead enter for sport tourism purposes in a separate non-competitive event, accepting a liability waiver and health declaration on the entry form |
| Estra Firenze Marathon | Italy | Yes for the competitive race, no for the non-competitive entry | The regulation for the 29 November 2026 edition requires a competitive athletics fitness certificate valid on race day, uploaded to the ENDU portal before the event. Foreign runners not resident in Italy may use a certificate issued in their own country provided the same Italian tests were carried out and are listed on it. Unregistered foreign athletes may take part in the non-competitive event, with a time but no FIDAL or World Athletics ranking place |
| Zurich Marató Barcelona | Spain | No | The race regulation requires a health self-declaration at entry, in which the runner declares they are physically and psychologically fit. The organiser recommends, but does not require, a medical examination before the race. No certificate is collected |
| BMW Berlin Marathon | Germany | No | The registration information page sets no certificate requirement. It advises that anyone running a marathon should have a medical check at least once a year, and offers a free, non-binding online health screening that the organiser states does not replace seeing a doctor |
| TCS London Marathon | UK | No | The event’s FAQs set no certificate requirement. Its medical advice page tells runners to speak to their GP first, particularly with a family history of heart problems, high cholesterol, high blood pressure or diabetes, and to write medical conditions and medication on the back of the race number |
| TCS Amsterdam Marathon | Netherlands | Not published as a requirement | The competition regulations for the 2026 edition set no medical certificate requirement. They require the participant to list medical details on the back of the bib, and allow the organiser to withdraw a participant on medical grounds |
France: The Pass Prévention Santé Replaced The Medical Certificate
France no longer asks adult runners for a doctor’s certificate to enter a road race. The law of 2 March 2022 on democratising sport allowed the requirement to be lifted, and the Fédération Française d’Athlétisme replaced it with the Parcours de Prévention Santé, which became compulsory for non-licensed adults from 1 September 2024. Since 15 January 2026 it is called the Pass Prévention Santé, it costs 5 euros, and it is valid for one year rather than three months.
English-language pages run by French organisers, including the Paris Marathon and Run In Lyon, call the same thing the Health Prevention Course, or HPC. It is not a separate system and it is not a cardiac profile. It is the FFA’s own pass, obtained on the federation’s platform at pps.athle.fr, and it carries civil liability cover as well as the health prevention content.
What UK Runners Need To Know About The French Pass
The pass is obtained from the FFA directly. You create an account, work through the prevention material and health questions, pay the 5 euro annual fee and receive a pass number and a downloadable document. That number goes on your race entry. Holders of a valid FFA competition, entreprise or running licence do not need a separate pass. A letter from a UK GP is not an alternative to it, and neither is a UK Athletics registration. A doctor becomes relevant only if the health questions raise something that needs assessing before the pass is issued.
Under-18s who are not FFA licence holders are outside the pass system. They complete a free health questionnaire before each race, and a doctor’s certificate of no contraindication to competitive athletics is required only where the questionnaire indicates one.
Italy: The Competitive Sports Certificate, And Why A Remote Consultation Cannot Produce One
Italy is the stricter of the two regimes and it has not followed France. To run an Italian marathon as a competitive entrant you need a certificate of fitness for competitive athletics, the certificato di idoneità agonistica, and organisers are explicit that it must be issued for athletics specifically. Rome’s rules state that certificates issued for other sports will not be accepted, and Rome’s Italian-language rules add that wording such as running, road running, marathon or half marathon is not valid.
Where a foreign runner is allowed to use a certificate issued in their own country, Rome, Milan and Florence all publish the same list of examinations that must have been carried out, following Italian health legislation:
- A medical examination
- A complete urinalysis
- An electrocardiogram at rest and after exercise
- Spirometry, also written as spirography
Rome and Milan both direct foreign entrants to a specific form for the doctor to complete, sign and stamp, and Rome requires the reports of the examinations to be authentic or original. Florence requires the examinations to be listed on the certificate itself.
The Non-Competitive Route Foreign Runners Often Miss
Rome, Milan and Florence all publish a separate entry route for foreign citizens resident abroad who are not members of a FIDAL or World Athletics affiliated club. Rome allows entry by accepting a disclaimer during registration. Milan describes it as participation for sport tourism purposes in a non-competitive event held alongside the marathon, with a different bib. Florence offers a non-competitive place. In each case no competitive sports certificate is required, and in each case you appear in the results with a time but without a ranking position, and you cannot receive prizes. For most visiting UK club runners that is the practical option. Check the current rules before you rely on it, because the route is set by the organiser each year.
What A UK Sports Medical Certificate Should Contain
This applies to events that accept a certificate from the runner’s own doctor. It does not satisfy the French pass requirement, and on its own it does not meet the Italian competitive standard described above. Where a UK certificate is accepted, it should include:
| Element | Detail |
|---|---|
| Runner’s full name and date of birth | Identifies the certificate holder, and should match the race entry exactly |
| Statement of fitness for the specific event | Explicit confirmation for distance running, not just “fit for sport” generally |
| Cardiovascular assessment | Confirmation of no known cardiovascular contraindication, based on the history and any tests actually carried out |
| Date of examination or consultation | Many organisers require the certificate to be dated within 12 months of the race, so check the rule for your event |
| Doctor’s name and GMC registration number | Enables the organiser to verify the doctor |
| Doctor’s signature and practice details | Authentication |
| The organiser’s own form, where one exists | Several races publish a template. Where they do, a free-text letter is likely to be rejected even if its content is correct |
Entering An Event That Accepts Your Own Doctor’s Certificate?
GMC-registered doctors, online consultation, certificate issued digitally. Send us your event’s form or published wording with your consultation so the certificate is issued in the format the organiser asks for.
Frequently Asked Questions: Marathon Medical Certificates
Will my UK GP letter be accepted at the Paris Marathon?
No. The Paris Marathon’s own health certificate page for the 2026 edition states that the medical certificate has been replaced since 2024 and that you must complete the Health Prevention Course, the English name for the FFA Pass de Prévention Santé. The French version of the page allows an FFA licence as the alternative. A UK GP letter is neither of those. The pass is obtained online from the FFA and the number is entered on your Time To dashboard up to seven days before the race.
How long before the race do I need to sort the paperwork?
Earlier than most runners expect, because the deadline is usually before race week. The Paris Marathon wants your pass number up to seven days before the race. Rome requires the medical certificate to be uploaded to ENDU.net by the tenth day before the race. Run In Lyon starts validating uploaded documents a month out. Florence takes uploads after entry but before the day of the event. The French pass is valid for one year from issue, so it must still be in date on race day.
What if my document is not accepted?
You will not be given a race number. Entry fees are generally non-refundable, and Rome states plainly that the registration fee is not refundable. The realistic protection is to read the rules for your specific edition when you enter, use the organiser’s own form where one is published, and upload well before the cut-off so there is time to correct a rejection. If a document is refused and you believe it met the published rule, contact the organiser in writing straight away.
Do I need a certificate for a half marathon or 10K in Europe?
In France, no certificate, but the FFA pass applies well beyond the marathon. The federation lists 5km, 10km, 20km, ekiden, half marathon, marathon, ultra marathon, trail, ultra trail, mountain running, cross country, race walking and Nordic walking. In Italy, competitive races of shorter distances are also run under FIDAL rules and generally require the same competitive athletics certificate. Elsewhere in Europe the pattern for shorter races follows the marathon, but check the individual event.
Can a UK doctor issue the certificate for an Italian marathon?
Only if that doctor can carry out the full set of tests in person. Rome, Milan and Florence accept a certificate issued in the runner’s own country, but only where a medical examination, a complete urinalysis, an electrocardiogram at rest and after exercise, and spirometry have all been performed, and Rome and Milan direct entrants to a specific form for the doctor to sign and stamp. An online consultation cannot produce those test results, so MedicalCert cannot issue this certificate. Foreign runners who do not want to arrange the testing usually use the non-competitive entry route instead.
Which major European marathons do not require a certificate?
Of the races checked here, Berlin, London, Amsterdam and Barcelona set no certificate requirement in their published rules, and the French races require the FFA pass rather than a doctor’s certificate. Berlin advises an annual medical check and offers a voluntary online health screening. London tells runners to see their GP first if they have relevant risk factors. Barcelona asks for a health self-declaration and recommends a medical examination. Amsterdam publishes no medical requirement in its competition regulations. Do not generalise from this list to other races, as each organiser sets its own rule.
Does a UK Athletics registration count instead?
Not in France or Italy. The French system recognises FFA licences, and the FFA pass is the route for everyone else, whatever national body they are registered with. In Italy, membership of a club affiliated to a World Athletics member federation is recognised, but a runner entering on that basis has to evidence the membership, and runners without it fall into the RUNCARD categories that require the competitive sports certificate. Check which category your entry falls into before assuming your home registration carries across.
Sports Medical Certificate From GMC-Registered Doctors
Online consultation, digital certificate, no appointment. Suited to events that accept a certificate from your own doctor. It does not replace the French federation pass or an Italian competitive sports certificate.
