Research: Unfit for Service

Research Paper Title

Unfit for Further Service: Trends in Medical Discharge from the British Army 1861-1998.


Military service requires individuals who are free from ill-health and who are physically and mentally robust, and throughout history those who have become unfit for service have been discharged on medical grounds.

This paper used published historical records to examine trends in the rate of discharge for six key conditions for the period 1861-1998 and to draw conclusions.

In the late 19th and early 20th centuries, communicable diseases such as tuberculosis and syphilis were a major problem together with illdefined conditions such as “disordered action of the heart”.

By the mid-20th century, psychiatric and gastrointestinal disorders had become the principal causes of medical discharge, whereas in the late 20th century, the majority of discharges resulted from injuries and musculoskeletal disorders.

The pattern of conditions leading to medical discharge from the Army tends to mirror conditions which are prevalent at that time in the civilian population.

Source: Bergman, B.P. & Miller, S.A.StJ. (2000) Unfit for Further Service: Trends in Medical Discharge from the British Army 1861-1998. Journal of the Royal Army Medical Corps. 146, pp.204-211.


5 thoughts on “Research: Unfit for Service

  1. I notice that one of the conditions that may preclude candidates from entry in the RAF is ADHD. Is this a blanket exclusion? I ask because a) it is an increasingly diagnosed condition (possibly over-diagnosed, if statistics from the US are to be believed b) it covers a broad spectrum where minor symptoms have little or no impact on ability to function c) the US military seem to be relaxing their stance on it d) for some with ADHD, the strict discipline and routine that is part of RAF life may be highly beneficial – and they may prove very valuable recruits.

    I know someone that is applying to the RAF who falls into this category (borderline diagnosis). What’s the best advice to them? Should they apply for a waiver? Should they proactively bring it up at their medical? Who can they (confidentially) go to for advice?

    Many thanks

    1. Hi Marcus,

      Simple Answer: No.
      Longer Answer:
      1. The guidance notes state: Attention deficit hyperactivity disorder (ADHD) unless free of symptoms and not requiring treatment for at least three years.
      2. You friend would have no choice but to bring it up during their medical, as the MOD requests medical information from the candidate’s GP as part of the recruitment process.
      3. Your friend could speak to their GP or SSAFA (
      4. It should be noted that Careers Advisers and their office staff are not medically qualified and that all final decisions regarding medical suitability for entry are only made by appropriately appointed (MOD) medical staff.

  2. Im trying to join British army reserve and my medical came back rejected as I’ve had a splenectomy, on researching the Internet I read the US military take recruits on with a splenectomy if it’s been removed from a trauma which mine was from a road accident.

    Any advice on helping my appeal to get a medical

    Many thanks

    1. Hi Rod,

      You are correct, history of splenectomy (for the US Military) is disqualifying, except when resulting from trauma (AR 40-501, p.4). The British Army’s Application Guidance Notes (Section 3.16) specifically state that splenectomy makes an individual permanently unsuitable for entry into the Army. Reasons why the Army may have reached this conclusion includes individuals (my wife is a qualified medical professional):

      1. At increased risk of infection;
      2. Being non-deployable;
      3. Requiring lifelong penicillin; and
      4. Requiring a pneumococcal vaccination every year.

      You could appeal the outcome but I doubt you would get the decision reversed. Sorry, not what you wanted to hear.

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