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Occupational health screening during Gurkha Central Selection: a retrospective cohort study
  1. Andrew Ka Ho Wong1,
  2. M Paton2,
  3. P Dalbahadur3,
  4. A M Williams4,
  5. F Semakula5,
  6. C Sweeney6,
  7. M Smith7 and
  8. I T Parsons8,9
  1. 1 Royal Centre for Defence Medicine, Birmingham, UK
  2. 2 Medical Regiment, Brecon, UK
  3. 3 Pokhara Medical Centre, Pokhara, Nepal
  4. 4 Royal Lancs Regiment, Chester, UK
  5. 5 Spines and Upper Quadrant Department, Defence Medical Rehabilitations Centre, Loughborough, UK
  6. 6 32 Royal Engineers, Catterick, UK
  7. 7 Defence Primary Healthcare Pirbright, Pirbright, UK
  8. 8 Leeds Beckett University, Leeds, UK
  9. 9 Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Andrew Ka Ho Wong, Royal Centre for Defence Medicine, Birmingham, UK; andrew.wong{at}


Objective The selection process to the British Army’s Brigade of Gurkhas is rigorous, demanding and competitive. The ethos of recruitment to the Gurkhas is grounded in an overarching tenant: that selection is free, fair and transparent. The aim of this study was to retrospectively review reasons for potential recruits (PRs) to be deemed medically unsuitable or deferred suitability on medical grounds for selection to the Brigade of Gurkhas.

Methods A retrospective review was conducted by extracted data from published post-exercise reports for the past four years to ascertain numbers of PRs deemed medically fit, medically unsuitable or deferred suitability on medical grounds. The International Classification of Disease version 11 (ICD-11) codes were retrospectively assigned to code medical reasons for non-progression. Rates of medical non-progression were compared by year.

Results A total of 3154 PRs were analysed between 2018 and 2021. There was no significant difference between PRs deemed medically fit and those deemed medically suitable or deferred on medical grounds over the study period (p=0.351). There was a significant difference in the ratio of PRs deferred on medical grounds and those deemed medically unsuitable over the study period (p<0.05).

Conclusion Selection to the Gurkhas is extremely competitive. These data demonstrate that, overall, reasons for medical deferral or unsuitability have remained constant despite the impact of a global pandemic. These data reinforce the central tenant of Gurkha selection; that it continues to be free, fair, and transparent.

  • audit
  • occupational & industrial medicine
  • audit
  • quality in health care
  • sports medicine

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.

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  • Contributors AKHW conceived the study, collected results, performed data analysis and drafted the manuscript. MP, CS and AMW critically reviewed the manuscript. PD assisted with data collection. ITP edited and critically reviewed the manuscript, provided insight to data analysis and was responsible for the overarching review of the content. AKHW is the guarantor for this study and accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.