MEDICAL STANDARDS FOR FITNESS TO RIDE
These Standards apply to all applicants for amateur and professional jockeys licences and permits (under the Rules of Racing) and riders qualification certificates (under the Regulations for Point-to-Point Steeple Chases).

PREFACE
Race riding is an activity that requires each and every jockey to exercise physical skills and judgement of an extremely high order. Any failure in a jockey's performance may not only put his/her life in danger but may also put others at risk of injury, permanent disability or death.

The British Horseracing Authority requires that all jockeys applying for a licence or permit to ride under Rules or Point-to-Point Regulations provide a Declaration of Health and appropriate medical evidence of his/her 'fitness to ride'.

Each application is subject to scrutiny ourChief Medical Adviser who may request additional medical reports or specialist examination as appropriate. All costs incurred in providing this information are the responsibility of the applicant.

When sufficient information is available, a medical recommendation regarding each applicant is made to the Licensing Committee or the Point-to-Point Department for their consideration.

The final decision to grant or refuse a licence or permit rests solely with the Licensing Committee and such decisions may be subject to a Medical Review Procedure where appropriate.

Existing licence or permit holders who, during the period of the licence or permit, suffer a significant injury (eg. concussion, fracture) or significant illness (eg. hepatitis) that could in any way affect their fitness to ride, must inform the Chief Medical Adviser at the earliest opportunity. This applies to any significant illness or injury - regardless of whether or not it resulted from a racing incident (eg. road traffic accident, hacking, eventing, on the gallops, winter sports, hang gliding, etc.).

Dr Michael Turner
Chief Medical Adviser

IF ANY OF THE FOLLOWING STATEMENTS APPLIES, THE LICENCE/PERMIT WILL INVARIABLY BE DECLINED OR DEFERRED -

1) THE THERAPEUTIC EFFECT OF THE MEDICATION MAY PUT A RIDER AT RISK WHEN HE/SHE RIDES OR FALLS.
2) THE SIDE EFFECTS, ACTUAL OR POTENTIAL, OF THE MEDICATION ARE SUCH THAT THEY COULD INTERFERE WITH THE RIDER'S PHYSICAL CAPABILITY, JUDGEMENT, CO-ORDINATION OR ALERTNESS.
3) A VOLUNTARY OR INVOLUNTARY ADJUSTMENT OF THE DOSAGE, ADMINISTRATION OR ABSORPTION OF THE MEDICATION MAY INTERFERE WITH THE RIDER'S PHYSICAL CAPABILITY, JUDGEMENT, CO-ORDINATION OR ALERTNESS.

Examples -
1) Individuals taking WARFARIN will not be granted a licence.
2) When an applicant requires the short term administration of a psychotropic drug (eg. AMITRIPTYLINE), the application will be deferred until the individual has been "off all medication and symptom free" for an acceptable period of time - normally 3 to 12 months.
3) Applicants with insulin dependent diabetes or who have, or have had, epilepsy will not be granted a licence or permit to ride under the Rules of Racing or the Regulations for Point-to-Point Steeple Chases, save in so far that an individual meets ALL the following criteria in relation to epilepsy -
a) has been free of epileptic attack for at least 10 years
b) has not taken any anti-epileptic medication during this 10 year period
c) does not have a continuing liability to epileptic seizure.

These criteria mirror the current Epilepsy Regulations for applicants for Group 2 Driving Licences, which the Licensing Committee has decided are the appropriate criteria to follow, and it is therefore likely that the Licensing Committee will adopt any relevant changes to the Epilepsy Regulations from time to time.

These Medical Standards cover the areas of major concern to the British Horseracing Authority but, inevitably, cannot deal with every medical condition seen in practice.

The Standards are not intended to restrict or limit in any way the discretion of theBritish Horseracing Authority to adopt a different approach in any case and to depart from these Standards where it considers it necessary or desirable to do so.

Each application is considered individually on its merits and further clarification can be obtained by contacting -

The HRA Chief Medical Adviser
The British Horseracing Authority
151 Shaftesbury Avenue,
London
WC2H 8AL

T: 020 7189 3037
F: 020 7189 3836

Key to Classification
A = Normally ACCEPTABLE

D = DEFERRED - specialist opinion will normally be required prior to acceptance or refusal. Examination by the Chief Medical Adviser may also be necessary. (All costs involved in satisfying these criteria are the responsibility of the individual applicant.)

R = Normally REFUSED

AGE
Although no upper age limit exists for race riding, it is unusual for jockeys to continue racing after they reach the age of -

40 - professional Jump jockeys

50 - Amateur jockeys

50 - professional Flat jockeys

Any applicant for a Jump Licence whose age is 40, or above, will normally be required to undergo additional investigation, which may include an MRI brain scan. A medical examination by the Chief Medical Adviser is required in every case.

Any applicant for an Amateur Permit, Flat Jockey's Licence or Point-to-Point Permit whose age is 50 or above, will normally be required to undergo additional investigation which may include an exercise stress test and/or MRI brain scan. A medical examination by the Chief Medical Adviser is required for all amateur and professional Flat jockeys aged 50 or over.

CARDIOVASCULAR DISORDERS
Ischaemic heart disease/Angina - R
Heart failure - R
Myocardial infarction - R
By-pass grafting - R
Angioplasty - R
Cardiac transplant - R
Dysrhythmias - D
Pacemakers - R
Cardiac valvular disease - D
Hypertension - D
Cardiomyopathies - D
Congenital heart disease - D
Marfan's Syndrome - R
Treatment with anticoagulants - R
Peripheral vascular disease - R

Thyroid disease - D
Diabetes insipidus - R
Adrenal disorders - D

GASTRO-INTESTINAL AND ABDOMINAL DISORDERS
Acute gastric erosion - R
Chronic gastritis - D
Gall stones - D
Active peptic ulcer - R
Hiatus hernia - A
Inguinal hernia - D
Haemorrhoids, anal fissure, fistulae - D
Cirrhosis - R
Chronic pancreatitis - R
Colostomy, ileostomy - D
Colitis (ulcerative or Crohns) - D

GENITO-URINARY AND RENAL DISORDERS
Chronic Renal Failure - R
Renal transplant - R
Nephritis - D
Kidney stones - D
Prostatitis - A
Single kidney or horseshoe kidney - D

GYNAECOLOGICAL CONDITIONS
Pregnancy - D
Caesarian section - D (see Surgery below)
Hysterectomy - D (see Surgery below)

HEARING
Hearing must be adequate for the jockey to hear instructions and to ensure that the safety of other riders is not put at risk.

Tuberculosis (active) - R
Hepatitis - D
HIV positive - D
AIDS syndrome - R

MEDICATION
IF AN APPLICANT REQUIRES, OR HAS REQUIRED, REGULAR MEDICATION TO MAINTAIN HIS/HER PHYSICAL OR MENTAL WELLBEING, A LICENCE MAY BE DECLINED.

IF ANY OF THE FOLLOWING STATEMENTS APPLIES, THE LICENCE WILL INVARIABLY BE DECLINED OR DEFERRED -

1) THE THERAPEUTIC EFFECT OF THE MEDICATION PUTS A RIDER AT RISK WHEN HE/SHE RIDES OR FALLS. (eg WARFARIN)

2) THE SIDE EFFECTS, ACTUAL OR POTENTIAL, OF THE MEDICATION ARE SUCH THAT THEY COULD INTERFERE WITH THE RIDER'S PHYSICAL CAPABILITY, JUDGEMENT, CO-ORDINATION OR ALERTNESS.

3) A VOLUNTARY OR INVOLUNTARY ADJUSTMENT OF THE DOSAGE, ADMINISTRATION OR ABSORPTION OF THE MEDICATION MAY INTERFERE WITH THE RIDER'S PHYSICAL CAPABILITY, JUDGEMENT, CO-ORDINATION OR ALERTNESS.

MUSCULO-SKELETAL DISORDERS
Amputation of a limb or part of a limb - R
(loss of digit(s) will be reviewed on an individual basis - D)
Fracture - D (see below)

Before applying to return to race riding, the jockey should have an appropriate range of painfree movement, radiological evidence of a sound bony union, clearance from an orthopaedic surgeon and be able to show that his/her ability to ride is unaffected. No jockey may race wearing a plaster cast, backslab, fibre-glass support, prosthesis or similar appliance.

Fractures of the skull and spine are of particular concern and medical clearance by the Medical Adviser is required in every case. This will normally involve an examination by the Chief Medical Adviser.

Dislocated Acromio-Clavicular (A/C) joint - D - see below.
Before applying to return to race riding, the jockey should have an appropriate range of painfree movement and be able to show that his/her ability to ride is unaffected.

Dislocated or subluxed shoulder - first occasion - D.
Before applying to return to race riding, the jockey should have an appropriate range of painfree movement and be able to show that his/her ability to ride is unaffected.

Dislocated or subluxed shoulder - recurrent - R.
Before returning to race riding, the jockey must have an appropriate surgical repair. After rehabilitation, the jockey should have an appropriate range of painfree movement and be able to show that his/her ability to ride is unaffected.

Rheumatoid Arthritis - D
Spondylolisthesis - D
Slipped Disc - D (normally R for a minimum of 12 months)
Joint replacement or internal metal fixation - D

NEOPLASIA/CANCER - D

NEUROLOGICAL DISORDERS
Chronic migraine - D
Chronic neurological disorders - R
(eg. Parkinson's Disease, Multiple Sclerosis etc.)
Chronic Menieres, vertigo or labyrinthitis - R
Cerebrovascular disease - R
Meningitis or encephalitis - D
Intracranial tumour requiring craniotomy - D

Epilepsy - R
unless the applicant can meet ALL the following criteria -
a) has been free of epileptic attack for at least 10 years
b) has not taken any anti-epileptic medication during this 10 year period
c) does not have a continuing liability to epileptic seizure.

Single seizure - following acute head injury or intracranial surgery - D. An applicant may be reviewed after a minimum of 12 months provided that he/she has been off all anti-epileptic medication and has been free of fits during that period.

PLEASE NOTE - following any cranial fracture or surgery, the integrity and/or strength of the skull must not be significantly compromised.

PSYCHIATRIC DISORDERS
Neuroses (eg. Anxiety state, depression) - D.
Applicants will be required to be off all medication and to be symptom free for an acceptable period of time (normally 3 to 12 months, depending on the diagnosis and type of therapy required).

Psychoses (eg. Manic Depressive Illness, Schizophrenia) - R
Schizo-affective disorders - R
Dementia (eg. Pre-senile, Alzheimer's Disease) - R
Personality disorder (eg. Post head injury syndrome, psychopathic disorders) - R
Dependance (or chronic abuse) - alcohol or drugs - R
Chronic solvent misuse - R

RESPIRATORY DISORDERS
Asthma - A
Chronic obstructive airways disease - D

Appendicectomy - D (uncomplicated - minimum 12 weeks)
Hernia repair - D (minimum 16 weeks)
Cholecystectomy - D (minimum 16 weeks)
Caesarian Section - D (minimum 16 weeks)
Hysterectomy - D (minimum 16 weeks)

VISUAL ACUITY
Corrective lenses are acceptable provided that these are in the form of "soft contact lenses".
MINIMUM requirements with or without corrective lenses -