A football medical can take up to six hours and includes physical exams, cardiovascular tests like ECGs and echocardiograms, blood work, musculoskeletal assessments, and neurological evaluations. These tests check overall health, heart function, liver and kidney performance, and injury history. Players undergo MRI scans, X-rays, and concussion assessments as part of the process.

Results are reviewed by the buying club's medical team, who help determine whether the transfer should proceed. A player doesn't technically pass or fail a medical; instead, clubs weigh the risks and benefits of signing them. Dr Charlotte Cowie, former medical head at Tottenham and Fulham, explained that decisions depend on the player's condition, the club's needs, and the financial implications.

Some transfers have fallen through due to medical concerns. For example, Ruud van Nistelrooy's 2000 move to Manchester United was delayed after he tore his ACL shortly afterward. In 2013, George Boyd's transfer to Nottingham Forest collapsed following an inconclusive eye test.

More recently, Kurt Zouma's move to Shabab Al-Ahli in 2024 and Jean-Philippe Mateta's proposed transfer to AC Milan in 2026 were both called off due to medical issues. Medical providers like the Manchester Institute of Health and Performance (MIHP) remain on standby during transfer windows to conduct thorough evaluations quickly. MIHP's Sarah Mc Dermott emphasized maintaining high clinical standards while being flexible enough to work nights and weekends.

Verbal results are typically available the same day, with blood tests returned within four hours. Players react differently to medicals, ranging from relaxed to anxious, but all receive the same comprehensive care.