A pre-employment medical in China for foreign hires is a legal requirement for obtaining a work permit and residence permit. The exam is standardized by Chinese immigration health regulations and must be completed at a designated health examination center — not just any hospital. Whether you are an HR manager planning onboarding or a foreign employee preparing for relocation, understanding the process prevents delays. This guide covers what the exam includes, how to prepare, and common pitfalls.
What the Pre-Employment Medical Exam Includes
The foreigner employment medical exam is a standardized set of tests required by Chinese immigration authorities. It is not the same as a voluntary health checkup — it has a fixed scope determined by regulation.
The Standard Test Panel
- Physical examination: height, weight, blood pressure, vision, hearing
- Chest X-ray: screening for active tuberculosis
- Blood tests: HIV, syphilis, and sometimes other infectious disease markers
- ECG (electrocardiogram): basic cardiac screening
- Abdominal ultrasound: screening for major organ abnormalities
- Urine analysis: basic kidney and metabolic screening
The exam is designed to screen for conditions that would make a foreigner ineligible for a work permit under Chinese law — primarily active infectious diseases and conditions that pose public health risks. It is not a comprehensive health checkup. See how this differs from a voluntary checkup in our case studies.
What It Does Not Include
The employment medical does not include cancer screening, comprehensive blood panels, hormone testing, or specialist consultations. If you want a thorough health assessment, you should book a separate voluntary checkup. Many employers offer this as a benefit — see our corporate planning resources and the cost comparison page for budgeting.
Where to Get the Exam: Designated Health Examination Centers
The employment medical must be done at a designated International Travel Healthcare Center or a hospital authorized by Chinese immigration health authorities. Not every hospital qualifies.
International Travel Healthcare Centers
These are purpose-built facilities in major cities (Beijing, Shanghai, Guangzhou, Chengdu, and others) that specialize in foreigner employment medicals. They are efficient, English-speaking, and familiar with the documentation requirements. Booking is usually straightforward — call or visit with your passport and employer’s offer letter.
Authorized Hospitals
Some large public hospitals are also authorized to conduct the employment medical. The process may be less streamlined than at a dedicated center, and English support varies. If your employer has a preferred hospital, confirm it is authorized before booking.
Doing the Exam Before or After Arrival
Some foreign hires complete a medical exam in their home country before departing for China, then have it legalized/apostilled and submitted with the work permit application. However, Chinese authorities often require the exam to be repeated in China at a designated center. Confirm with your employer whether a home-country exam will be accepted or whether you need to complete it in China after arrival.
Required Documents and Preparation
Arriving prepared prevents wasted trips and delays in your work permit processing.
What to Bring
- Passport (original and a copy of the photo page)
- Employer’s offer letter or invitation letter
- Passport photos (usually 2-4, white background — confirm the exact requirement)
- Any prior medical records or vaccination history
- Payment (the exam fee varies by city and center — confirm in advance)
How to Prepare
The exam requires fasting for the blood draw — no food or water after midnight. Avoid alcohol for 24 hours before. Wear loose clothing for the physical exam and X-ray — you may need to change into a gown for the chest X-ray. If you take regular medications, ask whether to pause them before the blood draw.
Common Pitfalls and How to Avoid Them
Delays in the employment medical directly delay work permit issuance, which can affect your start date and your employer’s compliance timeline.
Abnormal Results and Follow-Up
If a test result is abnormal, the center may request follow-up testing before issuing the health certificate. This is most common with chest X-rays (which can show old scarring from resolved infections) or blood tests. If you have a history of tuberculosis that has been treated, bring documentation of treatment and resolution — this can prevent unnecessary delays. See our visa and documentation page for what medical records to bring.
Timing the Exam in the Onboarding Process
The employment medical should be scheduled as early as possible after arrival in China, because the health certificate is required for the work permit application. Delays compound: late medical → late work permit → late residence permit → potential overstay of your entry visa. HR should book the exam slot before the employee arrives, if possible.
For HR Managers: Planning Foreign Hire Onboarding
If you are managing onboarding for foreign employees, build the medical into your timeline from the start. Key steps:
- Identify the nearest designated health examination center before the employee arrives
- Pre-book the exam slot if the center allows advance booking
- Ensure the employee knows to fast and bring the required documents
- Build a 5-7 day buffer between arrival and work permit submission for the medical and certificate processing
- Consider offering a voluntary comprehensive checkup as a benefit alongside the mandatory employment medical
For broader corporate health program planning, see how we approach it in our corporate case studies.
Post-Exam Steps: From Health Certificate to Work Permit
After completing the employment medical, the process is not over — the health certificate must be obtained and submitted as part of the work permit application. Understanding this timeline helps HR and employees avoid compliance gaps.
The designated health examination center issues a health certificate, typically within 3-5 working days if all results are normal. This certificate is valid for one year and must be submitted to the local Foreign Experts Bureau or Labor Bureau as part of the work permit application. The employer’s HR or an agency usually handles this submission, but the employee should track the timeline to ensure nothing falls through the cracks.
If you are converting from a Z visa (entry visa for work) to a residence permit, the health certificate is a required document. The residence permit application must be submitted within 30 days of entry, so delays in the medical directly compress the window for residence permit processing. Plan the medical within the first week of arrival to leave maximum time for the full permit process.
Some employers also request a voluntary comprehensive checkup beyond the mandatory employment medical, as part of their corporate health program. This can be done at the same hospital or a different one, and the results are shared with the employee, not with immigration authorities. Combining both in one visit saves time — the mandatory medical at a designated center, followed by a comprehensive checkup at an international department. See our corporate case studies for how companies structured this.
Get Help Planning Your Pre-Employment Medical
Whether you are an HR manager coordinating onboarding or a foreign hire preparing for relocation, we can help. Tell us your situation — city, timeline, number of hires — and we will identify the nearest designated center, confirm the required documents, and build the medical into your onboarding timeline. Contact us to start planning.