Employment law
Pre-employment medical examination in Mali
Monday, 6:30 a.m., Baobab Chantiers building site in Sébénikoro. Twelve masons hired last week are already mixing concrete under a beating sun. None of them has seen a doctor. If one of them feels faint on the scaffolding, the labour inspector’s first question will be simple: where is his pre-employment medical certificate?
Baobab Chantiers and the people mentioned in this article are fictitious: they are used as examples only.
1. What exactly are we talking about?
Baobab Chantiers is a construction company with 85 employees based in Bamako. For a new site, it has just hired twelve masons and an engineer who lives in Ségou. Its manager thinks the medical examination is a formality for large companies only. He is wrong.
The pre-employment medical examination is the check by which an occupational doctor verifies that a new employee can hold their job safely, for themselves and for their colleagues. It is compulsory for every worker, before hiring or at the latest before the end of the trial period that follows hiring (Social Security Code, article 43).
The same article sets three objectives for the examination:
- to check that the worker is medically fit for the intended work;
- to check that they do not suffer from a condition dangerous to their co-workers;
- to indicate the jobs to which they must not be assigned, and those that would suit them best.
This rule first protects the employee, who must not be exposed to work their health cannot bear. It also protects the team and the company, which knows from the outset which tasks to assign to whom.
The most common mistake
Believing that the examination only concerns dangerous jobs or open-ended contracts. The text covers “every worker”: the accountant as well as the mason, the employee on a fixed-term contract as well as the one on an open-ended contract.
Every worker, every contract, every job: the pre-employment examination has no exceptions.
2. Who carries out the examination, and who pays?
The manager of Baobab Chantiers has no doctor in the company. He does not need one: the law provides for a shared service.
Every undertaking must provide its workers with a medical or health service (Labour Code, article L.177). The Social Security Code organises this service around inter-company medical centres (CMIE): occupational health centres set up by the National Social Security Institute (INPS) and shared by the undertakings of the same locality. All employers must join the CMIE of their locality (Social Security Code, article 37). Each CMIE is headed by a chief medical officer appointed by the Director General of the INPS (article 42).
In case of geographical isolation or special working conditions, a centre dedicated to certain undertakings may be set up, after consulting the labour inspector (article 38). CMIE expenses are borne by the INPS, which collects contributions for this purpose (article 39).
Time spent on the examination is working time
The doctor may request additional tests at the time of hiring. Time spent on medical examinations, including additional tests, is taken from working hours without any deduction from pay, or paid as normal working time (Social Security Code, article 46).
Mistake to avoid: sending the employee to the examination on their rest day without paying them, or deducting from their pay the half-day spent at the CMIE.
What you need to do
- Check that the company is properly registered with the CMIE of its locality.
- Send each new hire to the CMIE as soon as they start, during working hours.
- Make no deduction from pay for time spent on examinations.
3. The right time: before the trial period ends
The manager of Baobab Chantiers plans to send his masons to the CMIE “once the site is up and running”. The legal deadline is, however, shorter than he thinks.
The trial period is the initial phase of the contract during which either party may terminate without notice or compensation (article L.33). It must be provided for in writing. Its length is in principle equal to the notice period; it may be longer, up to a maximum of six months including renewal (Labour Code, article L.30).
The notice period itself depends on the employee’s category (article L.41). In the absence of a collective agreement, the window for the examination is therefore as follows:
| Employee | Statutory notice (L.41) | Standard trial period (L.30) |
|---|---|---|
| Paid by the day or by the week | 8 days | 8 days |
| Paid by the month | 1 month | 1 month |
| Supervisor | 2 months | 2 months |
| Executive or management staff | 3 months | 3 months |
Example. The Baobab Chantiers masons are paid by the day and were hired on a trial basis on Monday 2 March. The engineer, an executive, was hired on the same day.
Masons: standard trial period of 8 days, like their notice period
Examination to be done within the first 8 days of the contract, i.e. in the first week on site
Engineer: standard trial period of 3 months, like his notice period
Examination to be done before these 3 months end, and preferably on arrival
Why this deadline changes everything
During the trial period, if the examination reveals unfitness for the job, the contract may be terminated without notice or compensation (article L.33). Once the trial period is over, the hiring becomes final: any termination then follows the rules on dismissal, with written and reasoned notice and information to the labour inspector (articles L.40 and L.41).
Without a trial period provided for in writing, there is no grace period: the examination must take place before hiring.
What the examination does not allow
Fitness is assessed in relation to the job. The Labour Code prohibits all discrimination in employment, in particular on the basis of invalidity, disability, HIV and AIDS (Labour Code, article L.4). Only requirements linked to the qualifications for a specific job fall outside this prohibition. A medical result therefore cannot be used as a pretext to reject a candidate for reasons unrelated to the requirements of the job.
The pre-employment examination checks fitness for a job, not a person to be screened out.
What you need to do
- Send each new hire to the CMIE in the first few days, before the trial period ends.
- Provide for the trial period and its length in writing in the contract.
- Base every decision on the fitness for the job stated by the doctor, never on an illness or disability unrelated to the job.
4. Workers from elsewhere, foreigners, young people: special cases
The engineer hired by Baobab Chantiers lives in Ségou. He will have to move to Bamako for the site. His hiring is subject to additional rules.
For a worker recruited away from the place of employment, the examination takes place at their usual place of residence. The results must be sent to the occupational doctor at the place of employment (Social Security Code, article 43). Where the contract requires the employee to move away from the locality where they live, it must, after the medical examination, be recorded in writing and filed for an opinion with the regional labour inspectorate of the place of performance (Labour Code, article L.26).
For a foreign worker, the contract is drawn up in four copies after the pre-employment medical examination. It forms part of the work permit application sent to the National Labour Directorate (Order No. 2024-4363/MTFPDS-SG of 27 December 2024, article A.26-3).
For a young person under 18, the examination takes place before hiring, by the company doctor or, failing that, an approved doctor (Decree No. 96-178/P-RM of 13 June 1996, article D.189-32). The medical certificate is attached to the declaration of hiring that the employer sends to the National Employment Agency within 15 days (article D.189-33, as amended by Decree No. 2022-0125/PT-RM of 4 March 2022). These young workers are then examined every three months (Social Security Code, article 44). No child may be employed before the age of 15, except for derogations set by ministerial order (article L.187).
For an apprentice, a medical certificate attesting fitness is annexed to the apprenticeship contract (Decree No. 96-178/P-RM, article D.7-7).
What you need to do
- Have the examination carried out where the employee lives if recruited outside the locality, and send the results to the occupational doctor at the place of employment.
- Attach the examination to the contract filed with the regional labour inspectorate (relocated employee) or to the work permit file (foreign employee).
- For anyone under 18, obtain the medical certificate before hiring and attach it to the declaration sent to the National Employment Agency within 15 days.
5. After the examination: the certificate, confidentiality and follow-up
At the time of hiring, the occupational doctor draws up three documents (Social Security Code, article 43):
- a medical fitness certificate for the employer, who keeps it in order to present it to the labour inspector or the medical labour inspector;
- a medical file, covered by medical confidentiality, which stays with the doctor;
- a record given to the worker on request or when they leave the company.
You therefore receive an opinion on fitness, not a diagnosis. You must take into account the occupational doctor’s opinions, in particular on changes of job or position (Social Security Code, article 48).
The pre-employment examination opens a follow-up: an examination at least once a year, every three months for those under 18 (article 44), and a return-to-work examination after certain absences (article 45). See our article Regular medical check-ups.
What a missed examination costs
An undertaking that does not comply with the prevention measures required by law, or with the labour inspector’s instructions on the matter, faces a fine of XOF 25,000 to 250,000 (Social Security Code, article 244). Medical examinations are among these measures: the company’s medical service has a prevention role (article 36). The heaviest risk lies elsewhere: in the event of an accident, you will not be able to show that you had checked the employee’s fitness for the job.
No fitness certificate, no proof.
What you need to do
- File each employee’s fitness certificate in their personnel file, ready to show the inspector.
- Apply, and record in writing, the job restrictions indicated by the doctor.
- Schedule the periodic examination from the date of hiring: yearly, or quarterly for those under 18.
6. A closer look: household staff
Private individuals who employ a cook, a guard or a nanny are also concerned. For household staff, the employer arranges the medical examination before the hiring becomes final, then the periodic occupational health examinations (Decree No. 96-178/P-RM, article D.86-7).
The trial period of a household employee lasts one month, renewable once, and must be set in writing (article D.86-8). The examination must take place within this period. If the employee continues working after the trial period without objection, the hiring is final and termination follows the rules on dismissal.
Key takeaways in 6 points
- Have every new employee undergo a pre-employment examination, whatever their job or contract.
- Join the CMIE of your locality: it provides occupational health services for your employees.
- Organise the examination before the trial period ends, which sometimes means within the first 8 days.
- Pay the time spent at the examination as working time, without any deduction.
- Base your decisions on fitness for the job, never on an illness or disability unrelated to the work.
- Keep each employee’s fitness certificate: it is your only proof for the inspector.