CDS Medical Standards 2026: IMA, INA, AFA & OTA

Four academies — pick the right standard

UPSC CDS routes candidates to four different academies, each with its own medical standard. Knowing your target academy before the SMB is critical — the standards differ significantly, especially for vision and height.

SMB / AMB / RMB process

After you are recommended by the Service Selection Board (SSB), you will be directed to report to the nearest Service Medical Board (SMB) for a comprehensive fitness examination. The form used is AFMSF-2 / AFMSF-2A.

Stage 1 — Service Medical Board (SMB)

Conducted at military hospitals designated as SMBs. Typically lasts 2–3 days. Specialists cover ophthalmology, ENT, dental, orthopaedics, medicine, surgery, psychiatry, and dermatology. Outcome: FIT, UNFIT, or referred for specialist opinion.

Stage 2 — Appeal Medical Board (AMB)

If declared UNFIT at SMB and you wish to contest, apply through the recruiting directorate for an AMB within 42 days. Conducted at a higher command-level military hospital. AMB findings supersede the SMB.

Stage 3 — Review Medical Board (RMB)

If still declared UNFIT at AMB, one final appeal may be made to the Armed Forces Medical Services (AFMS) HQ, New Delhi for an RMB. The RMB decision is final and binding. No further appeals are permitted beyond the RMB stage.

Mandatory investigations at the SMB

All candidates must present results of the following investigations. You may arrange these at any NABL-accredited laboratory before your SMB date to save time at the board.

Height & weight

Minimum height by academy

Regional height relaxations

AFA Flying — ejection-seat anthropometry

In addition to height, AFA Flying candidates must meet ejection seat clearance dimensions measured at the SMB:

Chest: minimum circumference 77 cm with at least 5 cm expansion. This applies across all CDS Army entries as well.

Army graduate entry — weight chart (IMA / OTA)

Vision by academy

Vision is the single most common reason for rejection at the SMB. Understanding exactly which standard applies to your target academy — before you appear — is essential.

IMA / OTA / Graduate Army — vision standard

Source: DGMS (Army) Medical Standards SN 76060/DGMS-5A, 01 Aug 2019, pages 5–8.

INA / Navy — vision standard

Source: UPSC CDS 2025 Notification page 37; NDA Annexure B para 8.

AFA Flying — vision standard

Source: NDA Annexure C; AFCAT 02/2023 Appendix C.

Key difference from NDA — comparison table

LASIK policy for CDS / IMA / OTA

The DGMS (Army) circular of August 2019 formally permitted LASIK for graduate Army entries (IMA and OTA). The following 8 conditions must ALL be satisfied:

1. Age: Candidate must be over 20 years at the time of the SMB.
2. Post-operative period: At least 12 months must have elapsed since LASIK surgery at the time of the medical board.
3. Corneal thickness: Central Corneal Thickness (CCT) ≥ 450 microns post-op.
4. Axial length: ≤ 26 mm (rules out progressive myopia risk).
5. Residual error: ≤ ±1.0 D in any meridian (Sph or Cyl).
6. Retinal health: Normal retina on dilated fundoscopy. Any lattice degeneration, holes, CNVM, or prior laser treatment = unfit.
7. Certificate: Original LASIK surgery certificate from the operating surgeon with date, pre-op prescription, and current refraction mandatory.
8. AFA Flying additional: Nil residual for Pilot/Observer; pre-operative myopia ≤ ±6.0 D only.

Common visual disqualifications

ENT & hearing

ENT is the second most commonly flagged specialty at the SMB. The following standards apply across all CDS entries unless noted.

• Hearing (whisper test): Must hear conversational whisper at 610 cm (6 metres) in each ear independently. Any failure = referred for PTA.
• Pure Tone Audiometry (PTA): Average threshold >20 dB at speech frequencies (500, 1000, 2000 Hz) = UNFIT. AFA Flying: stricter — >10 dB average = unfit.
• Active otitis media: Discharge, perforation, or active infection = UNFIT (Temporary). Dry, healed perforation = case by case.
• Nasal polyps: Any active polyposis = UNFIT. Post-polypectomy with clean endoscopy and 3-month symptom-free period = re-evaluate.
• Deviated Nasal Septum (DNS): Symptomatic DNS causing nasal obstruction = UNFIT (Temporary). Asymptomatic mild DNS = FIT. Septoplasty resolves this — wait 3 months post-surgery.
• Chronic tonsillitis: Recurrent attacks or tonsillar hypertrophy = UNFIT (Temporary). Tonsillectomy with 6-week healing = FIT.
• Tinnitus: Persistent unexplained tinnitus = UNFIT.
• Eustachian tube dysfunction: Failure of middle ear pressure equalisation test = UNFIT for flying entries.

Dental standards

All CDS entries require a minimum of 14 dental points calculated using the standard Armed Forces dental scoring system.

Dental point scoring

• Each healthy standing incisor/canine = 1 point
• Each healthy standing premolar = 1 point
• Each healthy standing molar = 2 points
• A tooth requiring extraction or with advanced caries = 0 points
• Crowned/capped tooth in good condition = full points
• Implant: maximum 2 implants accepted (1 per quadrant) if osseointegrated and functional

Disqualifying dental conditions

Heart & blood pressure

• Blood pressure: Persistent BP >140/90 mmHg on three separate readings across two days = UNFIT. White-coat hypertension differentiated using 24-hour ABPM (Ambulatory Blood Pressure Monitoring).
• ECG abnormalities: LBBB, RBBB with symptoms, WPW syndrome, complete AV block, prolonged QTc (>450 ms) = UNFIT.
• Cardiac surgery: Any history of open heart surgery, CABG, valve replacement = PERMANENTLY UNFIT.
• Congenital heart disease: Corrected ASD/VSD with residual shunt = UNFIT. Successfully closed small PDA with normal echo = specialist evaluation.
• Arrhythmias: AF, SVT, or sustained VT = UNFIT. Isolated occasional SVPB on Holter with normal echo = case by case.
• Varicose veins: Symptomatic varicosities requiring treatment = UNFIT (Temp.). Post-sclerotherapy/surgery with asymptomatic outcome = re-board after 3 months.

Lungs & asthma

• Asthma: Any history of repeated asthma attacks = UNFIT. A single childhood episode before age 12 with complete resolution (no medication for 10+ years) may be assessed as FIT by RMB after specialist review.
• Tuberculosis: Active TB = UNFIT. Completed treatment with residual changes on X-ray (fibrosis, calcification) = UNFIT. Fully treated with clear chest X-ray and normal PFT = case by case.
• Chronic bronchitis / COPD: Any confirmed diagnosis = UNFIT.
• Pneumothorax: Spontaneous pneumothorax history = UNFIT for flying entries; specialist evaluation for ground entries.
• PFT (Spirometry): FEV1/FVC < 70% predicted = UNFIT across all entries.

GI & abdominal

• Hernia (inguinal, femoral, umbilical): Unrepaired = UNFIT (Temp.). Post-herniorraphy (laparoscopic): fit after 3 months. Post-herniorraphy (open): fit after 6 months.
• Appendicectomy: Laparoscopic: fit after 6 weeks. Open appendicectomy: fit after 3 months.
• Inflammatory bowel disease (IBD): Crohn's disease or ulcerative colitis (any grade) = PERMANENTLY UNFIT.
• Hepatitis B/C: Active carrier or cirrhosis = UNFIT. Hepatitis A/E: fully recovered with normal LFTs for 6 months = FIT.
• Splenomegaly: Any cause = UNFIT until investigated and resolved.
• Peptic ulcer: Active ulcer = UNFIT (Temp.). Healed with H. pylori eradication and normal endoscopy = FIT.
• ACL reconstruction: History of ACL ligament reconstruction = PERMANENTLY UNFIT for all entries.
• Haemorrhoids (piles): Symptomatic piles = UNFIT (Temp.). Post-haemorrhoidectomy with 3-month healing = FIT.
• Cholecystectomy: Post-laparoscopic cholecystectomy: fit after 3 months with asymptomatic outcome.

Genito-urinary system

• Undescended testis (UDT): Unilateral/bilateral undescended testis = UNFIT. Post-orchidopexy with normal testis = case by case at AMB.
• Hydrocele: Any clinical hydrocele = UNFIT (Temp.). Post-hydrocelectomy with 6-week healing = FIT.
• Varicocele: Grade I–II = assess. Grade III (visible varicocele) = UNFIT (Temp.). Post-varicocelectomy with 3-month healing = re-evaluate.
• Renal calculi: Any history of renal/ureteric calculi = UNFIT. Asymptomatic small non-obstructing calculi on USG = UNFIT.
• Phimosis: True phimosis = UNFIT (Temp.). Post-circumcision with 6-week healing = FIT.
• Proteinuria: Persistent proteinuria on two samples = UNFIT pending investigation.

Knock knees, flat feet & spine

Knock knees (Genu Valgum)

Surgical correction of knock knees (osteotomy) does not render a candidate fit — the corrected condition is reassessed at AMB.

Flat feet (Pes Planus)

The key differentiator is whether the flat foot is flexible or rigid:

Spine conditions

CNS & mental health / epilepsy

• Epilepsy: Any history of epilepsy or seizure (febrile or otherwise) after age 5 = PERMANENTLY UNFIT for all entries.
• Psychiatric illness: Schizophrenia, bipolar disorder, major depressive disorder, or any diagnosis requiring hospitalisation = PERMANENTLY UNFIT.
• Drug / alcohol dependence: Confirmed substance dependence = PERMANENTLY UNFIT.
• Migraine: Recurrent migraine attacks (>3 per year) requiring medication = UNFIT. Single isolated episode in childhood with no recurrence = case by case.
• Anxiety / adjustment disorder: Clinically diagnosed = UNFIT (Temp.) pending specialist clearance.
• AFA Flying — EEG: EEG is mandatory for AFA Flying. Any epileptiform discharge on the EEG = UNFIT even in the absence of clinical seizures.
• Vasovagal syncope: Isolated unexplained syncope — cardiac and neurological workup required before fitness can be declared.

Skin & hyperhidrosis

Tattoo policy

The UPSC CDS Notification does not contain a dedicated tattoo section, but established service practice (mirroring NDA Appendix IV) is enforced at all CDS SMBs:

Key rules

• Tattoos on the neck, face, chest, back, shoulders, upper arms, or front of hand = UNFIT with no appeal relief.
• Tattoo content must not be offensive, communal, or anti-national — even on permitted locations.
• Tribal exemption: Candidates from tribal communities with permanent traditional tattoos on the face or body may be individually exempted by the SMB on documentary proof of tribal affiliation.
• Laser removal: if a tattoo has been laser-removed and no scar/pigment remains, the SMB may accept this. Partial removal with residual marks = assessed by SMB.

Female candidates / OTA Women

OTA Women is the only CDS route for female candidates. Medical examination follows the same multi-stage SMB/AMB/RMB structure with the following additional provisions:

General principles

• Medical examination is conducted by a Lady Medical Officer (LMO) only.
• No per-vaginal (PV) examination for unmarried candidates.
• USG Pelvis is mandatory for all female candidates.
• Pregnancy at the time of the SMB = UNFIT.

Gynaecological disqualifying conditions

Post-surgery recovery table (OTA Women)

Breast examination

Clinical breast examination is part of the routine SMB for OTA Women. Discrete fibroadenoma confirmed on USG in a candidate under 25 = case by case. Any malignancy = PERMANENTLY UNFIT.

Eligibility categories for OTA Women

Only the following categories of women are eligible for OTA (Women): Unmarried women, issueless widows, and issueless divorcees. A woman with children is not eligible regardless of marital status.

Age, eligibility & marriage rules

Defects to rectify before the medical board

If you are targeting a CDS cycle 12–18 months away, address the following before your SSB or SMB date:

1. Ear wax (cerumen impaction): Get professional syringing done 1 week before the SMB — wax blocks the view of the tympanic membrane and can incorrectly trigger referral for PTA.
2. DNS / nasal obstruction: Symptomatic DNS is temporary unfit. Septoplasty + 3-month recovery = fit. Plan 6 months ahead.
3. Hydrocele: Hydrocelectomy is a minor day-care procedure. Allow 6 weeks post-op before the board.
4. Phimosis: Circumcision resolves this. Allow 6 weeks post-op.
5. Overweight / underweight: Aim to be within the height-weight chart range at least 3 months before the SMB to allow for minor fluctuation.
6. Under-sized chest expansion: Breathing exercises and swimming improve chest expansion. Minimum 5 cm expansion is required.
7. Haemorrhoids (piles): Treat and heal (3 months) before the board.
8. Gynaecomastia: Significant breast tissue development in males = temporary unfit. Surgical correction is assessed 3 months post-op.
9. Chronic tonsillitis: Tonsillectomy + 6-week recovery. Do not present with an active sore throat at the board.
10. Varicocele: Grade III varicocele — varicocelectomy + 3-month recovery resolves this.
11. Dental deficiency (<14 points): Crown/fill all restorable teeth. Remove fixed orthodontic braces. Allow 4–8 weeks for treatment completion.
12. Hyperhidrosis: Significant palmoplantar or axillary hyperhidrosis. Consult a dermatologist for botulinum toxin injections — effective for 6–8 months and reduces SMB flag.
13. LASIK documentation: If you have had LASIK, ensure you have: (a) original surgery certificate, (b) pre-op spectacle prescription, (c) post-op refraction (≤±1.0 D), (d) CCT report (≥450 microns), (e) axial length (≤26 mm). All documents must be originals or notarised copies.

Deep-dive guides — by academy & topic

Each sub-pillar covers a single topic in full depth, with complete tables and authority sources.

Priority 1 — most searched topics

Priority 2 — academy & procedure deep dives

Priority 3 — policy reference

Frequently asked questions

Sources & references

• UPSC CDS Examination (I) 2025 Notification (11 Dec 2024) — pages 25–44 (Army medical standards), page 37 (CDSE vision table), pages 28–29 and 32–33 (weight charts), pages 7–8 (age/qualifications), pages 16–17 (marriage restrictions)
• DGMS (Army) Medical Standards, Circular SN 76060/DGMS-5A, 01 Aug 2019 — pages 5–8 (graduate-entry vision table, weight chart, LASIK conditions)
• NDA & NA (I) 2025 Notification Annexure B (Navy medical standards) and Annexure C (Air Force/AFA Flying standards)
• AFCAT 02/2023 Notification Appendix A and Appendix C (Air Force comprehensive medical standards including AFA anthropometry)
• Official recruiting portals: joinindianarmy.nic.in · joinindiannavy.gov.in · careerindianairforce.cdac.in
• Photo credits: Hero — OTA Chennai campus, Indian Army Training Command / Wikimedia Commons, GODL-India. Inline — Hockey IMA vs AFA, Sabhiki Cup 2016, Indian Navy (photographer Navtej) / Wikimedia Commons, GODL-India.