Two Types of NDA Medical Rejection
Permanent Rejection

Condition cannot be rectified. Candidate is ineligible for that wing regardless of treatment. Examples: keratoconus, epilepsy, ACL reconstruction, cardiac surgery.

Temporary Rejection

Condition is rectifiable. Candidate may reappear after treatment within the prescribed recovery period. Examples: DNS, varicocele, overweight, hydrocele.

The SMB → AMB → RMB Appeal Ladder

After receiving an SSB recommendation, candidates undergo a medical examination. There are three boards in the process:

1
First Examination

SMB — Special Medical Board

Conducted at a designated Armed Forces hospital after SSB recommendation. This is your first formal medical examination. Result: Fit or Unfit. If declared Fit, you proceed to merit listing. If declared Unfit, you may appeal via AMB.

2
Your Right

AMB — Appeal Medical Board

Available to candidates declared Unfit at SMB. You must request it within the timeline communicated by the President SMB. Held at a Command Hospital, typically within approximately 42 days of the SMB date. Board proceedings are confidential; only the Fit/Unfit outcome is communicated to you.

3
Discretionary

RMB — Review Medical Board

Available after an AMB Unfit verdict. Must be requested within ONE day of the AMB result. RMB is NOT a matter of right — it is granted at the sole discretion of DGAFMS on merit. Venues: Delhi or Pune only. No further board exists after RMB.

Request AMB promptly. The window to request an AMB after your SMB result is very short. Missing this deadline means you forfeit your right to appeal, regardless of the merits of your case.

Permanently Disqualifying Conditions — By Body System

The following conditions will result in a permanent medical rejection regardless of which wing (Army/Navy/Air Force) you apply for unless noted otherwise. This list is drawn from NDA Notification Annexures A, B, C.

Vision System

ConditionApplies ToNotes
KeratoconusAll wingsProgressive corneal thinning; no surgical treatment is accepted
Radial Keratotomy (RK)All wingsPermanently disqualifying; LASIK policy differs — see LASIK guide
Pseudophakia (IOL implant)Air Force; most entriesIntraocular lens implant post-cataract surgery
Manifest squint (any degree)All wingsAny deviation that cannot be controlled by fusion
Nystagmus (non-physiological)All wingsInvoluntary eye oscillation of pathological origin
ExotropiaAll wingsOutward deviation of the eye
Night blindnessAll wingsAny degree of nyctanopia
Heterochromia IridumAll wingsDifferent coloured irides
Optic Nerve DrusenAll wingsCalcific deposits on the optic disc
Active / recurrent uveitis with permanent lesionsAll wingsInactive old uveitis may be individually assessed
Anisocoria >1 mmAll wingsUnequal pupil size beyond 1 mm

ENT (Ear, Nose & Throat)

ConditionStatusNotes
Tympanoplasty / Myringoplasty (for chronic otitis media)PermanentEardrum repair surgery
Stapedectomy, ossiculoplasty, canal-wall-down mastoidectomyPermanentMiddle ear surgery of any type
Cochlear implants or bone-anchored hearing aidsPermanentAny hearing device implanted
OtosclerosisPermanentAbnormal bone growth in the middle ear
Meniere's diseasePermanentAny history
Nasal polyposis (CRS with nasal polyps)PermanentRecurring polyps post-surgery included
Atrophic rhinitisPermanentOzaena included

Cardiovascular System

ConditionStatusNotes
Any cardiac surgery or cardiac interventionPermanentIncludes CABG, valve repair/replacement, ablation
All congenital cardiac anomaliesPermanentEven if repaired (e.g. ASD, VSD, PDA closure)
Diastolic murmursPermanentInvariably organic; always disqualifying

Respiratory System

ConditionStatusNotes
Pulmonary tuberculosis with residual scarringPermanentTreated TB without residual scarring may be considered individually
Bronchial asthma (repeated attacks)PermanentA single childhood episode may be assessed on merit

Musculoskeletal System

ConditionStatusNotes
ACL reconstruction (anterior cruciate ligament)PermanentRegardless of time elapsed since surgery; regardless of outcome
All intra-articular fractures of major jointsPermanentShoulder, elbow, wrist, hip, knee, ankle
Active varicose veinsPermanentPost-operative varicose veins are also permanently disqualifying
Club foot (talipes equinovarus)PermanentAll cases, treated or untreated
Scoliosis: lumbar >15°, thoracic >20°PermanentMeasured on standing X-ray (Cobb angle)

Nervous System & Psychiatry

ConditionStatusNotes
EpilepsyPermanentAny history of seizures, regardless of aetiology or duration since last episode
History of mental illness, psychosis, psychoneurosisPermanentIncludes schizophrenia, bipolar disorder, severe anxiety disorders
Drug dependence (any form)PermanentIncludes past or present dependence on any substance

Skin Conditions

ConditionStatusNotes
Tattoo in non-permitted locationsPermanentPermitted only on inner forearm and not on face, neck, or dorsum of hand
Keloid (any)PermanentAny keloid scar formation anywhere on the body
Leprosy (any sign)PermanentAny present or past sign of leprosy
Extensive vitiligo (exposed parts)PermanentLimited vitiligo in non-exposed areas may be assessed individually
Psoriasis (chronic relapsing)PermanentCurrent or documented history of chronic relapsing psoriasis

Haematological Conditions

ConditionStatusNotes
Sickle cell diseasePermanentHbSS and all sickle variants
Beta Thalassaemia (all variants including trait)PermanentThalassaemia minor (trait) is also disqualifying
HaemophiliaPermanentAny hereditary coagulation factor deficiency

Female-Specific Conditions

ConditionStatusNotes
Primary or secondary amenorrhoeaPermanentAbsence of menstruation; underlying cause relevant
Endometriosis and adenomyosisPermanentAny stage or degree
Complex ovarian cyst of any sizePermanentSimple functional cysts are assessed on merit

Rectifiable (Temporary) Rejection Reasons

The NDA Notification Appendix IV para 2 lists defects that candidates should rectify before appearing at the medical board. These conditions may result in a Temporarily Unfit verdict if found during SMB.

DefectHow to RectifyMin Recovery Before SMB
Wax in earsENT cleaning (syringing or suction)Immediate
Deviated Nasal Septum (obstructing)Surgical correction (septoplasty)4–6 weeks post-op
HydroceleSurgical correction (hydrocoelectomy)8 weeks post-op
PhimosisSurgical correction (circumcision or preputioplasty)4 weeks post-op
Overweight / UnderweightDiet + exercise to bring weight within chart rangeBefore medical date
Under-sized chestPhysical conditioning (compound exercises, swimming)Before medical date
Piles (haemorrhoids Grade III/IV)Surgical treatment (haemorrhoidectomy)12 weeks post-op
GynaecomastiaSurgical correction (subcutaneous mastectomy)12 weeks post-op
TonsillitisTonsillectomy if indicated; benign histology required2 weeks post-op
VaricoceleSurgical correction (varicocoelectomy or embolisation)8 weeks post-op
Source: NDA Notification Appendix IV para 2 (pages 29–30). "Defects to be rectified before appearing for medical examination." Recovery times are minimum estimates; your treating surgeon's clearance is required before presenting at the SMB.

Other Commonly Treatable Conditions

These conditions do not appear on the official "rectify before SMB" list but are frequently encountered and can affect your medical outcome. Address them well in advance:

  • Dental caries / calculus: Scale and fill all teeth before the medical. Examiners count dental points; significant untreated decay can affect fitness grading.
  • Mild pyorrhoea: Periodontal treatment including scaling, root planing, and gingival therapy.
  • Warts / corns: Treat at least 3 months before the medical board date.
  • Mild acne: Dermatological treatment; severe cystic acne may be independently evaluated.
  • Fungal infections: Topical antifungal; infection must be completely cleared before examination.
  • Mild iron-deficiency anaemia: Iron supplementation for 4–6 weeks; confirm Hb levels are within normal range before the medical.

What Does "Temporarily Unfit" Mean?

At the SMB, some candidates receive a verdict of "Temporarily Unfit" rather than simply "Unfit." There is an important distinction:

VerdictMeaningNext Step
Temporarily Unfit A treatable condition is present. The board specifies a recovery period after which you may be re-examined. Get treated; reappear at SMB after the specified period
Unfit A condition that may be permanent or serious has been found. The candidate may appeal via AMB. Request AMB within the specified window
Fit Candidate meets all medical standards for the applied wing. Proceed to merit list

The "Temporarily Unfit" route is separate from the AMB/RMB appeal route. If you are Temporarily Unfit, you do not go through AMB — you simply get treated and present for re-examination.

Borderline Cases — When to Appeal

If you are declared Unfit at SMB for a condition you believe was incorrectly assessed or borderline, the AMB is your right and you should request it:

AMB is your right. You do not need to justify your appeal to request an AMB. Request it as soon as you receive the SMB result, within the specified window. Bring all documentation.
  • Documentation to bring: Operative notes, post-op discharge summaries, specialist clearance letters, investigation reports, imaging studies (X-rays, MRIs, ECGs).
  • White-coat hypertension: If borderline BP at SMB, a 24-hour ABPM (ambulatory blood pressure monitoring) report from a cardiologist confirming normal ambulatory readings can support your AMB case.
  • Borderline hearing loss: Unilateral mild loss near the threshold — a formal audiological assessment with PTA and speech discrimination scores from a tertiary ENT centre strengthens your case.
  • Mild flat feet: If you were tested under suboptimal conditions, a formal podiatric assessment and functional performance evidence may help at AMB.
RMB is not guaranteed. After AMB, if still declared Unfit, you may request RMB within ONE day — but the DGAFMS grants it only on merit. Do not treat RMB as an automatic next step. Prepare your AMB case as thoroughly as possible.

Frequently Asked Questions

What are the most common reasons for NDA medical rejection?

The most common NDA medical rejection reasons include vision defects (keratoconus, manifest squint, poor distant vision uncorrected), musculoskeletal issues (ACL reconstruction, flat feet beyond limits, knock knees), ENT problems (DNS, tympanoplasty), overweight or underweight, dental issues, and varicocele. Some are permanent disqualifiers; others are rectifiable before the SMB.

What conditions lead to permanent rejection from NDA?

Conditions that permanently disqualify a candidate from NDA include: keratoconus, epilepsy, any cardiac surgery or congenital cardiac anomaly, ACL reconstruction (regardless of time elapsed), history of mental illness or psychosis, drug dependence, sickle cell disease, beta thalassaemia (including trait), haemophilia, active varicose veins, club foot, and extensive vitiligo on exposed parts, among others.

What is temporary rejection in NDA medical?

Temporary rejection (or "Temporarily Unfit") means the candidate has a condition that is present but can be treated or rectified. The candidate is given a recovery period and may reappear at the medical board after treatment. Examples include deviated nasal septum, hydrocele, varicocele, overweight/underweight, and phimosis.

Can I appeal after being rejected at the NDA SMB?

Yes. Candidates declared Unfit at the SMB (Special Medical Board) can request an AMB (Appeal Medical Board) within the timeline communicated by the President SMB. If still found Unfit at AMB, they can request an RMB (Review Medical Board) within ONE day — but RMB is not a right and is granted at the discretion of DGAFMS on merit.

What is the difference between SMB, AMB and RMB?

SMB (Special Medical Board) is the first examination after SSB recommendation at a designated Armed Forces hospital. AMB (Appeal Medical Board) is available to candidates declared Unfit at SMB, held at a Command Hospital within approximately 42 days. RMB (Review Medical Board) is a discretionary final review available after AMB unfit verdict, held only at Delhi or Pune.

Is knock knees a reason for NDA rejection?

Yes, knock knees (genu valgum) beyond the prescribed limits can be a reason for NDA medical rejection. Mild knock knees may be acceptable depending on the degree of deformity, but significant knock knees causing functional impairment are disqualifying.

Can I join NDA after getting a defect treated?

For temporary/rectifiable conditions (such as DNS, hydrocele, varicocele, overweight), yes — after successful treatment and adequate recovery, you may reappear at the medical board. However, for permanently disqualifying conditions (such as ACL reconstruction, keratoconus, epilepsy), no amount of treatment will make you medically eligible.

How long does the NDA appeal medical board process take?

The AMB (Appeal Medical Board) is typically held within approximately 42 days of the SMB result. The RMB (Review Medical Board), if granted, is held at Delhi or Pune and the timeline varies. Board proceedings are confidential; only the Fit/Unfit outcome is communicated to the candidate.

Sources & References
  • NDA Notification Appendix IV paras 2–6 (pages 29–30) — Defects to be rectified before medical examination
  • NDA Notification Annexure A — Army wing medical standards (system-by-system disqualifiers)
  • NDA Notification Annexure B — Navy wing medical standards
  • NDA Notification Annexure C — Air Force wing medical standards
  • AFCAT 02/2023 Appendix A — Air Force medical standards (cross-reference)
  • DGMS (Army) SN 76060/DGMS-5A August 2019 — Physical standards and weight-for-height tables
Disclaimer: This page is for informational purposes only and is not a substitute for official UPSC/NDA notification documents or advice from a qualified medical officer. Medical standards are subject to revision — always verify against the latest official NDA notification.