A mandatory medical examination is required for all expatriate workers entering Saudi Arabia before or upon arrival to assess their fitness for work and to screen for communicable diseases. The examination typically covers general health assessment, blood tests, chest X-ray and screening for conditions including HIV and tuberculosis. Medical clearance must be obtained from GAMCA (Gulf Approved Medical Centres Association) accredited centers in the worker's home country. Failure to pass the medical examination prevents Iqama issuance. Employers are responsible for ensuring new hires obtain valid medical clearance certificates as part of the onboarding process.