Written by Dr. Josh Mularella, DO, FACEP, FAWM, DTM&H - G2G Medical Director
The utility of medical screening for a running event is often debated online amongst runners and medical staff alike. Most would agree that it is the runner’s responsibility to ensure they are fit to compete (or accept the consequences), and I would agree. Why then do we mandate medical screening for G2G?
Medical screening at the Grand to Grand Ultra attempts to accomplish three goals:
1. It gives the G2G medical team insight into your medical history. This helps us from a logistical perspective (what supplies we bring) and allows us to guide you to the finish line in a safe manner. The course at G2G is very remote, and many sections are only reachable by foot. Anything we can do to mitigate any potential incidents on the course makes medical screening worth it.
2. It forces you to sit down with (ideally) your primary care provider and discuss any current injuries/illnesses and medications/supplements that could impact your race at G2G. It is also a good time to review any indicated preventive health testing (immunizations including tetanus, PAP smears, mammograms, colonoscopies, etc) and routine lab work (lipid panel, etc) to keep you happy and healthy for a long time to come.*
3. Additionally, as a long distance runner, regardless of your age, it is a great time to discuss CARDIAC CLEARANCE**.
*Some providers are more eager than others to order ancillary testing for you. At the end of the day, you have to be your own patient advocate. Personally, I would recommend all of you get a 12-lead ECG, check your blood pressure, and check basic blood work including a lipid panel (with LpA)- I do this myself as well. I acknowledge that the AHA does not recommend routine 12-lead ECG as screening in asymptomatic patients (mostly due to costs) but you are not a statistic. If your provider will not order this testing for you, there are usually multiple options available online.
**There is no mandatory cardiac testing for G2G. However I would recommend using the AHA 12-element cardiovascular screening with your primary care provider to estimate potential cardiac risk. If your screening is positive, I would further recommend at least a 12-lead ECG and potentially an echocardiogram, stress test and/or coronary CT angiogram. It is very important to keep in mind that you could have significant heart disease and have no symptoms. In fact, the first presentation of heart disease can be sudden cardiac death. Although rare, this is not something to be taken lightly.
If you really want to geek out on cardiac clearance, check out the recent podcast by Andy Galpin on Intense Exercise & Potential Heart Damage (May 2026).
You may unfortunately encounter a provider who is wary of signing your medical screening form due to perceived liability on their end, especially for runners residing in the UK. If you have issues leave a comment on the Grand to Grand Ultra Facebook Group and hopefully someone can provide advice. For the Brits out there, a popular option is the London Doctor’s Clinic.
I will not know if you lie or omit information from your medical form. Nor will your primary care provider. But I assure you this process is in no way meant to disqualify you, so PLEASE BE HONEST!
If you have any questions/concerns please feel free to email me at
