On September 13, a 55-year-old man died during the Auray-Vannes half-marathon in Morbihan, France. This tragic incident has sparked renewed debate about the PPS (Parcours puis Pass prévention santé), a health screening system introduced in 2022 by the French Athletics Federation (FFA). The PPS replaced the traditional mandatory medical certificate for participating in organized running events. It involves watching three short educational videos and paying a 5-euro fee, allowing runners to register for races. The change was made to streamline the process and promote ongoing health awareness among athletes. The death has raised concerns about whether the PPS is as effective as the previous medical certificate, which was no longer mandatory as of 2024. François Carré, a cardiologist and sports doctor in Rennes, and Emmanuelle Jaeger, deputy president of the FFA, addressed these concerns in an interview with 20 Minutes. Between April and September, seven cardiac arrests were reported in connection with organized running events. Carré notes that while this is a small number, it is worth monitoring, but he does not see a significant increase in such incidents since the PPS was introduced. He points out that the number of deaths has remained roughly the same since 2018, with most victims being over 35 years old and suffering from heart attacks. Carré explains that the old medical certificate involved a more thorough assessment, including an interview, physical exam, and an electrocardiogram (ECG), which can detect 80 to 85% of potential heart conditions. In contrast, the PPS does not include an ECG, detecting only 10 to 15% of such risks. In Italy, an ECG is required for marathon participation, while in other major races like New York, Berlin, and London, no medical certificate is mandatory. The FFA, however, highlights benefits of the PPS, such as the ability to provide ongoing health messages to runners and ensuring that participants are properly insured. Jaeger notes that the previous responsibility of checking medical certificates fell on event organizers, but the PPS provides more certainty about participants' health status. Carré emphasizes that athletes should be attentive to their own symptoms, as half of the reported incidents involved people who had warning signs before the race. He advises runners to consult a doctor if they experience symptoms like shortness of breath, heart palpitations, chest pain, or unusual fatigue. He also says that if participants are concerned about the health messages in the PPS, they should seek professional medical advice. A general practitioner in Lyon, who routinely includes ECGs in medical certificates, notes that it is unclear whether the deceased runners would have been identified with a standard certificate. Carré agrees, noting that some heart conditions cannot be detected by even a normal stress test. Carré also points out that cardiac arrests during sports have a much higher survival rate compared to those in public places, with six to seven out of ten cases being successfully resuscitated, compared to only one in ten on the street. He stresses the importance of trained medical personnel at events and urges runners to follow the "ten golden rules" of good cardiovascular practice. He believes that if runners adhere to these guidelines, the number of cardiac incidents during sports could be reduced by about 40%.