Scott McTominay, Napoli's 29-year-old Scottish midfielder, is awaiting a medical fitness assessment that will determine whether he can return to competitive football following heart surgery — a clearance appointment now confirmed, with the certificate required before Massimiliano Allegri's side can consider him available for selection.
The significance of that appointment extends well beyond one player's fitness. Napoli sit ninth in Serie A with seven points from five matches, a record of two wins, one draw and two defeats that reflects a squad operating below its ceiling. McTominay has managed just two appearances this season, contributing no goals and no assists for an average rating of 6.45 — numbers that tell the story of a campaign interrupted almost before it began. An AI overall of 73 out of 100 suggests a player with meaningful quality to offer; the question has never been his level, only his availability.
The surgery itself — cardiac in nature — placed McTominay in a category of absence that demands more than a fitness coach's sign-off. The required idoneità certificate is a formal medical-legal clearance under Italian sporting regulations, and without it no club can field a player regardless of how well training sessions have gone. McTominay has returned to training at Castel Volturno, which is an encouraging sign, but the certificate appointment is the decisive gate.
Allegri's squad absorbs a further blow in the same international window: Mathias Olivera has picked up an injury while on duty with Uruguay and returned to Castel Volturno to begin rehabilitation. The timing compounds the pressure on a side already navigating a difficult early stretch of the season.
Billy Gilmour, McTominay's compatriot, offered a telling character note in recent days, describing it as "very hard to say no" when Napoli approached him — and adding that McTominay had "grown massively." The endorsement carries weight precisely because Gilmour has seen him up close; it also underlines why Allegri's staff will be eager to integrate McTominay properly rather than rush him back into a squad that needs his energy and physicality in the engine room.
The clearance appointment is now the only thing standing between McTominay and a Serie A return. Get the certificate, and Allegri has a decision to make. Without it, the wait continues.