What kit category does my ship need?

Category A — for ships on voyages of any length, with the most comprehensive supplies. Category B — for short-international or limited voyages. Category C — for inland and very short coastal vessels. The IMGS (International Medical Guide for Ships, WHO 3rd edition 2007) gives the contents of each category. Some flag states publish their own annex (e.g. UK MS Notice 1768) with additional country-specific items.

Who prescribes shipboard medication?

The shipowner-appointed shipboard medical officer (typically the master, or the chief officer with STCW Reg. VI/4-2 medical care certification) administers medication on advice from a TMAS (telemedical assistance service) — for example CIRM (Italy, free 24/7), CCMM (France), Radio Medical Norway, or RMC USA. The TMAS doctor is the prescribing authority remotely. Some controlled drugs require authorisation from the flag state and a controlled-drug register kept on board.

Where is the kit kept and who has access?

Locked medical store, accessible only to the master / medical officer. Refrigerated items in a dedicated medicines fridge (2-8 °C) with continuous temperature logging. Controlled drugs in a separate locked compartment with the master holding the key. Inventory checked monthly, restocked at major port calls. Expired medicines disposed of via shore pharmacy; do not flush or throw overboard (MARPOL Annex V special-care category).

What does MFAG cover?

Medical First Aid Guide for use in accidents involving dangerous goods (IMO MSC/Circ.857). Required carriage on SOLAS ships carrying DG. For each substance group, gives signs, symptoms, immediate treatment, antidotes. Used alongside the IMDG Code's EmS Guide which covers the fire/spillage response. The MFAG is consulted by the shipboard medical officer in the absence of telemedicine.

Shipboard medical kit & medical care

The International Medical Guide for Ships (IMGS, WHO 3rd edition 2007), the IMO/ILO/WHO Joint Guidelines, and MLC 2006 Regulation 4.1 govern the medical equipment, medicines, and care every ship must provide. Flag states publish national annexes (UK MS Notice 1768, US 46 CFR 184.610, Norwegian Maritime Authority guidance) with country-specific items. Verification at MLC inspection.

Kit categories

Category A. Ships on international voyages, especially deep-sea trade where shore medical attention is more than 24 hours away. Most comprehensive list — full antibiotic course, controlled analgesics, IV fluids, suture material, splints, AED.
Category B. Ships on short-international voyages (within 24 hours of a port). Reduced list; major trauma items unchanged.
Category C. Inland and very short coastal vessels (within a few hours of help). Basic first-aid plus a few prescription items.

Crew competence

Medical First Aid (STCW Reg. VI/4-1). Required of every officer in charge of cargo handling on tankers and chemical tankers and many other roles.
Medical Care (STCW Reg. VI/4-2). Required of officers nominated as the shipboard medical officer. Course includes simulated patient assessment, drug administration, suturing, splinting, telemedicine procedure.
Crew first-aiders. Most operators ensure each watch carries a crew member trained in basic first aid plus AED operation.

Telemedicine — TMAS providers

CIRM (Italy). Centro Internazionale Radio-Medico. Free 24/7 service to any ship at sea. Phone, fax, email, satellite. Handles >7,000 cases/year.
CCMM (France). Centre de Consultation Médicale Maritime. 24/7, free, French- and English-speaking.
Radio Medical Norway. Operated by Haukeland University Hospital. Free 24/7 to any vessel.
RMC USA / Future Care / VIKAND. Commercial telemedicine services subscribed by major ship operators; richer service (case-management, follow-up, repatriation logistics) but at cost.

Controlled drugs and record-keeping

· Controlled drugs (opioid analgesics, benzodiazepines, ketamine) kept in a separate locked compartment.
· Master holds the controlled-drug register and signs every administration.
· Medical Officer's daily log records all consultations, drugs given, and outcomes.
· Disposal of expired controlled drugs requires shore-based authority — typically the destination port's environmental health office or a contracted pharmacy.

Common PSC / MLC findings

· Expired medicines on the shelf — single most common deficiency.
· Refrigerator temperature log not maintained.
· Controlled-drug register entries missing or non-sequential.
· STCW VI/4-2 certificate not held by any current crew member.
· MFAG / EmS Guide not on board (carriage required for ships handling DG).
· Medical Officer's log entries blank for known events recorded in the OLB.

Sources: International Medical Guide for Ships (WHO 3rd edition 2007); IMO/ILO/WHO Joint Guidelines on Maritime Medical Examinations; MLC 2006 Reg. 4.1 + Standard A4.1; STCW Reg. VI/4; MSC/Circ.857 (MFAG); ILO/WHO publication 'International Medical Guide for Ships' (free download). National variants: UK MS Notice 1768; US 46 CFR 184.610. See also injury at sea, medical help, CIRM, MFAG.

Last verified 4 months ago