Where candidates trip up
Most candidates name 'the ship's doctor' or vaguely say 'call someone on the radio'. Neither is sufficient at command standard. The examiner wants to hear a layered, prioritised answer that shows you understand what is available, when each source is appropriate, and your own responsibilities as master throughout.
The correct, complete picture
1. Ship's Medical Guide / Ship Captain's Medical Guide (SCMG) The primary onboard reference for ships without a doctor. The SCMG (UK-published, required under the MCA's medical stores regulations, with certification requirements underpinned by MSN 1858) provides guidance on diagnosis, treatment, medication administration and dosage. You must know where it is and be able to use it — the examiner may press you on whether you have actually read it.
2. Radio Medical Advice All UK-flagged vessels have access to telemedical assistance. In UK and adjacent waters this is provided through HM Coastguard, who can connect you to a duty medical officer. Internationally, other Contracting States provide equivalent services — Italy's CIRM and France's CCMM are well-known examples. Contact is via DSC distress/urgency channel, VHF Ch 16, or MF/HF as appropriate. Declare an urgency (PAN PAN MEDICO) if the situation warrants it. The radio medical advice service is free of charge to the vessel.
3. TMAS — Telemedical Assistance Service The formal SOLAS/ITU term for the above services (SOLAS Reg IV/7 refers). MCA expects candidates to know this term and that the UK designates HM Coastguard as the coordination point.
4. International Medical Guide for Ships (IMGS) Published by WHO; a recognised alternative or supplement to the SCMG, particularly relevant on internationally trading vessels. Some companies carry both.
5. Company / Flag State resources Some SMS procedures include a named medical advisory service contracted by the company (e.g. MedLink, Falck). These are supplementary and do not replace statutory channels.
6. Diversion to port / evacuation A source of definitive care, not of information per se — but at command standard you must be able to articulate when no amount of remote advice is sufficient and evacuation or diversion becomes the correct decision.
Command-level emphasis
You cannot delegate the decision on medical management. You receive advice — from the SCMG, from radio medical services, from a TMAS doctor — but you decide the course of action, and you document it in the Official Log Book: the casualty's condition, advice received, actions taken, and outcome.