The Three Sources You Must Know
An examiner will probe whether you know what resource to use, when, and why — not just that resources exist.
1. Ship Captain's Medical Guide (SCMG)
The onboard reference book required under UK MCA regulations. It is the first point of reference for the OOW when managing a medical casualty at sea without a doctor on board. It covers assessment, treatment protocols, drug administration guidance, and use of the medical equipment required to be carried. It is designed to be used by non-medical personnel. Use it when: you need immediate, self-contained guidance and communication with shore is not yet established, or to support decisions already taken after consulting MRCC.
2. Radio Medical Advice (CIRM / MRCC)
Real-time medical advice from a qualified doctor via radio or telephone. In UK waters and for UK-flagged vessels, this is obtained through HM Coastguard (MRCC). Other countries operate equivalent services (e.g., CIRM in Italy, which is referenced in MSN 1858). This is the primary resource for any serious or deteriorating casualty — the doctor can direct treatment, advise on drug dosages, and make decisions the SCMG cannot. Use it when: the condition is serious, uncertain, or potentially life-threatening, or when you need authority to administer prescription medicines. Contact on VHF Ch 16 or MF DSC, then transfer to a working channel.
3. Telemedical Assistance Services (TMAS)
MSN 1858 implements the EU/ILO framework requiring flag states to ensure access to TMAS — shore-based medical advisory services available 24/7 to ships at sea. TMAS is the formal name for the system within which Radio Medical Advice operates. All UK-flagged vessels must have access to a TMAS provider. In practice, for the oral exam, understand that MRCC/HM Coastguard connects you to TMAS-compliant medical advice.
Distinguishing the Three in an Exam
| Resource | Nature | When to use |
|---|---|---|
| SCMG | Onboard book | Immediate reference; supports TMAS consultation |
| Radio Medical Advice | Live doctor, via MRCC | Any serious casualty; drug authorisation |
| TMAS | The regulatory framework/service | Underpins radio medical advice; the system you are accessing |
Key Practical Point
These resources are complementary, not alternatives. The correct sequence is: assess using the SCMG, then contact MRCC/TMAS for a doctor's guidance. Document all advice received, the name of the advising doctor if given, times, and actions taken in the medical log and deck log.