MEDICAL EXAMINATIONS OF SEAFARERS, explanation
Obligation to have a medical certificate
Anyone who signs on in maritime service must have a medical certificate. This at
any rate includes crewmembers who are listed in the Safe Manning Document.
Seafarers who sign on voluntarily or at the request of the shipping company,
captain or for insurance purposes must also be able to provide a valid medical
certificate.
Moreover, a valid medical certificate is necessary to apply for a certificate of
competency.
Medical examiners
Only doctors who have been appointed by the Minister of Transport, Public Works
and Water Management can perform medical examinations. The medical
examiner may not be the seafarer’s own attending physician!
What to take to the medical examination
y Seaman’s book or a statement by the shipping company that the candidate is (or will be) in
service.
In the case of students, proof of registration at a nautical college is sufficient.
y The old medical certificate.
y The results of the tuberculosis test.
y If blood type is known but is not yet stated in the seaman’s book:
blood type card or attending physician’s statement. In the event blood type is
not known, the medical examiner will as yet establish this.
y If a candidate wears glasses or contact lenses: bring spare glasses.
Checking and registration
Via the internet, medical examiners have access to ShipExam: the medical
database of the Netherlands Shipping Inspectorate, containing examination
results.
Prior to the medical examination, the doctor will check the previous approvals and
rejections. This with the purpose of avoiding doctor shopping.
At the end of the examination, the new results will be electronically recorded.
Only appointed doctors have access to this data. The site is secured against
unauthorised inquisitive persons.
Medical fitness requirements
The examination is carried out on the basis of the seafarer medical fitness
requirements:
Ministerial Decree “Medical Examinations of Seafarers 2005”.
What does the medical examination entail
y A questionnaire and interview which will not only cover the current complaints
but also earlier incidents of ill health and accidents (anamnesis).
y A general physical examination.
y A test to establish blood type, if this has not yet been carried out.
y A urine test.
y Test to establish near and distance visual acuity, possibly with the aid of glasses (and
spare glasses).
y Eye movement test and double vision check.
y Field of vision test.
y Colour vision test.
y Occasionally, a night blindness test.
y Inspection of the ear canal and the eardrum.
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y Test to establish auditory acuity with an audiogram and, on occasion, a
conversation test.
In the event further information is required for the assessment, an additional
examination of blood or stools may take place. Consultation with the attending
physician or specialist may be required from time to time.
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Tuberculosis test
In principle, a lung photo or Mantoux test is obligatory for everyone unless
candidates sail in restricted areas and do not moreover come from areas with a risk
of tuberculosis. The medical certificate will, however, state that the sailing area is
restricted to North and West Europe and the northern part of the Mediterranean Sea.
Approval
A candidate will be approved if he/she meets the medical requirements. This
means that no condition has been discovered that would hinder a safe
performance of the activities, that he/she is deemed to act effectively at all times,
also in the event of an emergency, and that his/her presence on board does not
represent a threat to the health of the other crew and passengers.
Medical certificates are valid for a maximum of two years.
Rejection and re-examination
Seafarers may be temporarily or permanently rejected.
If the rejection is temporary, the examiner anticipates that, following treatment, the
candidate will be able to return to work within three years. The same medical
examiner may re-examine the candidate. Approval by a different medical examiner is
invalid.
A permanent rejection means that it is improbable that a candidate will return to work.
Following a permanent rejection, candidates may only request a referee for re-
examination.
Referee
In the event there is a conflict of opinion on the results of the medical
examination, seafarers may request a re-examination through KLM Health
Services, phone:+31(0)20-6490372. The re-examination will be carried out by an
appointed referee, a doctor who was not involved in the first examination. The
referee may carry out the re-examination in person or engage a specialist.
Exemption
A medical certificate offers no guarantees for the future. Seafarers whose
vision deteriorates or who contract certain illnesses may be subsequently
rejected.
Only in exceptional cases, where a person has gained many years of
experience in performing particular duties, certain medical examination
requirements may be departed from. A candidate therefore no longer meets
the criteria but his/her experience provides sufficient assurance for the safe
performance of the activities. The Medical Adviser of the Netherlands Shipping
Inspectorate may in that case issue an exemption, often subject to restrictions
concerning duties, sailing area or type of vessel.
Costs of medical examination
Charges have been set for the medical examination of shipping personnel.
The costs of the medical examination, re-examination, tests and requests for
medical information are for the candidate’s account. Employers usually assume
the costs of the medical examinations.
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