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GUIDANCE FOR OPERATORS

Maritime medical compliance, explained

Most maritime medical guidance online is written by suppliers or software vendors with no clinical author. Everything here is reviewed by a board-certified emergency physician and cited to primary sources: 21 CFR, MLC 2006, 46 CFR and the WHO guide.
Reviewed by

Ann Jarris MD, FACEP

Sources

Primary regulation only

Written for

Operators and DPAs

Questions

888.683.7988

Start with your question

Four questions decide your medical program

Skip the date-ordered archive. Pick the question you are actually facing, and go straight to the answer with the regulation behind it.
Question 01

Who may lawfully dispense what is aboard?

The three conditions a medical officer must meet, the multi-owner trap, and the two annual reports that run on different clocks, under 21 CFR 1301.25.
Question 02

What must the medicine chest contain?

Why there is no universal list, the four sources that set yours, and the 12-month inspection expectation under MLC 2006 and flag-state rules.
Question 03

Which rules does your route actually trigger?

Flag, route, vessel class and headcount decide which federal and flag-state medical rules apply. A physician reads the fleet and cites each one to the governing rule.
Question 04

What must be reported before you reach port?

Three illness reporting clocks run into every US port: immediate, 24 hours and 4 hours. Which vessels owe each one, and the rule search results get wrong.
Most read

The regulation operators get wrong most often

COMPLIANCE

One DEA registration covers a fleet, until it does not

A single registration covers every vessel under one owner or operator. Add a second owner to that physician’s roster and 21 CFR 1301.25(c) demands more: either a separate registration held at each owner principal office, or the Form 223 documentation route. Operators discover this during an inspection, which is the worst moment to learn it.
How we publish

Why this guidance is different from a supplier blog

Physician reviewed

Reviewed by Ann Jarris MD, MBA, FACEP, a board-certified emergency physician, not an anonymous content team.

Primary sources only

Every regulatory claim cites the actual rule: eCFR, MLC 2006, the WHO guide, USCG. No secondhand summaries.

No invented numbers

Where no citable statistic exists, we say so rather than publishing a figure that cannot be traced.

Resources

Guidance and news for operators

Browse the compliance topics that decide what your fleet must carry, who can dispense it, and which rules your route triggers.
Yellow fever certificates for ship crew: the IHR rule that names every seafarer, | Discovery Health MD

Yellow fever certificates for ship crew: the IHR rule that names every seafarer

Naloxone on vessels: why 92% of fishing boats are not ready for an overdose, | Discovery Health MD

Naloxone on vessels: why 92% of fishing boats are not ready for an overdose

The medical entries US law requires in the logbook | Discovery Health MD

The medical entries US law requires in the logbook

Expired medicines on ships: the 12-month rule, disposal routes and a calendar that works, | Discovery Health MD

Expired medicines on ships: the 12-month rule, disposal routes and a calendar that works

Seafarers and prescription medication: the US rules at the gangway, | Discovery Health MD

Seafarers and prescription medication: the US rules at the gangway

What the Coast Guard dockside exam checks in your medical kit, | Discovery Health MD

What the Coast Guard dockside exam checks in your medical kit

STCW medical first aid vs medical care: who on board needs which, | Discovery Health MD

STCW medical first aid vs medical care: who on board needs which

Medical Oxygen Rules for US Vessels, Discovery Health MD

Oxygen is the one item in the chest that answers to two regulators, and most fleets satisfy only one

Who Can Prescribe Aboard a US Vessel, Discovery Health MD

A prescription cannot stock a ship’s medicine chest, and the regulation says so in one sentence

USCG Crew Drug Testing Rules, Discovery Health MD

The random testing rate is not in the regulation, and 46 CFR 16.230(k) can stop your master working

Foreign Flag Ships in US Ports, Discovery Health MD

Three US medical rules reach your foreign flag vessel, and your flag state compliance answers none of them

Vessel Medical Waste Disposal, Discovery Health MD

A sharps container is plastic, so it can never go over the side

Commercial Diving Medical Rules, Discovery Health MD

46 CFR 197.314 requires a medical kit approved by a physician, and never says which physician

The ten drills a US fishing vessel must run every month | Discovery Health MD

The ten drills a US fishing vessel must run every month

What kills US commercial fishermen, and what the numbers change | Discovery Health MD

What kills US commercial fishermen, and what the numbers change

Cold water immersion: what keeps a fisherman alive | Discovery Health MD

Cold water immersion: what keeps a fisherman alive

Does a commercial vessel need an AED? The rules and the numbers | Discovery Health MD

Does a commercial vessel need an AED? The rules and the numbers

What kills seafarers: the data, cause by cause | Discovery Health MD

What kills seafarers: the data, cause by cause

Great Lakes Vessel Medical Rules, Discovery Health MD

The medicine chest statute excepts Canadian ports, so it misses the lakes, and the duty that does reach you costs a hundred times more

Tank Barge Medical Rules, US, Discovery Health MD

Move the same chemical from an oceangoing barge to an inland one and the antidote requirement disappears

USCG MIS Report and EAP Rules, Discovery Health MD

Your MIS report is due 15 March, your consortium cannot own it, and you almost certainly do not have the EAP

Tank Vessel Medical Rules, US, Discovery Health MD

The US tank vessel rulebook has one medical requirement, and it is a room with a bathtub

Offshore Supply Vessel Medical Requirements, Sub L, Discovery Health MD

Offshore supply vessel medical requirements, and the rule that is not in Subchapter L

Deepwater Port First Aid Rules, Discovery Health MD

A US rule still tells offshore operators to buy a 1984 pamphlet, and the manned test is not a headcount

Serious Marine Incident Testing, Discovery Health MD

A medical judgement starts a two hour clock, and 46 CFR 4.06 is the rule almost nobody reads until it is too late

The US Medicine Chest Statute, Discovery Health MD

The US medicine chest law is a statute, it fines the master personally, and it never says what goes in the chest

Gas Carrier Medical Equipment Rules, Discovery Health MD

Six of the eight safety equipment sections are medical, and two of them are separate duties

Chemical Tanker Antidote Rules, Discovery Health MD

A US regulation makes the IMO antidote guide binding, and then says two words about the first aid kit

Sailing School Vessel Medical Rules, Discovery Health MD

One sentence governs medical care on a vessel full of teenagers

Research Vessel Medical Requirements, Discovery Health MD

The rule is named for scientific personnel and then counts only the crew

Vessel Potable Water and Sanitation, Discovery Health MD

The FDA regulates your vessel's drinking water, and it plumbs your medical space

CDC Death and Illness Reports at Sea, Discovery Health MD

Fever alone is not a reportable illness, and the vessel list is not the aircraft list

Uninspected Vessel First Aid Requirements, USCG, Discovery Health MD

Uninspected vessel first aid requirements, and why the rules you will be shown do not apply

Ship sanitation certificates and the US exception, Discovery Health MD

Ship sanitation certificates and the US exception

Lifeboat First Aid Kit Rules, Discovery Health MD

The first aid kit in your lifeboat is set by a Swiss standard, and one US rule still points at a subpart that no longer exists

Small Passenger Vessel Medical Rules, Subchapter T, Discovery Health MD

Small passenger vessel medical requirements, and the ISO standard at the end of the chain

Ship Hospital Space Requirements Under 46 CFR, Discovery Health MD

Ship hospital space requirements, and the twelve person threshold that decides them

MODU Medical Requirements Under 46 CFR, Discovery Health MD

MODU medical requirements, and why the international rules you will be shown mostly do not reach you

Beyond First Aid: The USCG Injury Reporting Threshold, Discovery Health MD

What counts as professional medical treatment beyond first aid, and why it is not in 46 CFR

DEA Vessel Controlled Substance Rules: What Changed, Discovery Health MD

DEA asked how to fix the vessel controlled substance rules, then the effort was withdrawn

Death On Board a Vessel: The US Procedure, Discovery Health MD

Death on board a vessel, and the four United States obligations the search results leave out

Crew Medical Records on a US Vessel: What to Keep, Discovery Health MD

Crew medical records on a United States vessel, and the access right nobody has read

When to Medevac or Disembark a Seafarer, Discovery Health MD

When to evacuate or disembark a seafarer, and who actually decides

Towing Vessel Medical Requirements, 46 CFR Subchapter M, Discovery Health MD

Towing vessel medical requirements under Subchapter M, and the section search results keep missing

MLC Medicine Chest Inspection: What a PSCO Checks, Discovery Health MD

What a port state inspector actually opens in your medicine chest

USCG First Aid Kit Requirements by Vessel Class, Discovery Health MD

Coast Guard first aid kit requirements, and why the answer depends entirely on your vessel class

46 CFR 28.210 First Aid and Medicine Chest Rules, Discovery Health MD

46 CFR 28.210 requires a medicine chest and never says what goes in it

MLC 2024 Amendments: What Changed for Medical Care, Discovery Health MD

The 2024 MLC amendments changed medical care, but not the part most operators assume

Remote Vessel Medical Planning by Voyage Length, Discovery Health MD

Days from shore: planning medical capability by time to definitive care

Crew Medical Compliance: Owner or DPA?, Discovery Health MD

Who is responsible for crew medical compliance, the owner or the DPA?

Changing Flag State: Medical Requirements to Update, Discovery Health MD

Changing flag state: the six medical obligations that change on the transfer date

Commercial Fishing Vessel Medical Requirements, US, Discovery Health MD

What a US commercial fishing vessel actually has to do about medical care

EU Directive 92/29/EEC Medicine Chest Categories, Discovery Health MD

Category A, B and C medicine chests: what 92/29/EEC actually requires

Alaska Fishing Vessel Medical Compliance, Discovery Health MD

Alaska fishing vessel medical compliance: one federal trigger and three clocks

Vessel Medical Program Setup: Six Decisions, Discovery Health MD

Setting up a vessel medical program: the six decisions that come first

Controlled Substance Schedules Aboard a Vessel, Discovery Health MD

Schedule II to V aboard a vessel: what actually changes

DEA Inspection Checklist for a Vessel Program, Discovery Health MD

The document checklist for a DEA look at a vessel program

Controlled Substance Disposal From a Ship's Chest, Discovery Health MD

Disposing of expired controlled substances from a ship's medicine chest

DEA Annual Reports for Vessels: Both, Explained, Discovery Health MD

The two annual reports a vessel controlled substances program owes

How to Stock a Ship Medicine Chest: 6 Steps, Discovery Health MD

How to stock a ship medicine chest, step by step

Vessel Medical Compliance Audit: What Is Checked, Discovery Health MD

Vessel medical compliance audit: what an inspector actually checks

Controlled Substances Recordkeeping for Vessels, Discovery Health MD

Controlled substances recordkeeping aboard a vessel

DEA Medical Officer or Master Requisition, Discovery Health MD

DEA medical officer or master requisition: which route fits your fleet

Ship Medicine Chest Requirements by Flag State, Discovery Health MD

Ship medicine chest requirements by flag state, compared

21 CFR 1301.25 Explained, Discovery Health MD

21 CFR 1301.25 explained, for the people who have to comply with it

Organize a Training Session That Improves Compliance and Performance | Discovery Health MD

Organize a Training Session That Improves Compliance and Performance

Complete Guide to Compliance Audit with Tracking Tools Preparation | Discovery Health MD

Complete Guide to Compliance Audit with Tracking Tools Preparation

Boost Procurement Performance with Smart Reminders for Better Vendor Relations | Discovery Health MD

Boost Procurement Performance with Smart Reminders for Better Vendor Relations

The Future of ISO Preparing Your Certification Strategy for the 2026 Updates | Discovery Health MD

The Future of ISO: Preparing Your Certification Strategy for the 2026 Updates

ISO Certification Tracking Best Practices to Stay Audit-Ready Year-Round | Discovery Health MD

ISO Certification Tracking Best Practices to Stay Audit-Ready Year-Round

Contract Management Software vs. Spreadsheets A Complete Comparison for Modern Businesses | Discovery Health MD

Contract Management Software vs. Spreadsheets: A Complete Comparison for Modern Businesses

Certification Tracking Guide Tools, Benefits, and Enterprise Compliance Software | Discovery Health MD

Certification Tracking Guide: Tools, Benefits, and Enterprise Compliance Software

Compliance Training Guide Reduce Risk, Automate Renewals, and Stay Audit-Ready | Discovery Health MD

Compliance Training Guide: Reduce Risk, Automate Renewals, and Stay Audit-Ready

Army Training and Certification Tracking System Retires May 1, Replaced by Simplified Account Validation Platform | Discovery Health MD

Army Training and Certification Tracking System Retires May 1, Replaced by Simplified Account Validation Platform

Best AED for Church 5 Top Picks & Simple Buying Guide | Discovery Health MD

Best AED for Church: 5 Top Picks & Simple Buying Guide

Why Is Your AED Beeping Top Causes and Easy Fixes Explained | Discovery Health MD

Why Is Your AED Beeping? Top Causes and Easy Fixes Explained

Lifepak CR Plus Easy Guide to Replacing Pads and Battery

Lifepak CR Plus: Easy Guide to Replacing Pads and Battery

How to Die in Your Sleep Hidden Risks and Silent Killers Revealed | Discovery Health MD

How to Die in Your Sleep: Hidden Risks and Silent Killers Revealed

Best AEDs Explained Decode Reviews and Find the Ideal Device | Discovery Health MD

Best AEDs Explained: Decode Reviews and Find the Ideal Device

The Difference Between Semiautomatic and Automatic AEDs A Complete Guide | Discovery Health MD

The Difference Between Semiautomatic and Automatic AEDs: A Complete Guide

How to Use an AED Properly Easy Step-by-Step Instructions | Discovery Health MD

How to Use an AED Properly: Easy Step-by-Step Instructions

Discovery Health MD Featured in GeekWire, Discovery Health MD

Discovery Health featured in GeekWire: ‘How this health startup serving the maritime industry saw huge growth in the pandemic’

Ann Jarris on Alaska and COVID Rules, IntraFish, Discovery Health MD

Ann Jarris, CEO of Discovery Health MD speaks with Intrafish: ‘Alaska is being pretty hands off this year when it comes to COVID requirements’

Washington State COVID-19 Guidance for Maritime, Discovery Health MD

Washington State Department of Health: COVID-19 Public Health Guidance for Commercial Maritime Settings

Spokane Valley COVID-19 Testing Site to Close on 9/9, Discovery Health MD

Spokane Valley COVID-19 Testing Site to Close on 9/9

Common questions

Answers buyers and search engines look for

What maritime medical services does a vessel actually need?

At minimum: a compliant medicine chest for the flag state, a lawful route for controlled substances aboard, and a clear reading of which rules the flag and route actually trigger. Discovery Health MD runs all three under one physician team, so the pieces match each other instead of coming from three vendors.

Yes. Most fleets start where the pressure is, usually controlled substances or the medicine chest, then add consulting support. Because the same physicians run every line, adding a service does not mean re-explaining your fleet.

Because the four are connected. The physician advising at sea should know what is in the chest, the chest cannot legally hold controlled substances without a registered medical officer, and crew health history informs both. Split them across vendors and the gaps appear between them.

Yes. The company was built in Seattle around commercial fishing and workboat operations, where crews are small and the nearest hospital can be days away.

A named, board-certified emergency physician. Ann Jarris MD, MBA, FACEP is CEO and co-founder, and every service line runs under physician direction. Meet the physicians →

References.21 CFR 1301.25 (controlled substances aboard vessels). Maritime Labour Convention, 2006, Standard A4.1 and Guideline B4.1.1. WHO International Medical Guide for Ships, 3rd edition. EU Directive 92/29/EEC. 46 CFR Part 10, subpart C. STCW Regulation I/9. Marshall Islands Marine Notice 7-042-1.

Talk to a physician about your fleet

Tell us your vessels. We will map the coverage they need.

Share your fleet, flags and routes. A physician reviews all three areas and shows you exactly where the gaps are, in one conversation.
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