Preventive Medicine

Following the guidelines of the ILO's Maritime Labour Convention, 2006 and the Work in Fishing Convention, 2007, the Social Marine Institute carries out free embarkation medical examinations for all seafarers.

These examinations are established in Royal Decree 505/2024 of 28 May, which regulates medical examinations for the aptitude and health protection of workers in the maritime-fishing sector on board.

There are several types of recognition:

• Medical examinations for maritime embarkation: They are compulsory prior to enlistment and are intended to ensure that the applicant's psychophysical conditions are compatible with the characteristics of the job and do not pose a danger to the health and safety of the individual or the rest of the crew. Such conditions shall also not endanger maritime navigation.
• Medical examination of fitness for professional diving: They are intended to ensure that the psycho-physical conditions of professional divers are compatible with working in hyperbaric environments.
• Extraordinary medical examination: It can be carried out at the request of the worker, the company or the Social Marine Institute, with the previous medical examination in force. Its objective is to check the medical conditions of the worker, when there has been a change in the psychophysical conditions initially assessed.

These examinations not only guarantee that workers enter the ship in the best possible psychophysical conditions, but from the health point of view, they are the starting point to know the state of health of the working population, which is an important support in the event that a worker needs medical assistance on board from the different assistance units that make up the Maritime Health Programme.

Interested parties can submit their application at any of the Maritime Health Centres of the Social Marine Institute, through the corresponding service of the Social Security e-Office with or without an electronic certificate, from their mobile phone using the Social Security app or the ISM in your pocket app, and meet the following requirements:

Be over 16 years of age, 18 for professional divers, and not be in a situation of temporary disability or suspension of the employment relationship due to risk during pregnancy or risk during breastfeeding. If the applicant is in a situation of total permanent disability, they must prove that they have prior authorisation from the managing body to carry out a professional activity other than that for which the situation of permanent disability was recognised.

Be affiliated and in a situation of being registered or assimilated to registration in the Social Security Special Scheme for Seafarers in jobs that require a medical examination of aptitude for sea embarkation, or in the category of professional diver, or be in periods of inactivity between seasonal jobs in the maritime-fishing sector that require any of these requirements.

Where this is not the case, the persons concerned must prove that they are in one of the following situations:

1. Be registered as job seekers in the maritime-fishing sector in jobs that require a medical examination for embarkation at sea or as a professional diver in the categories included in the Social Security Special Scheme for Seafarers.

2. Be pending a contract for a position on board a Spanish-flagged vessel or as a professional diver in the categories included in the Social Security Special Scheme for Seafarers, which must be accredited by means of a certificate from the company.

At the time of application they must prove their identity by presenting, depending on their nationality, their National Identity Card, NIE or passport.

Applicants for medical examinations for maritime embarkation must prove their status as seafarers by presenting the Maritime Navigation Book or its equivalent in the case of crew members of foreign nationality.

Professional divers must provide a professional diving identity card if they are Spanish nationals, or an equivalent document in the case of citizens of another nationality. Divers extracting marine resources shall be required to provide certification authorising them to carry out this activity.

The Social Marine Institute, during regular pre-embarkation medical examinations, sends reminder letters and SMSs to workers informing them that the validity of the previous medical examination is about to expire and reminding them of the need to renew it.

The period of validity of the examination shall be determined in each case by the examining doctor according to the state of health of the person being examined, their age and the type of work they perform, with a maximum validity limit of two years in general and one year for those under 18 years of age or those who are professional divers.

If the period of validity of a medical certificate of embarkation expires during a voyage, it shall remain valid until the date of arrival at the next port of call where the person concerned can obtain a medical certificate issued by a medical officer, provided that this extension of validity does not exceed three months.

Once the seafarer's fitness assessment has been completed, the seafarer shall be issued with a certificate containing a declaration of fitness (in accordance with the Maritime Labour Convention, 2006 and the Work in Fishing Convention, 2007 as well as the International Maritime Organisation Convention STCW-78/10).

They will also receive a medical report and an analysis report. These reports can also be accessed via the "ISM in your pocket" application and at the Social Security e-Office.

Regulation 4.1 of the Regulations and Standard A4.1 of the Code, both constituent texts of the ILO Maritime Labour Convention (MLC Convention) and Article 29 of the ILO Work in Fishing Convention, 2007 (Convention No. 188), provide that those responsible for medical care on board who are not medical doctors shall have satisfactorily completed a course approved by the competent authority of theoretical and practical training in medical care, providing for elementary and higher level training depending on the tonnage of the ship and the time delay in obtaining qualified medical care.
Furthermore, the International Maritime Organization's International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978 (STCW Convention), the Seafarers' Training, Certification and Watchkeeping Code and the International Convention on Standards of Training, Certification and Watchkeeping for Fishing Vessel Personnel, 1995 (STCW-F Convention), as well as Directive (EU) 2022/993 of the European Parliament and of the Council of 8 June 2022 on the minimum level of training of seafarers (Regulation VI/4 of Chapter VI of Annex I) also establish minimum requirements for first aid and medical care for awarding the professional certificates it regulates.

In this respect,Royal Decree 258/1999 of 12 February establishing minimum conditions for the protection of the health and medical care of seafarers regulates certain basic matters relating to the health protection of seafarers: the contents of the medicine cabinets on vessels, including the Health Guide on board, the minimum health facilities on vessels, compulsory health training for crew members and the designation of the Radio-Medical Centre of the Social Marine Institute as the permanent health care centre for the fleet.

Order PJC/1424/2025 of 9 December establishes the minimum contents of the specific health training programmes and the conditions for the issuing and approval of the health training certificate for seafarers.
Five types of health training certificates have been established for seafarers:

• Basic Initial Specific Healthcare Training: Intended for skippers on watchkeeping duties on fishing vessels required to carry kit C, up to 30 miles.
• Initial Specific Healthcare Training: Intended for captains, skippers and officers in charge of a navigational watch on ships required to carry kit C up to 60 miles, and those authorised to sail with the adapted type B kit.

• Advanced Specific Healthcare Training: Mandatory for captains, skippers and officers in charge of a navigational watch on ships fitted with Type A or B medical stores.

This certificate enables the use of the type C first aid kit in any of its forms.

• Initial Specific Healthcare Training – Machines: Intended for the chief engineer officer and other officers on watch in the engine room.
• Initial Specific Healthcare Training – Radio: Compulsory for first and second class radio-electronic officers of the Merchant Navy.

The certificates for initial specific healthcare training, initial specific medical training–machinery and initial specific medical training–radio, are equivalent to the training in shipboard first aid and medical care provided for in Regulation VI/4, paragraph 1, Chapter VI of the Annex to the STCW Convention and the corresponding section A-VI/4, paragraphs 1 to 3, of the STCW Training Code.

The advanced specific healthcare training certificate is equivalent to the training in shipboard medical care provided for in Regulation VI/4, paragraph 2, of Chapter VI of the Annex to the STCW Convention and the corresponding section A-VI/4, paragraphs 4 to 6, of the STCW Training Code.
The specific health training certificates required for bridge and deck crew, irrespective of the mode of issue, shall be valid for five years from the date of issue. The initial and advanced specific healthcare training certificates may be extended for equal periods of validity by completing the corresponding refresher course.
Refresher courses must be completed before the end of the period of validity of the specific healthcare training certificate.
After the completion of two successive refresher courses or when the validity period of the corresponding certificate is exceeded, a complete course is required to obtain a new certificate.
The healthcare training certificates required for personnel in the machinery or radio-electronics and radiocommunications departments, irrespective of the mode of issue, shall have no expiry date.

The information gathered during the medical examinations for sea service is used to design and run preventive health advertising campaigns.

They constitute the fourth link in the preventive action carried out by the provincial and local health at sea centres( Social Marine Institute provincial and local directorates ). The aim is to influence the health knowledge of workers, involving them as an element responsible for their health and providing the necessary means to prevent the appearance of the pathologies with the highest effect in that population.

The following campaigns, among others, are worth mentioning:

• Prevention of sexually transmitted diseases, especially AIDS.
• Malaria prevention.
• Prevention of drug addiction.
• Prevention of occupational risks in the sector.
• Accident prevention on board.
• Risk prevention on deck.
• Mental health campaign.
• First aid on board.
• Smoking Prevention.
• On Board Physical Exercise Benefit.

• Healthy Eating.

En la siguiente tabla podrá descargarse los siguientes Documentos.

Documentos	Download	Fecha
175150 Cancer prevention leaflet	(PDF,3653 KB)	21/04/2014
193617 Drinking water on board campaign leaflet	(PDF,2371 KB)	03/06/2015
193622 Drinking water on board campaign poster	(PDF,754 KB)	03/06/2015
203540 Radio Medical Centre Campaign Leaflet	(PDF,816 KB)	10/10/2016
203545 Radio Medical Centre Campaign Poster	(PDF,195 KB)	07/10/2016
203551 On-board Health Coordinator Campaign Leaflet	(PDF,1037 KB)	07/10/2016
203556 On-board Health Coordinator Campaign Poster	(PDF,1951 KB)	07/10/2016
219352 Leaflet on the importance of colours on-board	(PDF,1757 KB)	24/07/2017
219357 Poster on the importance of colours on-board	(PDF,293 KB)	10/02/2017
229324 Díptico Campaña Higiene Bucal	(PDF,3497 KB)	22/12/2017
229342 Díptico Campaña Manipulación Manual de Cargas	(PDF,2138 KB)	22/12/2017

Vaccination campaigns are implemented through the Maritime Health Care Centres, located in the Provincial Directorates and Local Offices of the ISM, either working independently or with other Public Health Organisations.

In addition, many Maritime Health Care Centres carry out important preventive work by running national, provincial and local vaccination campaigns against particularly serious diseases such as tetanus, influenza and hepatitis B.

The mandatory first-aid kits on board are regulated by Royal Decree 258/1999of 12 February establishing minimum conditions for the protection of the health and medical care of seafarers.

The control of the health and hygiene conditions of ships is a major task in the prevention of accidents and diseases on board ships.

There are different types of medical kits on board, depending on how far from shore the vessels work and how long it would take medical assistance to reach the vessel in case of emergency.

The periodical revisions of the regulatory medical kits  are carried out by the designated health personnel in the ISM Health at Sea Centres, located in the Provincial and Local Directorates of the Social Marine Institute, and their results are recorded in the corresponding medical kit revision certificate, valid for one year.

In all inspections, it shall be verified that the on-board medical kits are adequately stocked, that the conditions of conservation of the container and contents are adequate, that the expiry dates of the components are respected and that they are duly marked and identified. Likewise, the existence, registration and custody of the obligatory health documentation shall be verified, depending on the type of medical kit.

The application for the periodic review of the on-board medical kit will be made on the unified application form to be completed by companies (point 2) -available at the bottom of this information-, and must be submitted through the REVIEW SERVICE FOR MEDICAL KITS (REM) available at the Social Security E-Office. Applications for the revision of a medical kit may be submitted no later than two months after the expiry date of the previous medical kit revision certificate.

The application must be accompanied by the document checking the contents of the medical kit(s) for which the review is requested, duly completed by the on-board health officer, dated not more than 15 days prior to the application for review (see form at the bottom of this information).

Evidence must also be provided on the above aspects to verify compliance with the requirements established in relation to the container, contents, location, signage, maintenance of the on-board medical kit and availability of the health documentation of the medical kit (responsible declarations, invoices for the purchase of medicines, images relating to the container, signage and location of the medical kit, etc.).

Once it has been carried out, the skipper, captain or person in charge of health on board must keep the documents controlling the contents of the medical kit together with the Certificate of Health Check signed by the shipowner, until the next check-up. 

In order to apply for the prescription of the medicines included in the pharmacological provision of the medical kits of the ships, the unified application form to be completed by the companies (point 1) will be sent through the REVISION SERVICE FOR MEDICAL KITS (REM) available at the Social Security Electronic Headquarters.

The request for the documentation comprising the medical kit shall be made, where applicable,  in the unified application form to be completed by companies (point 3), through the REVISION SERVICE FOR MEDICAL KITS (REM) available at the Social Security E-Office.

En la siguiente tabla podrá descargarse los siguientes Documentos.

Documentos	Download	Fecha
156441 Technical Specifications	(TXT,2 KB)	08/02/2013
156440 Medicine Chest A Control Document	(XLSM,292 KB)	18/01/2013
156442 Medicine Chest B Control Document	(XLSM,282 KB)	18/01/2013
156443 Medicine Chest C Control Document up to 60 miles	(XLSM,149 KB)	18/01/2013
156444 Medicine Chest Control Document up to 10 miles	(XLSM,145 KB)	21/04/2014
156445 Antidote Medicine Chest Control Document	(XLSM,128 KB)	18/01/2013
156446 Medicine Chest C Control Document for life boats	(XLSM,147 KB)	18/01/2013
169878 Drug Administration Log Book	(XLS,519 KB)	18/01/2013
178483 Unified Request for First Aid Kits	(PDF,815 KB)	26/10/2020