Ship's doctor

from Wikipedia, the free encyclopedia
Ship doctors at a hernia - operation aboard the Harry S. Truman in 2007

A ship's doctor is a doctor who ensures medical care on board ships in the civil and military sectors and is responsible for compliance with hygiene and safety regulations. According to the Maritime Labor Convention , a ship's doctor must be on board for ships with more than 100 people on board and journeys lasting more than three days. The qualifications of a ship's doctor are regulated by national regulations.

requirements

Badge of rank of a civil ship doctor

Civil shipping

Prerequisites for employment as a ship's doctor in the civil sector are, after completing a degree in medicine with a medical license , several years of medical activity in at least one acute discipline and experience in emergency medicine. In addition, solid language skills in English and fitness for sea service are useful.

Each individual flag state defines the exact requirements for qualification as a ship's doctor. To work on seagoing vessels flying the German flag, you need to register as a ship's doctor with the trade association for transport and traffic management (see below).

The certificate Maritime Medicine of the Medical Association of Schleswig-Holstein can since June 6 2001 on the basis of the ship's doctor training course of the German Navy at the Marine Medical Institute of Marine in Kronshagen (from 2023 Template: future / in 3 yearson the site of the Military Hospital in Hamburg ) (and other training content expertise rescue service, training: 1 year surgery, 1 year internal medicine, 6 months anesthesia, tropical and diving medicine course, survival at sea) can be acquired, but is not compulsory. Completed specialist training is also not required. A five to ten year clinical activity in surgery and internal medicine is expected today for a job as a ship's doctor. Experience in travel and tropical medicine as well as basic knowledge of dentistry are also desirable in order to cope with the wide range of diseases that arise. Qualifications in radiation protection and rescue services must be available. The German Society for Maritime Medicine (DGMM) recommends participation in the Introduction to Maritime Emergency Medicine course .

The final decision on the hiring of the ship's doctor and his qualification profile lies with the respective shipping company.

The ship's doctor receives a fixed salary from the shipping company , or a basic salary with a percentage share. Alternatively, some of the ship's treatment rooms can be rented and doctors can be billed in accordance with the German fee schedule .

German Navy

Ship doctors of the German Navy
Rank group Captains Staff officer
Sleeve badge ( human medicine ) GE-NAVY-OF-2med StArzt.svg GE-NAVY-OF-3med OStArzt.svg
Sleeve badge ( dentistry ) GE-NAVY-OF-2dent StArzt.svg GE-NAVY-OF-3dent OStArzt.svg
Rank Medical officer Chief Medical Officer
abbreviation Doctor OStArzt
NATO rank code OF-2 OF-3
Grade A 13 A 14

The German Navy has 62 medical officers , 20 of them women. The ship's doctor on board is currently 28 (as of October 2009) medical officer candidates from the Navy undergo basic training on land which has been shortened to six weeks and then take part in a training trip abroad with the training ship Gorch Fock with the officers of their crew's troop service . This is followed by medical studies at a civil university, during which the officers' courses are also completed. After this training, the young medical officers (after obtaining their license to practice medicine ) are transferred to the Bundeswehr hospitals in Hamburg , Westerstede , Berlin , Koblenz or Ulm for a first three-year assignment in the clinic . During the clinical training, the additional qualification in rescue medicine in anesthesiology is acquired . A further training period in surgery , internal medicine and radiology is aimed for. This is followed by a year-long maritime specialist training at the Naval Medical Institute of the Navy. In this training section, the ship's doctor course (with a dentistry part ), diving doctor and aviation doctor course are completed and advanced training courses in tropical medicine , sonography , gynecology , survival at sea and telemedicine are completed . After completing the training, the ship's doctors meet the requirements for obtaining the Maritime Medicine certificate from the Schleswig-Holstein Medical Association.

Higher ranks are not on board as ship doctors, only as embarked directors of a marine rescue center or as senior medical officers .

tasks

The scope of duties of a ship's doctor includes general medical , emergency medical , preventive medical and company medical care, such as monitoring kitchen and accommodation hygiene , carrying out vaccinations and measures to prevent epidemics in the event of infections. The job description also has tropical medicine aspects. A ship's doctor is also responsible for the medical supplies and their care and maintenance. In the Navy, the ship's doctor is also entrusted with carrying out medical training for the crew members. In the civilian sector, periodic first aid and cardiopulmonary resuscitation courses, as well as rescue exercises, are also the responsibility of the ship's doctor for the crew.

Medical supplies

The spectrum of diseases to be treated on board a ship is wide and also depends on the crew and passengers . In addition to seasickness , there are various other health problems. The most common causes of medical consultations are respiratory diseases of passengers, skin diseases of the crew and injuries . Passengers are more likely to injure themselves on land, and crew members on board. Cardiovascular diseases are more common in passengers than in crew members. Dental treatments are also often necessary, especially for crew members, and, more often than for other illnesses, result in treatment by a (dental) doctor in the nearest port.

Role of telemedicine

Due to the variety of possible clinical pictures to be treated , medical advice from Medico Cuxhaven was set up as early as 1931 , which is available to the ship's doctors. In the meantime, various systems can be used to transmit ECG values, images and video material to a consulting doctor. This increases the effectiveness of the ship's doctor, so that the risk of a misdiagnosis and the resulting incorrect treatment is significantly reduced. In addition to the medical benefit for the patient, costs can be saved through unnecessary evacuations and repatriation.

Legal basis

The manning of ships with medical personnel is regulated by respective national regulations. The regulations of the country under whose flag the ship is sailing apply. According to standard A4.1 of the Maritime Labor Convention , ships with more than 100 people on board and voyages over more than three days must have a doctor on board. However, the national regulations may contain stricter requirements. In the British The Merchant Shipping (Ships' Doctors) Regulations of 1995, it is declared in addition to the obligation of a British ship owner, for ships with more than 100 people on board and a distance of more than 1.5 days to the nearest port with adequate medical conditions Care to have a qualified doctor on board. In the Turkish Regulation on Sanitary Safety of Passengers on Ships of January 28, 1943, on the other hand, it is stipulated that a ship's doctor is only required if there are more than 200 passengers.

Germany

According to Section 6 of the Ship Occupation Ordinance, a ship's doctor is required on merchant ships flying the German flag if there are 100 or more people on board and a journey of more than three days. If the number of people on a ship exceeds 800, a second ship's doctor must be on board. Ship doctors who want to work on merchant ships under the German flag must register with the Maritime Medical Service of the professional association for transport and traffic management in accordance with Section 19 of the Maritime Medicine Ordinance . Anyone who is a general practitioner, anesthesiologist, surgery or internal medicine doctor, has the additional qualification "emergency medicine" or the certificate of qualification "rescue medicine", has at least four weeks of practical experience on a seagoing vessel and who can prove that he / she is on a merchant vessel is registered as a ship's doctor is or will be active under the German flag (for example through an employment contract).

Corresponding Bundeswehr regulations apply in the military sector. Navy boats usually do not have a doctor on board, but a medical assistant (previously: medical master). In these cases, medical care is often provided by a supply ship accompanying the association, which has a hospital with a squadron doctor . On small military units, such as speedboats or class 206A submarines , the smut is trained as a medic , but in the event of an emergency, more highly qualified rescue personnel are embarked. The ship's doctor or the shipping medical assistant are available to assist the ship's doctor's assistants (formerly: medical mates) and medical guests in fulfilling their duties.

history

Ship doctors were already known in ancient times . For example, in the Roman navy it was a requirement to have a ship's doctor on board as a Duplicarii (legionnaire with double pay ) for a crew of 200 . Its main task was to examine the rowers for their physical fitness and to draw arrows from the wounded soldiers in the sea battle.

Up until the Middle Ages , ship doctors were not particularly welcome on board merchant ships . Breaks , bruises and dislocations occurring in accidents at work were partly treated by the captain himself. With the great voyages of discovery, shipping medicine experienced an upswing, although ultimately it was not academic doctors but surgeons and barbers who went to sea as ship doctors. They were supported in their work by the ship's cook and semi-skilled assistants. The Royal Navy decreed in 1814 more than 14 physicians, 850 surgeons and 500 assistant surgeons who were responsible for 130,000 men.

The French officier de santé aboard warships was a rank with basic medical training as a result of the reform of the medical system during the early Napoleonic era. In a medical two-class system, the officiers de santé went through a shorter and less specialized training that was supposed to prepare them for the standard cases of everyday medical life in the country. In contrast, training to become a regular doctor covered the entire spectrum of contemporary medicine.

At the time of the Austrian Empress Maria Theresa, the Editto politico di navigazione regulated the taking and equipping of medicine boxes on ships. In 1851 an imperial regulation on the organization of the health system was enacted, which also regulated medical care on board, in naval hospitals and epidemic protection.

With the establishment of the first all-German navy in 1848, ship doctors were mainly recruited from the ranks of army and civilian doctors. Due to the peculiarities at sea, however, special doctors were later trained at the Friedrich Wilhelms Institute , which later became the Kaiser Wilhelms Academy. Basic maritime knowledge was imparted by a marine medical officer commanding the school. In 1900 the Institute for Ship and Tropical Diseases was opened, which also provided marine doctors with the necessary knowledge about diseases that occur there for their work in the tropics. For the first time they actually acquired knowledge that differentiated them from army doctors and prepared them for the tasks on board. At the end of the Weimar Republic , future marine doctors received nautical training together with officer candidates from other careers. In 1934 the Military Medical Academy was founded in Berlin, where all military doctors continued to be trained. This only changed in 1941 when the Marine Medical Academy was opened in Kiel . Here, during the course, a condensed maritime knowledge about life on board, the demands on a naval officer and nautical basics was imparted. At the end of the Second World War , the medical academies, like all other military schools, were dissolved.

In 2009, the Swiss Medical Journal published an article about the Swiss specialist in marine medicine Urs Schifferli, in which it reported on the establishment of the Swiss Society for Marine Medicine, which would have been constituted on April 1, 2007. However, this article appeared on April 1, 2009 and was an April Fools joke .

See also

literature

Web links

Wiktionary: Ship's doctor  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ Job description on hafenkarriere.de
  2. ^ A b Hannelore Gießen: Doctor and Profession: Doctors on the High Seas. ( Memento of the original from January 5, 2009 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.arztberuf.deutsche-fachaerzte.info
  3. ↑ Ship's doctor in the Navy - a man from Hamburg talks about his work on the frigate “Sachsen”. Message from the Marine Press and Information Center
  4. ↑ a b Wolfgang Sartorius: The marine medical service after the restructuring of the Bundeswehr. ( Memento from May 5, 2014 in the Internet Archive )
  5. ^ H. Jäger: Medical care on board ship. Cruise medical experiences. In: Fortschr Med. 27, 1979, pp. 1191-1194. PMID 457011
  6. ↑ The German Navy. (III) In: Zeitschrift Truppendienst - magazine for training, leadership and use in the Austrian Armed Forces
  7. ↑ tasks. ( Memento of the original from December 31, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 189 kB) In: Medical Tribune . 41, 2008, p. 12 @1@ 2Template: Webachiv / IABot / www.schiffsarztboerse.de
  8. ^ DE Peake, CL Gray, MR Ludwig, CD Hill: Descriptive epidemiology of injury and illness among cruise ship passengers. In: Ann Emerg Med . 33, 1999, pp. 67-72. PMID 9867889
  9. ^ MP McKay: Maritime health emergencies. In: Occup Med (Lond). 57, 2007, pp. 453-455. PMID 17652345
  10. ^ E. Dahl: Medical practice during a world cruise: a descriptive epidemiological study of injury and illness among passengers and crew. In: Int Marit Health. 56, 2005, pp. 115-128. PMID 16532590
  11. ^ E. Dahl: Anatomy of a world cruise. In: J Travel Med. 6, 1999, pp. 168-171. PMID 10467153
  12. ^ Dentistry on board and at home, Bundeswehr Medical Service, Wilhelmshaven, September 13, 2007. Accessed December 6, 2013 .
  13. ↑ E. Dahl: Crew referrals to dentists and medical specialist ashore: a descriptive study of practice on three passenger vessels during one year. In: Int Marit Health. 57, 2006, pp. 127-135. PMID 17312701
  14. ↑ Last Volker: Telemedicine in seafaring - From the beginnings of telemedicine to its use today. Eberhard Karls University of Tübingen, Medical Telematics Seminar, SS 2006.
  15. ↑ Jane N. Zuckerman: Principles and practice of travel medicine . John Wiley and Sons, 2001, ISBN 0-471-49079-2 ( limited preview in Google Book Search).
  16. ^ The Merchant Shipping (Ships' Doctors) Regulations. Great Britain 1995.
  17. ^ Regulation on Sanitary Safety of Passengers on Ships. ( Memento from April 20, 2011 in the Internet Archive ) Turkey 1943. (DOC; 125 kB)
  18. ^ Stefan Oppermann, Christoph Redelsteiner: The manual for emergency and paramedics . Deutscher Ärzteverlag, 2009, ISBN 978-3-7691-1273-3 ( limited preview in Google book search).
  19. ^ Dean King, John B. Hattendorf, J. Worth Estes: A Sea of ​​Words: Lexicon and Companion for Patrick O'Brian's Seafaring Tales Henry Holt, 2001, ISBN 0-8050-6615-2 , p. 31.
  20. ^ Marc Föcking: Pathologia litteralis: narrated science and scientific narration in the French 19th century . Gunther Narr, Tübingen 2002, ISBN 3-8233-5613-5 .
  21. ^ Renate Basch-Ritter: The circumnavigation of the Novara 1857-1859: Austria on all seas . ADEVA, Graz 2008, ISBN 978-3-201-01904-0 ( limited preview in the Google book search).
  22. ↑ Antje KU Engfer: The training of the Navy medical officer candidate in the German navies (1848-1945). Dissertation . Medical Faculty, Ruprecht-Karls-Universität Heidelberg , 2004, summary (PDF; 63 kB)
  23. ↑ As a doctor in a floating practice. ( Memento of December 21, 2011 in the Internet Archive ) (PDF; 110 kB) In: Schweizerische Ärztezeitung. 90, 2009, p. 594
  24. ↑ Notification of the association of Swiss doctors FMH (professional association of the Swiss medical profession and umbrella organization of cantonal and specialist medical associations)