Mariner Credentialing

Merchant Mariner Medical Manual now available

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The Coast Guard announced in the Federal Register the availability of the Merchant Mariner Medical Manual, Commandant Instruction Manual (COMDTINST M16721.48). The guidance in this Manual should assist medical practitioners, the maritime industry, individual mariners, and Coast Guard personnel in evaluating a mariner applicant’s physical and medical status to meet the requirements of the merchant mariner medical certificate. This Manual incorporates and consolidates prior guidance on the medical evaluation of merchant mariners contained in several Coast Guard documents. The Manual includes guidance on the medical certificate and related processes, including procedures for application, issuance, and cancellation of the medical certificate.

The Merchant Mariner Medical Manual, COMDTINST M16721.4, is effective on Sept. 9, 2019.

The Coast Guard published a draft of the Merchant Mariner Medical Manual in the Federal Register and sought input from the public on the draft Nov. 13, 2018. The current version of the Manual includes revisions made to address comments received in response to the Federal Register notification. Although not required to do so for updates to policy documents, the Coast Guard sought public comment because of the perceived complexity of the Merchant Mariner Medical Manual, and because doing so provides the opportunity to (1) create a guidance document that is more viable and responsive to the needs of the impacted community; and (2) to identify and clarify remaining areas of confusion and concern among the regulated community.

The Coast Guard received 37 comment letters in response to the Federal Register notice. Comments covered a range of topics, including:

  • The manual’s ease and use of clarity
  • Requirements for medical certification
  • Guidance on the conduct of general medical examinations
  • Frequency of required medical examinations
  • Medical exam forms
  • Medical examiners
  • Internal National Maritime Center processes
  • Positive drug tests
  • Reporting material changes in medical conditions for mariners
  • Medications
  • NMC medical evaluation procedures for mariners with existing waivers
  • Alternative testing methodologies for color vision
  • Coast Guard mission and motives with respect to medical credentialing

To review all 37 comments, visit the public docket USCG-2018-0041 at

For information about this document or to suggest changes, call or email Adrienne Buggs, M.D., United States Coast Guard, Office of Merchant Mariner Credentialing, at 202-372-2357 or

This blog is not a replacement or substitute for the formal posting of regulations and updates or existing processes for receiving formal feedback of the same. Links provided on this blog will direct the reader to official source documents, such as the Federal Register, Homeport and the Code of Federal Regulations. These documents remain the official source for regulatory information published by the Coast Guard.

3 replies »

  1. I keep trying to load this and the link keeps saying “not available” or it acts like it is going to load but the webpage never refreshes.

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