해상응급의료 안전망 구축을 위한 선원 의료 교육 및 자격체계 개선에 관한 연구

초록

This study identifies the limitations of the current medical training system for seafarers, which fails to account for the distinct accident characteristics of merchant and fishing vessels, and proposes practical improvements aligned with international conventions such as STCW and STCW-F. The research methodology involves a comparative analysis of domestic and international regulations alongside a review of 55 maritime accident written judgments from 2024 to 2025 to identify vessel-specific risk factors. Furthermore, a survey of 220 seafarers was conducted to empirically verify differences in first-aid competencies and perceptions using statistical analysis. The findings reveal a stark contrast in accident mechanisms: merchant vessels primarily experienced system-driven accidents, such as asphyxiation in enclosed spaces (63.6%) whereas fishing vessels showed an overwhelming prevalence of severe trauma, including entrapment and amputation caused by machinery (72.7%). Despite completing identical statutory training, fishing vessel personnel exhibited significantly lower proficiency in equipment utilization and basic first-aid skills compared to merchant seafarers (p < 0.001). Additionally, both groups demonstrated insufficient proficiency in advanced medical care and remote medical collaboration. The analysis further indicates that current domestic curricula omit several core subjects required by international standards and lack differentiation due to overlapping content. Based on these findings, this study proposes three key improvements: the introduction of customized curricula that emphasize professional equipment operation for merchant vessels and intensive practical trauma care for fishing vessels; the supplementation of missing subjects to align with international standards including the elevation of Radio Medical Advice (RMA) to a mandatory subject; and a transition from theory-oriented education toward a field-oriented practical training and qualification system. These measures are expected to solidify the maritime healthcare safety net by aligning training with empirical accident data and international standards.

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