Traveling the Northern Sea Route is somewhat akin to space travel — beyond the Kara Gates, access to civilization shifts from challenging to impossible. This part of the journey is sometimes referred to as "white silence", as aside from ice and snow, one can only encounter the occasional lights of sparse ports. Ensuring safe passage along the Northern Sea Route is a key prerequisite for transforming it into an international transportation corridor. The projected increase in annual cargo volume to 400 million tons by 2035 necessitates the development of infrastructure around the Russian part of the Arctic Ocean, including medical services for marines.

Currently, one doctor and one paramedic are stationed on nuclear icebreakers. In a dedicated medical sector, they examine patients, provide treatment, and if needed, call for assistance from the mainland. The medical offices are well-equipped with diagnostic equipment, including ultrasound and X-ray machines, a laboratory, functional diagnostic equipment, and a surgical suite for laparoscopic and endoscopic procedures. A ship's doctor should be a versatile professional with a broad range of medical skills and abilities. An additional requirement is the ability to handle marine-specific conditions. Being in northern waters is inherently challenging for the body, and when combined with strenuous work and inevitable occupational injuries, treating marines requires specialized training. However, according to medical staff, most patients come with minor issues like colds and injuries such as cuts and bruises. Every case is documented — in 2023, ship doctors treated over 1,000 patients aboard ships traversing the Northern Sea Route.

In addition to onboard services, medical care on the Northern Sea Route involves constructing hospitals in ports along the entire route and establishing efficient methods for ship evacuation. In 2023, the Federal Medical and Biological Agency announced plans to build new hospitals in Pevek, Dikson, Tiksi, and Sabetta. These will serve as multidisciplinary facilities that not only admit patients but also provide remote consultations and dispatch mobile teams to assist victims. Whether by helicopter, icebreaker, or even dog sled, the doctor must reach the patient regardless of the circumstances. However, the state prefers to rely on effective, standardized procedures rather than appealing to the heroism of its employees. The new Arctic Medicine Center in Murmansk will soon take on this task. Established under the Federal Medical and Biological Agency, the center will primarily focus on organizational and methodological activities. This includes developing Arctic medical care standards, mapping optimal routes from doctors to patients, and refining existing practices. The center's jurisdiction extends across the entire icebreaker route.

In addition to establishing a medical care system for marines in the Arctic, the Russian Federal Medical and Biological Agency is also conducting fundamental research aimed at creating a unified "marine healthcare" service in the future. To this end, the Head Center for Marine Health Protection was established at the Sokolov North-West District Scientific and Clinical Center. The icebreakers are staffed by personnel from the Pirogov National Medical and Surgical Center, one of the oldest and largest in Russia and neighboring countries.