Civil Aviation Medical Standards
The history of medical standards in civil aviation dates back to just after World War I when the
International Commission on Air Navigation (ICAN) was established following the Paris Air
Convention of 1919. This organization was set up to establish rules and regulations for the safe conduct of civil
aviation. ICAN established a medical subcommission which set about producing the first ever
medical standards for civil aircrew which were extremely strict. In 1944, towards the end of World
War II, the International Civil Aviation Organization (ICAO), an agency of the United Nations, was
formed to carry on the work of ICAN, which had ceased to exist during World War II. Over the years,
the international standards and those of Canada have become more liberal to the point now that the
majority of the population over the age of 16, if they so wished, would pass aviation medical certification
examinations.
In Canada, the regulations pertaining to medical requirements are contained in Part 404 of the
Canadian Aviation Regulations (CARs) while the actual medical standards are in Part 424 of the
Canadian Aviation Regulations. Both Part 404 and Part 424 form part of this Handbook. CAR 424.05
permits the Civil Aviation Medicine Branch to exercise flexibility in medical certification of pilots
and air traffic controllers who technically do not meet the standard, but for whom
accredited medical conclusion is such that the failure to meet the standard is such that the exercise of the privilege of
the licence is not likely to affect air safety.
Over the years, guidelines have been produced in the major areas which cause problems with aeromedical
certification, namely neurology, cardiology and diabetes. A copy of these guidelines is available in
this Handbook.
In your role as a Civil Aviation Medical Examiner (CAME), you are usually the only person who
physically examines the pilot or ATC and makes a recommendation for medical certification. You are
therefore the most important link in the chain of safety in the medical certification process. While
performing your CAME function, you are acting as an agent of the Minister of Transport, so Transport
Canada will indemnify you for any litigation that may come from your aviation medical examination
activity which is conducted in good faith. Recent changes in the medical certification process, and
delegation of validation authority to the examiner have not resulted in increasing the exposure to
litigation, and will therefore not result in increases to malpractice insurance premiums for CAMEs.
Accompanying this book is a video outlining the changes that have taken place in the medical
certification process, and showing you how to complete the Medical Examination Report form
(26-0010) completely. The medical handbook part of this document is not a text on aviation medicine, it is
merely an introduction to the subject and covers the basic facts that you must have to understand the
medical problems associated with flight. It will help you deal with many of the questions you may be
asked and hopefully will encourage you to further
study the subject. More detailed information on the subject of aviation medicine can be obtained from the
following books:
Aviation Medicine – J. Ernsting, A. Nicholson and D. Rainford, Third Edition (1999), Butterworth –
Heinemann.
Fundamentals of Aerospace Medicine – R. DeHart and J. Davis, Third Edition (2002), Williams and
Wilkins.
Clinical Aviation Medicine – R. Raymond, Third Edition (2000), Castle Connolly Graduate Medical
Publishing, LLC.
Civil Aviation Medicine Branch has developed an Internet website which will be used more and more
for the dissemination of information between the Branch and CAMEs. Those of you who have Internet
access are welcome to browse the website and submit your comments. The address is:
http://www.tc.gc.ca/CivilAviation/Cam/menu.htm
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