The Medical Examination
It is your responsibility to interview and perform a complete examination on all applicants for aviation
medical certification. You may be the only physician in the normal course of events who has talked to the
pilot and had a “hands-on” opportunity to form an impression. Although the Medical Examination
Report form (MER) may look similar to others you have completed for insurance examinations, your input here is much more valuable and is of immediate
importance.
Since pilots and air traffic controllers are at risk of losing their medical certificate, and in some cases
their employment, each time they present themselves for a medical, they naturally find aviation medical
examinations threatening. For this reason, we recommend that you and your staff do all in your
power to put the applicant at ease prior to the examination. This examination is always stressful
and often becomes more stressful as aviation personnel grow older.
Aviation personnel, although not basically dishonest, may not volunteer information which may affect their
medical certification. They will, however, respond to direct questions and will sometimes give you much
more information than you expect if you convince them that your prime interest is keeping them at
work. Sometimes they have problems that may affect their medical certification that they would like to
discuss with someone of good will. Of particular importance in the interview is any suggestion of
substance abuse, mental instability, lack of insight or inappropriate reactions. You have an opportunity to
decide whether this is the type of person with whom you would fly or to whom you would entrust your family. Remember, that the next time you climb on board as a passenger this may be your Captain!
Normally when you deal with patients you are concerned with their immediate health. In aviation a
more important concept is that of sudden and/or subtle incapacitation. This may arise from such
diverse stresses as the pain of acute renal colic or the subtle loss of judgment that results from an occult
brain tumour. A pilot in trouble in the air cannot stop and pull over to the side of the road until the symptoms pass! A point to bear in mind is that in
annual medicals we are chiefly concerned with the short term, that is, the validity period of the medical
certificate.
The medical examination is recorded on the form, Medical Examination Report 26-0010 (MER), the
original of which should be sent to the Regional office. The MER is available in both English and
French and is periodically updated. The effective date is located in the lower left corner of the form as
(1999-03). Blank forms are available upon request from the Regional offices.
The MER is reviewed in the Regional office. If the MER is not complete or if there are errors or
omissions, it will be returned for correction. The original form should then be corrected and returned
to the Regional office.
The next few pages will help you to fill out the MER and indicate the type of answers required. There is
also an Appendix on the visual examination. This seems to be the most difficult part of the examination
and so befits greater explanation. Hopefully all else will be clear after your first seminar but, if in doubt,
your RAMO is no further away than your telephone (See contact numbers –Toll free).
A useful reference is the ICAO Manual of Aviation Medicine produced by the International Civil
Aviation Organization. Copies of this can be obtained by writing to the following address:
(The manual is currently being revised.)
Document Sales Unit
International Civil Aviation Organization
999 University Street
Montreal, Quebec
H3C 5H7
Canada
www.icao.int
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