CIVIL AVIATION MEDICINE
LEVELS OF SERVICE - 2005

1. PURPOSE

1.1 The purpose of this document is to highlight the Program Priorities established for the Civil Aviation Medicine (CAM) Branch for 2005-2006.

2. APPROACH

2.1 The establishment of program priorities helps to define the program goals and direction of the Branch for the upcoming year(s). This document is refined every year in accordance with the priorities established from within the Civil Aviation Directorate. The utilization of Flight 2005: A Civil Aviation Safety Framework for Canada plays a significant role in defining the Branch program priorities with a vision towards Flight 2010. It also follows the Civil Aviation Directive No. 35 presenting the requirements for Levels of Service Standards.

2.2 An effort was made, where appropriate, to dovetail with the priorities established by other Civil Aviation Branches.

2.3 The task categories included in the program priorities are ranked according to their importance. For example, assessment activities have a greater priority afforded them than advice activities. Furthermore, the individual tasks listed within each task category have been prioritized according to their level of importance.

3. RESOURCES

3.1 Resources should be allocated in keeping with the priority afforded each particular task.

3.2 In order to define a level of service policy and fulfill oversight commitments, regional offices will utilize 85% of their resources on the activities listed in (4.1) below.

3.3 In order to meet the requirements established in (3.2), a level of service standard has been produced to provide guidance to the Civil Aviation Medicine Branch, and is included in Appendix A.

3.4 Key Civil Aviation Medicine activities are listed below in order of priority.

4. PROGRAM PRIORITIES 2005-2006

4.1 Assessment Activities

1. Assess the medical fitness of pilots, air traffic controllers and initial applicants.
2. Provide a risk assessment of those applicants who do not meet the medical standards through the Regional Aviation Medical Officer (RAMO), clinical consultant advisors and/or Aviation Medical Review Board (AMRB).
3. Audit submitted Medical Examination Reports (MER) against the medical standards.
4. Appoint and train Civil Aviation Medical Examiners (CAMEs).

4.2 Expert Medical Advice Activities

1. Provide expert medical advice on behalf of the Minister on all aeromedical matters.
2. Provide professional aviation medicine advice and support to TC Case Presenting Officers at the Transportation Appeal Tribunal of Canada (TATC).
3. Provide expert medical advice on health issues of travelers by air.
4. Provide expert medical advice on medical and human factors in aviation accidents and incidents.
5. Provide advice on Airline First Aid Training Programs and Manuals.

4.3 Internal/Management Priorities

1. Ensure CAM has the appropriate management structure, staffing and financial levels, capabilities and skills to deliver the CAM program.
2. Revise and enhance the Civil Aviation Medical Information System (CAMIS).
3. Secure funding for the development of activities standards for the Branch through utilization of the Activity Reporting and Standards System (ARASS).
4. Continue the enhancement of the recruitment and retention plan for medical officers.
5. Develop general civil aviation and Transport Canada training programs for CAM staff in conjunction with the Learning Services Branch.

4.4 Maintain compliance with international medical standards and recommended practices

1. Participate in the International Civil Aviation Organization (ICAO) Study Groups on Medical Standards.
2. Recommend revisions to the International Standards and promote their adoption.
3. Influence the Civil Aviation Regulation Advisory Council (CARAC) process to ensure agreement and compliance with changes in medical standards and policies.

4.5 Maintain and improve current CAM medical education program

1. Publish a national aeromedical newsletter.
2. Develop aviation medical education communiqués for public and medical personnel.
3. Develop an educational video for new CAMEs.
4. Create a computer based training program for CAMEs.

5. EFFECTIVE DATE

5.1 This instruction comes into effect immediately.

6. RECOURSE

6.1 The courses of action available to clients if they feel standards have not been met or if they wish to compliment our service is via Civil Aviation Directive No. 28 entitled Complaint Handling Policy and Procedures. This will be followed until such time that the newly developed Civil Aviation Issues Reporting System (CAIRS) comes into effect.

The following document is designed to help our clients better understand the minimum and maximum number of calendar days (level of service) to expect following a complete request for each (class of) service offered by Transport Canada Civil Aviation Medicine. These standards have been implemented and published to improve the planning and quality of our services. Please note explanations that follow the table.

Information Notes:

1. The client will be advised as soon as possible after the initial request if unusual circumstances will prevent CAM from meeting the maximum level of service criteria.
2. The levels of service (number of calendar days anticipated for service delivery) specified do not take into consideration the waiting period for documents, forms, and requests that need to be supplied by the client before the Department is able to proceed with the service.
3. Weekends and statutory holidays may affect maximum levels of service less than 7 days.

The following may adversely affect service delivery criteria:

• CAMEs are independent "contractors" designated by CAM on behalf of the Minister. They are expected to forward medical files as soon as they are completed but there may be delays in this step.
• We are dependent upon the Records section to process, in a timely fashion, the medical documents that come into the Regional centers.
• Medical decisions involve individuals, often with complex medical problems. Balancing the medical issues against the risk analysis of the operational considerations can often be a time consuming process and can never be considered routine.
• Decisions on referred files to the AMRB may be delayed by up to eight weeks if a critical specialist is absent for a meeting, if additional medical information is required, or if clinical reports need updating.
• The condition of the Canadian health care system and debates regarding the necessity of certain tests can present delays.
• As with every other human, the pilot population has an increasing burden of illness as age progresses resulting in a significant increase in the percentage of "complicated" cases.