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
- Assess the medical fitness of pilots, air traffic controllers and initial
applicants.
- 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).
- Audit submitted Medical Examination Reports (MER) against the medical
standards.
- Appoint and train Civil Aviation Medical Examiners (CAMEs).
4.2 Expert Medical Advice Activities
- Provide expert medical advice on behalf of the Minister on all aeromedical
matters.
- Provide professional aviation medicine advice and support to TC Case
Presenting Officers at the Transportation Appeal Tribunal of Canada (TATC).
- Provide expert medical advice on health issues of travelers by air.
- Provide expert medical advice on medical and human factors in aviation
accidents and incidents.
- Provide advice on Airline First Aid Training Programs and Manuals.
4.3 Internal/Management Priorities
- Ensure CAM has the appropriate management structure, staffing and
financial levels, capabilities and skills to deliver the CAM program.
- Revise and enhance the Civil Aviation Medical Information System (CAMIS).
- Secure funding for the development of activities standards for the Branch
through utilization of the Activity Reporting and Standards System (ARASS).
- Continue the enhancement of the recruitment and retention plan for medical
officers.
- 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
- Participate in the International Civil Aviation Organization (ICAO) Study
Groups on Medical Standards.
- Recommend revisions to the International Standards and promote their
adoption.
- 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
- Publish a national aeromedical newsletter.
- Develop aviation medical education communiqués for public and medical
personnel.
- Develop an educational video for new CAMEs.
- 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.
LEVEL OF SERVICE STANDARD
SERVICE PROVIDED |
MINIMUM LEVEL OF SERVICE (In days) |
MAXIMUM LEVEL OF SERVICE (In days) |
COMMENTS |
Review of MER deferred by CAME. |
2 |
21 |
|
Approval of initial applicant |
7 |
14 |
After complete file arrived from Records, assessed and
entered into CAMIS. |
Request for further clinical information from initial
applicant |
2 |
28 |
Maximum time allows for absence of RAMO for 1-2 weeks. |
Review and assessment of complex medical files |
35 |
70 |
Internal RAMO review, request for additional info,
assessment by AMRB. |
Telephone inquiries from licensees, permit holders, and the
public |
1/2 |
2 |
Same day or 48 hours maximum unless a weekend intervenes. |
Extension of medical validity |
1/2 |
28 |
Request comes through Licensing. Maximum time allows for
absence of RAMO for 1-2 weeks. |
Notification to Licensing of cases assessed as unfit |
1 |
7 |
|
Request for further information when notified under Article
6.5 of the Aeronautics Act. |
1 |
7 |
|
Medical suspension letter |
2 |
7 |
Preparation for inclusion with Licensing letter. |
Letters of request for additional medical information. |
3 |
7 |
Prepared after assessment by RAMO/AMO. |
Provision of medical advice to government offices, external
clients and the public. |
1 |
15 |
Includes general inquiries received by e-mail from around
the world. |
Review of information on license holders involved in
accidents or incidents. |
1 |
5 |
When notified of name/Lic., DOB, etc. if file available (not
already with the TSB). |
AMRB report sent from HQ after a receipt of a referral. |
3 |
35 |
Normally reports are sent out within 48hrs. of AMRB meeting. |
Information Notes:
- 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.
- 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.
- 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.
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