The Civil Aviation Medical Examiner and You

Are you seeing your Civil Aviation Medical Examiner (CAME) too often?

by D.A. Salisbury, MD, MHSc, FACPCM, FRCPC, Director, Medicine, Civil Aviation,
Transport Canada

One of the complaints I often hear from pilots is that they have to get a medical exam too often, which takes time and money. Recently, this has also included the observation that if they were in the United States, they could get a medical certificate with their driver’s licence.

So let’s look at the requirements in Canada, where they come from, and how you can minimize your interaction with my profession. It’s not that we don’t love seeing you, but less time spent in the doctor’s office is potentially more time spent in the cockpit!

There are four levels of medical certification in Canada, appropriately enough known as categories 1 through 4. 

Category 1 Certification
Category 1 is for pilots engaged in commercial air operations; everything from instructing on light aircraft to flying for an airline. Of necessity, the medical standards for this group are quite high as the travelling public is putting their lives in their hands. These pilots will also likely be flying internationally into other countries.

In order to facilitate international commerce and flying, the International Civil Aviation Organization (ICAO) has established training, experience and medical standards that allow pilots to exercise the privileges of their Canadian licence in the other 190 signatory countries of the ICAO Treaty, without having to repeat their licensing exams and medical certification. While each country is free to implement the ICAO Standards and Recommended Practices (SARPs) as it sees fit, significant deviations from the Standards have to be communicated to ICAO and the other nations, and could result in those nations refusing entry of the aircraft. Canada has implemented all of the existing medical standards.

These standards are not unchanging and in my professional lifetime, we in Canada have led the charge in making them less restrictive and more accommodating. Canada was the first ICAO nation to allow licensure (under special circumstances) of diabetics treated with insulin. We were also a leading nation in pushing for the licensure of pilots using SSRI anti-depressants for non-psychotic psychiatric conditions.

 

   Medical Categories

Transport Canada

Federal Aviation Administration

ICAO / EASA

Category 1

  • Airline Transport Pilot Licence (ATPL)
  • Commercial Pilot Licence (CPL)
  • Flight Engineer Licence (F/E)

Class 1

  • Airline Transport Rating (ATR)

Class 1

  • Airline Transport Pilot Licence (ATPL)
  • Commercial Pilot Licence (CPL)

Category 2

  • Air Traffic Control (ATC)

Class 2

  • Commercial Pilot Licence (CPL)
  • No equivalent for ATC

 

Class 3

  • Air Traffic Control (ATC)

Category 3

  • Private Pilot Licence (PPL)
  • Balloon Pilot Licence (BPL)
  • Gyroplane Permit (PG)

Class 3

  • Private Pilot Licence (PPL)

Class 2

  • Private Pilot Licence (PPL)

Category 4

  • Recreational Pilot Permit (RPP)
  • Ultralight Pilot Permit (U/L)
  • Glider Pilot Licence (GPL)

 

 

  • No equivalent

(Sport Pilot)

 

  • Leisure Pilot Permit

(EASA only)

 

Category 2 Certification
Category 2 is used for the medical certification of air traffic controllers in Canada. Just to be confusing, it is equivalent to ICAO Class 3 certification.

Category 3 Certification
Canadian Category 3 certification is for PPL, which is equivalent to ICAO/European Aviation Safety Agency (EASA) Class 2 certification. The PPL, as currently constructed, is an ICAO compliant document that allows Canadian private pilots to engage in non-commercial flight operations in any ICAO signatory nation. The standards are set by international agreement and again, Canada has not filed any significant differences, which gives Canadian private pilots the maximal international flexibility, including flying into the United Sates.

Category 4 Certification
Several years ago when ultralights and other recreational aircraft were starting to become quite popular, Canada decided to create a non-ICAO compliant medical certificate, Category 4. The only requirement needed to obtain this level of medical certification is a form of self-declaration similar to that of a driver’s licence. To that end, a screening medical questionnaire was created and the need to see a Civil Aviation Medical Examiner (CAME) eliminated. However, you need to have your family physician countersign the questionnaire if you want to carry a passenger on your aircraft. That’s right: no physical examination, unless of course you have or have had one of the conditions that we are concerned about, in which case you may need to see a CAME.

So what can you do with a Category 4 medical certificate? It is the medical document required to validate a Student Pilot Permit, a RPP, a U/L and a GPL. With an RPP you can fly day VFR, on a non-high-performance, four-seat or less single engine aircraft with a single passenger. In other words, virtually all of the aircraft most recreational pilots fly. So, if you are a light aircraft driver who doesn’t need or want to fly to the U.S. or IFR, you don’t need to visit your CAME. Unlike the Sport Pilot Permit in the U.S., it is possible to receive a Category 4 medical certificate if you have previously been denied a Category 1, 2 or 3 certificate, assuming of course the medical condition has been dealt with and does not pose a flight safety hazard. You don’t need to have a driver’s licence and any decision made by Transport Canada (TC) can be appealed. The certificate can also be issued with a restriction as well, unlike the U.S. where you get it or you don’t, such as “no passenger” if your medical condition warrants.

In TC’s experience, over 90 percent of Category 4 applicants get the certificate, no questions asked. The other 10 percent may need to supply Civil Aviation Medicine with more information and less than 1 percent are denied. The standards are very close to those of a Class 5 driver’s licence in Canada, although TC is more stringent on issues such as respiratory disease requiring oxygen and seizure disorders.

So if you don’t like visiting your friendly neighbourhood CAME, take a look at the Category 4 Medical Certificate and the RPP and see if it meets your flying needs. Over 7 000 of your fellow pilots can’t be wrong!

In an upcoming issue we’ll talk about what you can do if you don’t like the medical certification decision made by Civil Aviation Medicine.

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