Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs)
The Personnel Licensing and Training Standards Respecting Medical Requirements outline the basic specifications for the medical requirements for applicants for or holders of Personnel Permits, Licences and Ratings in compliance with Subpart 404 of the Canadian Aviation Regulations .
Division I - General
424.01 Definitions
The words and expressions used in these Standards have the same meaning as in the General Provisions, Part I of the Canadian Aviation Regulations with the following additions or expanded explanations:
"Civil Aviation Medical Examiner" (CAME) - means a physician appointed by the Minister to examine the medical fitness of candidates for issue or revalidation of Pilot and Canadian Civil Aviation Personnel Licences and who report their findings to the Civil Aviation Medicine Division. Generally such authorization applies to physicians in private practice who are appointed on an individual basis to provide the Civil Aviation Medical Examiner service in a particular area. However, limited authorization also applies to Flight Surgeons of the Canadian Forces for the examination of candidates who are members of the Canadian Forces, and to physicians in other countries provided the physician is authorized as a civil aviation medical examiner by a member State of the International Civil Aviation Organization.
"medical category" - means the medical category classification relating to the degree of medical fitness necessary for the various aviation activities. i.e. A Medical Category 1 holder shall be considered fit for any licence for its respective duration of validity unless otherwise specified. It embraces all types of licence involving flying for hire and reward and is essentially the standard for the professional pilot.
"medical certificate" (MC) - is a document issued periodically to validate aviation licences which require special standards of medical fitness as laid down in the Personnel Licensing Standards Respecting Medical Requirements. MCs are issued by the Minister of Transport following receipt of a medical examination report assessed medically fit or fit subject to any restriction or limitation.
"accredited medical conclusion" - is defined as the conclusion reached by one or more medical experts with specialized knowledge or training in aviation medicine, acceptable to the Licensing Authority for the purposes of the case concerned, in consultation with specialists in flight operations or other experts as necessary specialists in flight operations, or other experts as necessary.
"eye specialist" - means either an ophthalmologist or optometrist, unless otherwise specified.
"Civil Aviation Medicine Division Medical Staff" - means the Regional Aviation Medical Officer, the Aviation Medical Officer, or Headquarters Medical Staff, but does not include Civil Aviation Medical Examiners.
Division II - Medical certificate
424.04 Issuance and Validity Period of Medical Certificate
- (1) Issuance
- (a) Minimum medical fitness requirements for the various types of licence are broadly defined by international agreement through the International Civil Aviation Organization (ICAO). Canadian medical requirements honour this agreement, and procedures and standards outlined in this document reflect International Standards and Recommended Practices.
- (b) A Medical Certificate is a necessary prerequisite for every licence which is subject to the Personnel Licensing Standards. Medical Certificates are issued by the Minister of Transport through the office of the Regional Director, Aviation Licensing following receipt of:
- (i) a medical examination report, provided the candidate meets the pertinent medical standards and has been assessed medically fit or fit subject to any restriction or limitation recommended by Civil Aviation Medicine Division Medical Staff; or
- (ii) in the case of a Student Pilot Permit -- Ultra-light aeroplanes, a Pilot Permit -- Ultra-light aeroplanes, a Pilot Permit - Recreational -- Aeroplanes, a Student Pilot Permit -- Gliders or a Pilot Licence -- Gliders the candidate completes and submits Part B Civil Aviation Medical Declaration of the Application for a student pilot permit - ultra-light aeroplanes or a pilot permit - ultra-light aeroplanes (form 26-0297 in english or form 26-0301 in french) see Appendix III .
- (a) Every applicant for a medical certificate or revalidation thereof shall undergo a medical examination by a CAME .
- (b) Every applicant shall, at the time of the medical examination:
- (i) sign a declaration provided by the CAME stating whether the applicant has previously undergone a medical examination in connection with an application for a medical certificate or revalidation thereof and, where applicable, provide a statement that sets out the results of the most recent such examination;
- (ii) answer all of the CAME ’s questions that are pertinent to the assessment of the applicant’s medical fitness;
- (iii) give written authorization for the disclosure of medical information to a physician named by the applicant; and
- (iv) undergo any other examinations or tests that are required by the CAME in order to assess the applicant’s medical fitness.
424.05 Medical Standards Flexibility - Limitations and Restrictions
- (1) Under special circumstances such as monocular or paraplegic applicants, flexibility may be applied and the permit or licence issued or validated where the following conditions are met:
- (a) Accredited medical conclusion indicates that the applicant’s failure to meet any requirement, whether numerical or otherwise, is such that exercise of the privileges of the permit or licence applied for is not likely to affect air safety. The Licensing Authority shall be satisfied that any relevant ability, skill or experience of the applicant has been given due consideration.
- (b) The permit or licence is endorsed with any special limitation or limitations when the safe performance of the permit or licence holder’s duties is dependent on compliance with such limitations or restrictions.
- (c) The applicant complies with any required conditions.
- (a) A practical test is in addition to all other standard medical requirements together with the licensing standards of skill, knowledge and experience for the permit or licence applied for.
- (b) A practical test will only be conducted when requested by the Regional Aviation Medical Officer (RAMO) or Aviation Medical Officer and approved by the Regional Director Aviation Licensing (RDAL).
- (c) A practical test shall only be requested when it is necessary to obtain an accurate evaluation of the applicant’s capabilities.
- (d) Except as provided in (i) and (ii), the initial test will be conducted by a Civil Aviation Inspector of the Aviation Licensing Division. Subsequent tests for the same applicant with the same deficiency may, at the discretion of the RDAL be delegated to a suitably qualified flight instructor.
- (i) The initial test for private pilot applicants may, at the discretion of the RDAL be delegated to a suitably qualified flight instructor, except when a prosthesis is required to be worn by the applicant or the aircraft is required to be modified.
- (ii) In the case of an air traffic controller, the practical test shall be conducted in accordance with the Report of Medical Practical Hearing Test (form 26-0503).
(amended 1999/03/01 )
- (a) Amputee and Physically-Handicapped Applicants
- (i) Applicants who have had an amputation of a limb or part of a limb, or have some other physical disability, may be considered fit for certain types of permits or licences through the application of flexibility.
- (ii) The practical test will be conducted with the applicant occupying the seat designated in the Aircraft Flight Manual as the seat to be occupied by the pilot-in-command. Where the Aircraft Flight Manual does not specify the seat, it shall be understood to be the seat which, in accepted practice, is occupied by the pilot-in-command.
- (iii) An applicant shall demonstrate the ability to compensate for physical deficiency and to perform competently a task or simultaneous tasks such as map reading, determining course, operating flight computer, conversation, simulating engine failure to estimate the applicant’s susceptibility to distraction.
- (iv) The practical test report shall include specific reference to:
- (A) description of deficiency to be assessed;
- (B) exercises required to be completed:
- (A) the applicant has accumulated sufficient flying experience; or
- (B) the addition of different types of aircraft of different undercarriage, flight control or cockpit configurations is desired.
- (i) A monocular applicant is an applicant who has lost the use of one eye or whose central vision is such that it cannot be corrected to at least 20/200 (6/60). A monocular applicant shall be granted the issue or revalidation of those permits or licences, for which a Category 3 or lower medical is required, provided that the following conditions are met:
- (A) on the initial request for flexibility, the applicant has undertaken an eye examination by an ophthalmologist whose report indicates that with respect to the better eye:
- (I) the vision is not less that 20/200 (6/60)corrected to 20/30 (6/9) or better and the equivalent spherical error is not greater than plus or minus 5 diopters;
- (II) the function of the eye and its adnexae shall be normal in all other respects;
- (A) issue of a permit or licence to a monocular person;
- (B) the first renewal after loss of binocular vision if the permit or licence was previously issued; and
- (C) subsequent renewals where the eye specialist’s report indicates significant deterioration of visual capability since the previous report.
- (A) required in addition to the medical examination for the issue of a Student Pilot Permit to monocular applicants; and
- (B) considered, in conjunction with the medical examination reports, when assessing the visual acuity of the applicant for the Permit;
- (A) in a competent manner; and
- (B) while maintaining an adequate look-out for other traffic and obstructions.
- (A) the applicant has completed the night and instrument flight time normally required for a night rating for a private pilot licence; and
- (B) a flight instructor designated by the RDAL has certified that the applicant has been flight tested and been found to be capable of performing at night the normal and emergency manoeuvres appropriate to the type of aircraft in a competent manner while maintaining an adequate look-out for other traffic and obstructions.
- (i) An applicant whose corrected central vision in one eye is less that 20/30 (6/9) but is at least 20/200 (6/60) shall be granted the issue or revalidation of a permit or licence in accordance with the Medical Requirements Standards provided that the following conditions are met:
- (A) on the initial request for flexibility, the applicant has undertaken an eye examination by an eye specialist whose report indicates that the visual acuity in the better eye meets the vision standards for the permit or licence applied for or held;
- (B) accredited medical conclusion indicates that the visual defect is unlikely to interfere with safe performance of duties related to the permit or licence considering pathogenesis of the condition, visual fields, etc.;
- (C) the licensing authority is satisfied that any relevant ability, skill or experience of the applicant has been given due consideration. In certain cases a practical test shall be advised;
- (D) an eye specialist’s report shall be required annually if the condition causing the reduced vision is not stable.