Medical Flight Test

Claude Preitner – Senior Medical Officer

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Civil Aviation Rules , Part 67

General An applicant must –(1) have no medical condition that is of

aeromedical significance; and(2)Without limiting paragraph(b)(1),have no

history or diagnosis of any of the following specific medical conditions, to an extent that is of aeromedical significance:

FLEXIBILITY (27B2)The Director may , relying on flexibility , issue a

medical certificate to the applicant Flexibility means the use of medical judgment to

issue a issue a medical certificate if the following conditions are fulfilled :

(a) An Accredited Medical Conclusion indicates that in special circumstances the applicants failure to meet any medical standard prescribed in the rules is such that the exercise of the privileges to which the medical certificate relates is not likely to jeopardise aviation safety; and

Flexibility(b) the relevant ability, skill and experiences of the applicant and operation conditions have been given due consideration; and (c)the medical certificate is endorsed with any conditions, restrictions or endorsements when the safe performance of the applicants duties is dependent on compliance with those conditions, restrictions or endorsements

What is of aeromedical significance?

Elevated risk of incapacitation

Cognitive impairment

Functional impairment:VisionHearingLimbs function (muscular, neurological,

amputations) Mobility (joints, paralysis, obesity)

How to determine if condition safe ?

Medical Flight testing can assist the decision making process as to whether a medical condition is or not likely to jeopardize flight safety.

Purpose of practical flight testing with regard to medical certification

To ascertain impaired individuals ability to perform the required tasks of a pilot safely without significantly greater risk than an able bodied person

Answer the question: Is the condition likely to jeopardize flight safety – Answer may be aircraft type or operation specific

Flight examiner roleApplicant requested by CAA to provide

Medical Flight test

Applicant may be requested to ask the flight examiner to contact CAA for a briefing

Conduct Medical Flight test following briefing or according to protocol

Report to CAA or other medical experts conducting the AMC

What is of aeromedical significance?

Elevated risk of incapacitation: No role for Medical Flight Test

Cognitive impairment (i.e. aging, head injury)

Behavioural / mental problems (i.e. Attention deficit, Asperger)

Functional impairmentVisionHearingLimbs function (muscular, neurological,

amputations) Mobility

Cognitive impairment

Simulator flight test: Usually a reliable tool

BFR, Instrument renewal etc. are demanding enough if well conducted

However routine tasks last affected so needs to include decision making and unusual situations.

Behaviour issues

Very mild case onlyUsually Class 2 certificate onlyNo Medical Flight Test, butRegular instructor report

Update CAA on any problem Instructor aware of problem

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Vision impairment issues to consider

Reduced vision in one eyeTrue monocularVisual fields impairmentDouble vision with certain eye

movements Near vision issues

Colour vision deficiency is not suitable for in flight testing

Hearing impairment Applicants need to demonstrate a hearing performance sufficient for the safe exercise of their licence and rating privileges.

Screening audiogramSpeech discrimination testFlight test

Important hearing issues for pilots Being able to fully understand and

comprehend all radio communicationsAbility to hear all alarms in cockpitBeing able to communicate effectively with

other crew membersBeing able to communicate effectively with

passengersAbility to hear sounds of safety significance

eg.

In flight hearing test according to protocol if concern with hearing or use of hearing aids

Musculoskeletal Impairment Degenerative

conditions – hands , feet , knees, spine – with pain and limitation of movement of the affected joints

i.e. difficulty turning their head sufficiently to gain all round good vision as a consequence of neck arthritis

Musculoskeletal ImpairmentPartial or complete

amputation of a limb

Muscle weakness – usually due to nerve damage

Paralysis due to spinal fracture (i.e. after helico accident)

Spinal cord injuriesLoss of sensationsLoss of powerLoss of bladder control (self

catheterisation)Loss of bowel control (manual

evacuation)Urinary infectionsMuscles spamsLoss or autonomic control (low tolerance

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Spinal cord injuries

Cessna 152Cessna 172

Hand control for rudder and brakes

ExamplesPilot reported to become confusedPenetrating eye injuryDeaf pilot with hearing aidsWeakness of left arm for pushing

movementsShoulder limitationAmputee lower legPartial paralysis of lower leg (inability to

flex down the foot)Stiff ankle following fracture

ConclusionFunctional in-flight testing is a

useful assessment toolIt is not a test to flight standards,

rather a test of physical ability to do the task

When asked to conduct such test, please liaise with CAA medics to learn about the functional concern and what answers are sought

Report accordingly

Statement on line by www.freedomintheair.org

“Pilots with a range of disabilities are able to fly all kinds of airplanes; for example:

Cessna: 150, 172, 182, 210, 337, Cardinal, Cutlass.

Piper: Cherokee 140, 180, 235, Warrior, Arrow, Six, Saratoga, Lance Beechcraft: Bonanza, Debonair, A-36, Baron, Duke.

All of these planes have been successfully equipped with a hand control for pilots with reduced lower limb mobility.”

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More information about Pilots with Disabilities

The British Disabled Flying Association - www.bdfa.net

Accessible Aviation - www.accessibleaviation.com

Thirty-Thousand Feet - www.thirtythousandfeet.com/pilots.htm

Today - www.airventure.org/news/2008/3tue29/ableflight.html

Citation: Disabled World News (2009-04-10) - Many times pilots with disabilities train alongside non-disabled pilots at local flying clubs: http://www.disabled-world.com/entertainment/hobby/pilots-disabilities.php#ixzz23eTWayDn

“Suzi Duncan, creator of the Vision air hand control for pilots with lower limb disabilities, a Commercial Pilot & Flight Instructor who herself has a disability. She is a pioneer in the world of disabled aviation and our inspiration”

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