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FAQ: Aviation Medicine


What are the medical requirements for different classes of medicals?

There are 4 classes of medical examinations. The medical examination requirements differ for the different classes of medical certificates.

 
Requirement
Class 1
Class 2
Class 3
Class 4 
Includes
ALTP
Commercial pilot
Flight engineer
Flight test rating
Private pilot
Student pilot
Cabin crew 
Air traffic controller
Microlight
Glider
Gyroplane
Free balloon
Validity
ALTP < 40: 12 months
ALTP > 40: 6 months
Comm >60: 6 months
Comm <60 : 12 months but must submit 6-monthly report if suffering from a medical condition or a treatable risk factor
< 40: 24 months
> 40: 12 months
< 40: 60 months
> 40: 36 months
Stress ECG and lung function test
Initial exam
< 40: every 4 years
40-59: every 2 years
> 60: annually
Only resting at initial exam, then
first exam after 40
Then every 3 years
Chest X-ray
Initial examination, thereafter if indicated on clinical grounds
 
The frequency of examinations may also vary depending on medical conditions affecting the applicant. The aviation medical examiner can answer many of the queries regarding medicals. Further queries can be referred to the medical department of the CAA.

Can my general practitioner examine me for an aviation medical certificate?

Applicants for Class 1, Class 2 and Class 3 licences have to be examined by a designated aviation medical examiner, which has been approved by the Commissioner for Civil Aviation. A Class 4 applicant may be examined by his general practitioner, provided that:

  • The examination is conducted in accordance with the requirements of Civil Aviation Regulations Part 67 and the corresponding technical standards (SA-CATS-MR)
  • The results are documented on the prescribed form and sent in to the Institute for Aviation Medicine for verification.

What happens to the medical examination results?

The medical examiner forwards all the medical information to the Institute of Aviation Medicine, for reviewing by medical officers. Once reviewed, the medical is endorsed as acceptable, or not endorsed if unacceptable for any reason. . All difficult cases are referred to a panel (consisting of aviation medical officers and specialists) for discussion. The decisions taken by the panel are relayed to the medical department of the CAA, and medical certificates (DD50) are issued for all cases discussed at panel. These are sent to  the medical department at the CAA, and certificates are sent out to the relevant aviators and medical examiners.

 

Confidentiality is maintained at all levels of these proceedings. Aviators wishing to appeal against decisions taken by the panel may apply to the Commissioner for Civil Aviation, and must also send the appeal notice to the Institute for Aviation Medicine. The Commissioner designates a panel of specialists to advise him on the adjudication of the appeal. This process may take up to 4 months to complete

Can I go to a foreign aviation examiner for my medical when I am in a foreign country?

Yes, you can contact an aviation medical examiner that has been approved by the Commissioner for Civil Aviation to perform medical examinations for South African pilots. A list of these approved aviation medical examiners can be found on the CAA web site. The examination has to be conducted in accordance with the requirements of Civil Aviation Regulations Part 67 (PDF) and the corresponding technical standards (SA-CATS-MR). The results have to be documented on the prescribed form and must be sent to the Institute for Aviation medicine for verification.

 

Alternatively, you can contact an examiner registered with other foreign civil aviation authorities to perform the relevant Authority's examination. All the results (that is all the examination forms and test results, and not only the medical certificate) have to be submitted to the CAA or the Institute for Aviation Medicine, as we need to have the medical details on our records. All the forms submitted have to be in English. The CAA or Institute for Aviation Medicine may request further additional examinations. The foreign medical examiner must hold a qualification recognised by the aviation authorities internationally and submit proof thereof to the Commissioner for Civil Aviation.

 

A medical certificate will be issued by the Institute for Aviation Medicine or the CAA and may be different from the certificate initially issued by the medical examiner.

Can I fly with a cold?

You should never fly with a cold. The pressure differences at altitude affect cavities found in the skull. When ill, these cavities which are lined by membranes get inflamed and may affect the normal equilibration important at altitude. Thus you may experience severe pain in the ears or sinuses. An eardrum might even rupture! In addition, having a cold and not feeling well may have an influence on your reaction time or decision making processes.

Is over the counter medications allowed?

An aviator should ground him/herself when not feeling well. The side effects of the medication can have an effect on flight safety and these effects can be worsened by altitude. One should avoid mixing various medication due to interactions that may occur that can prove fatal. One can also have allergic reactions to medication. Always consult your aviation medical examiner when you plan to take any medication before a flight.

How much alcohol can I drink before a flight?

None. The present rule is 8 hours between bottle and throttle. However, it is advisable to extend this period to 12 hours (preferably 24 hours). The maximum blood concentration allowed is 0,02 mg%. It is very important to remember that the effects of alcohol can last up to 72 hours. Therefore the blood alcohol concentration may be zero; but you can still suffer from the effects of alcohol which may have an impact on flight safety. The regulations state that you may not fly while under the influence of alcohol.

What are the visual requirements for different classes of medicals?

The visual examination has minimum requirements for different parameters examined depending on the class of medical applied for. You are allowed to fly with either spectacles or contact lenses. Surgical correction of refractive abnormalities is allowed but a three to six month waiting period is required before the applicant can be re-certified. The choice of the method of correction of visual abnormalities lies with the aviator and his ophthalmologist.

Can I fly if I have Diabetes?

Yes, if it is controlled well through a proper diet and oral medication. You will be required to submit additional medical reports to confirm control of blood sugar level. Presently diabetes treated with insulin is unacceptable and renders the applicant unfit.

Part 67 - Is the applicant’s signature a legal requirement before the medical certificate is issued?

Yes, as per Part 67.00.7 below:

(1)  An application for the issuing of a medical certificate shall be made on the appropriate prescribed form.

(2)  An applicant who attends a medical examination or test for the issuing of a medical certificate shall—

a) produce proof of his or her identity;

b) produce for inspection any licence held for which the certificate is required and the most

recent medical certificate held, if any;

c) provide the DAME with a statement of medical facts detailing personal, familial and

hereditary history; and

d) sign a declaration confirming the accuracy, completeness and truthfulness of the information contained in the medical examination form.

Part 67 - Is the DAMEs Signature a legal requirement?

Yes, as per Part 67.00.7 below:

(1)  An application for the issuing of a medical certificate shall be made on the appropriate prescribed form.

(2)  An applicant who attends a medical examination or test for the issuing of a medical certificate shall—

a) produce proof of his or her identity;

b) produce for inspection any licence held for which the certificate is required and the most

recent medical certificate held, if any;

c) provide the DAME with a statement of medical facts detailing personal, familial and     hereditary  history; and

d) sign a declaration confirming the accuracy, completeness and truthfulness of the Information contained in the medical examination form.

(3)  Subject to the provisions of regulations 67.00.3 (2) (c) and 67.00.4 (3) (b) (iii), an applicant who complies with the appropriate medical requirements and standards referred to in regulation 67.00.2 (6), shall be entitled to a medical certificate.

(4) Upon completion of the medical examination, a DAME shall complete and sign the appropriate part of the medical examination form

Part 67- Are all the documents in line with the Technical Standards/Medical Protocols (Part 67) required to be submitted before issuing a medical certificate?​

Yes, DAMEs are required to ensure that they upload the necessary information in line with the Technical Standards; Part 67 (Medical Protocols) requirements prior to submitting to the Medical Assessor at the SACAA.

Part 67- Are DAMES allowed to issue medical certificates that are not in line with Medical Protocols/Technical Standards in line with Part 67?

No, DAMEs who issue medical certificates to applicants who do not meet the prescribed Technical Standards/Medical Protocols are in contravention on the law, and possible enforcement /termination may take place against the DAME.

- Issuance of Medical Certificate by the DAME to a non-compliant applicant may result in an aircraft accident and criminal charges may be laid against the DAME if they are found to have been negligent.

- The Health Professions Council of South Africa will also be informed of such misconduct. (Sipho)

Part 67 - Can a DAME allow another Medical Practitioner/Specialists or other DAME use their password or any other CAA documentation without proper authorization by the CAA?

No, such action is deemed to be fraudulent and the DAME will be referred to the CAA Legal Division and HPCSA for investigation and possible enforcement.

Part 67 - Can the DAME conduct medical examination and issue a medical certification when their designation is not current?

No, DAMEs have to ensure that their designation is current yearly as per Part 67 Technical Standards. DAMEs practicing without official designation are non-compliant to Part 67 and will be referred to the Legal Division for Enforcement Action

Part 67 - Can a Regular DAME issue a Class: I and Class III Medical Certificate?

No, Class I & III Medical Certificate can only be issued by Senior DAMEs, Regular DAMEs found to issue Class I and Class III without official designation as Senior DAMEs are non-compliant to Part 67 and will be referred to the Legal Division for Enforcement Action

Part 67 - Can DAMEs issue medical certificates if they do not meet the requirements for the Refresher 4 Yearly as prescribed by Part 67

No, DAMEs who fail to comply with the requirement above and continue to issue aviation medical certificates in contravention of Part 67 will be referred to the vision Legal Division for Enforcement Action.

Part 67 - Are the Medical Assessors and Professional Nurses required to write once they complete verification?

Yes, the SACAA Medical Assessors/ Nurses are required to write their name when they     verifying and communicating with DAME, this will make it easy for communication between the DAMEs and the Medical Assessors/Professional Nurses

Part 67 - Can a DAME or any member of the public make a submission to the Civil Aviation Regulations Committee (CARCOM), if they wish, based on evidence based medicine and research?

Yes, any member of the community or DAME can submit a proposal to the Civil Aviation Regulations Committee(CARCOM),through the Legal Division of the DCA, which function as a Secretariat

Part 67 - Is the EMPIC System able to calculate period of validity to month end?

No, the software does not calculate validity to month end validity dates, the DAME has to  manually adjust the system  the to the last day of month before printing the certificates.

Part 67 - Is the DAME required to capture Near and Intermediate Vision?

Yes, the DAME is required to capture Near and Intermediate Vision values should be entered under comments as per Part 67 Technical Standards Requirements

Part 67 - The EMPIC System does not have a field to capture the Near and Intermediate Vision. Do we have to submit them?

These are required under Part 67, and the values have to be entered under comments.

Part 67 - The Cabin Crew medicals are linked to Class: IV in Licencing (FCL), should the DAME issue a Class 4 Medical Certificate?

  1. The Cabin Crew medicals are linked to Class: IV in Licencing (FCL) and the tab has been deactivated on the EMPIC-Med until further notice.
  2. The SACAA has submitted a proposal to CARCOM to move cabin crew from Class: II to Class: IV, DAMEs should issue Class: II to cabin crew until the Minister promulgate this regulation.

Therefore the DAME's will be required to issue a Class 2 Medical (from the SACAA-FCL tab for those cabin crews) thereafter they will specify on the "comments" or "explanation for FCL" section that the medical is for Cabin Crews

Part 67 - How should DAMEs manage applicants who inform them that they were medically cleared by the CAA Aeromedical Committee without evidence?​

-The applicant must present the DAME with the CAA letter and certificate as evidence.

-The CAA is currently updating the Aeromedical Committee outcome on the EMPIC System.

- Where DAMEs are not sure, they are welcome to contact the CAA Medical Assessors or Professional Nurses to verify the information.

Part 67 - How should a DAME calculate period of validity for an applicants who are 39 about to turn 40 years?

The DAME can issue a medical certificate for the duration of the outstanding period before 40 years: or

The DAME may issue a medical certificate of period of validity of 40 years and above.

Part 67 - When I load a new patient, it always says that a lung function test must be done as well, I then click no, and on the pop-up the previous and next dates for lung functions

1. The system always asks for the form to be printed, and if I do not print the form, I cannot go to the next application.

2. I struggle when I do a new application, I just want to make sure I do everything correct. 

- Firstly I go in at Manage Applicant, then look for the applicant, if not found create a new one.

- This is done by Applicant Form. Everything is typed in of the patient. Print and then the doctor and patient sign and doctor, scan and upload. Go to Work-list and select patient.

- At the Examination Form, everything is filled in, printed, signed, scanned and uploaded

- Go to the Examination Viewer, print certificate, if everything is correct, tick block and release to CAA.

Part 67 - Can a DAME issue a medical certificate retrospectively following promulgation of the Part 67.00.6? If the medical is now due for a new medical, but in the interim the period of validity changed to 2 years, can a DAME just issue a new certificate without seeing him or must he have his “normal” medical again?

DAMEs are advised that our regulations do not apply retrospectively unless it is specifically stated.  In this case of your ATC client, Regulation 67.00.6 provides that your client must be issued with a 24 months medical certificate but must be medically assessed first.

Part 67 - Part 67.00.6 Period of Validity: The legislation relating to period of validity came into effect around May 2017. Can DAME issue Part 67.00.6  Regulation retrospectively,

No: The SACAA regulations do not apply retrospectively, regulations come into effect on the date the regulation has been approved by the Minister of Transport and the Technical Standards (Medical Protocol) on the date that it has been signed by the Director of Civil Aviation. Please refer to www.caa.co.za,CAA Regulations: 2011 and Technical Standards under Personnel Licensing, Click Part 67

Medical Standards/Assessments - Are the measurements for visual standards similar to that of Europe on the EMPIC   System?

The visual values have still not been converted to the local values, for example 6/6=1, our office have issued the conversions to all the DAMEs for easy reference; this is still under development.

Medical Standards/Assessments - Does the EMPIC System have fields for Stereopsis and Phorias?

No, the system does not have  fields to enter  Stereopsis and  Phorias, this information is necessary as Part 67 and the DAME is required to enter this information under other comments 

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