Until recently, only Section 1 (the mandatory part) of the JAR was available free of charge on the JAA web site. The Manual of Civil Aviation Medicine (guidance material) is now also available on the JAA ‘Licensing’ web page. It should be noted that the Manual is part of the Joint Implementation Procedures (JIP) and is only for guidance – it does not from part of the Requirements, which are mandatory.
The UK had proposed that single pilot operations for those aged 60 – 65 years should be acceptable, subject to a cardiovascular review to include an exercise treadmill test at age 60 and 63 years. Although accepted by the LSST(M) (Licensing Sub-Sectorial Team (Medical)), the Licensing Sectorial Team (LST) decided to postpone a decision until the International Civil Aviation Organisation (ICAO) had completed its consultation process on the maximum age for professional pilots. This is likely to take at least six months.
The UK ceased requiring electroencephalograms (EEGs, the test of electrical brain activity) for initial Class 1 applicants in October last year. The LSST(M) has now agreed with the UK’s position and the LST has accepted the decision as a ‘long-term exemption’. This means that the LST expect that the JAR will be formally changed in the future, although a consultation process, known as discussion of a ‘Notice of Proposed Amendment’ is still required. It is, however, very unlikely that a different decision will be reached after consultation.
The JAR includes a number of words which have similar, but subtly different, meanings and this has resulted in confusion. In future, only the word ‘limitation’ will be used.
The UK proposed that some flexibility should be permitted within the JAR, but without having to use the ‘Deviation’ process, for applicants just outside a required numerical value. This is commonly the case when assessing applicants who are close to, but just outside, some of the visual dioptre limits. The LSST(M) did not accept the proposal but did agree to re-opening the working group on vision standards.
The UK proposed to re-open discussion on ophthalmological issues and this was agreed. A new working group will be formed.
A protocol was accepted to enable the adoption of currently unacceptable treatments or medical conditions. Topics for future discussion include the use of insulin, selective serotonin re-uptake inhibitors (SSRIs – a group of antidepressants) and warfarin (a ‘blood thinning’ agent i.e. an anticoagulant). The first to be assessed under the protocol is that of insulin. A detailed protocol will be presented at the next LSST(M) and other countries are expected to volunteer their support at that time. A trial will then be instigated, under the chairmanship of the UK.
The question of which state ‘controls’ the medical certificate of a licence holder who revalidates his medical certificate outside his state of licence issue (SOLI) has been debated for some time. Should the Aeromedical Section (AMS) of the National Aviation Authority (NAA), who appoints the AME undertaking the examination, audit the medical examination and ECG, or should these simply be sent to the AMS of the SOLI, which will have the initial medical examination record and a copy of subsequent examination reports? Most states agreed that the SOLI should have responsibility for determining that the certificate had been properly issued (e.g. no limitations left off or incorrectly applied) and for following up any abnormality on investigation (e.g. ECG). A procedure for this was agreed.
This primarily concerns non-JAA professional pilots applying for a JAA Class 1 medical certificate – should they undergo initial Class 1 investigations and are they required to achieve initial or revalidation requirements (revalidation requirements being less exacting). It was agreed that Class 1 applicants needed to have a valid CPL and Class 1 certificate and had to be examined at an Aeromedical Centre (at Gatwick for UK applicants), following the normal initial Class 1 procedure, but without the CXR and EEG, but including a full ophthalmological (vision) examination. They would be required to meet the JAA Class 1 revalidation/renewal requirements, not those of the initial Class 1. This is the current procedure in place in the UK.
For Class 2, applicants should have a valid PPL and medical certificate, could go to any AME and would need to meet the Class 2 revalidation/renewal requirements. Again this is the procedure applied in the UK.
The UK put forward an information paper asking for clarification of the OPL (no passengers) limitation, which the UK has previously used for applicants with physical deficiencies, rather than to mitigate risks due to pilot incapacitation. After discussion it was agreed that it could, at the discretion of the AMS, be used for pilots in the latter group. It is likely that the UK will use the OPL for those who, for some reason cannot obtain a NPPL, and who wish to fly in aircraft under 2,000kg, day/VFR i.e. in conditions applicable to the NPPL (which already has a ‘no-passenger’ limitation).
This will be discussed at the Licensing Sectorial Team Meeting with a request for these changes to be made a long-term exemption.
The proposal for removal of extended ENT examinations, except at the initial Class one examination, is also to be taken to the Licensing Sectorial Team Meeting.
The medical requirements for Class three certification for ATCOs have
now been agreed and the Eurocontrol Class Three medical certification requirements will become part of the forthcoming ATCO Licence EC Directive.
The minimum age for certificate issue was withdrawn from discussion by the JAAC in March 2005 for further consideration of likely impact.
The text of NPA 3-21will be available on 1 July 2005 with a due publication date of 1 August 2005.
National variants 1.060 and 3.060 have been withdrawn and in their place, an Annex has been created to JAR FCL 1.060. The Czech Republic National Variant has been withdrawn completely. The DGAC (French regulatory authority) have changed the text to the French National Variant so that a captain is not to be over the age of 60, but a first officer may be. Previously both first officers and captains over 60 were excluded from flying in French airspace.
Discussion continues on reducing the periodicity of medical examinations to match the changes to ICAO Annex 1 due to be implemented in November 2005. A Working Paper will be submitted on this at the next LSST(M) meeting.
It was agreed to amend the requirement to accept a history of IBD provided that it is in established remission and stabilised and that systemic steroids are not required for its control. This proposal will go to NPA.
It was agreed to remove the requirement for repeat colour perception assessment except when indicated clinically. This change will go to NPA.
The need for extended eye examinations periodically for individuals with
high refractive error and the need for periodic tonometry (eye pressure measurement) over the age of 50 was deferred to the Ophthalmological Working Group.
To be discussed in the Ophthalmological Working Group.
Also deferred to the Ophthalmological Working Group.
Cardiological review is no longer mandated for Class two certificate applicants.
It was agreed that it was more appropriate for a Flight Engineer to have a limitation specifically for Flight Engineers rather than using the “as or with qualified co-pilot” (OML) limitation that exists for pilots. A new limitation has been agreed “Class one valid for Flight Engineer duties only” with the code ‘OFL’. The description of this limitation is “This applies to Flight Engineers who do not fully meet the medical requirements for a Class one medical certificate but are fit for Flight Engineer duties”. The OFL is to be termed an annotation rather than a limitation.
A majority of delegates were in favour of the use of Deviations to facilitate a harmonised medical certification system without the need for additional National Licensing arrangements. It appears that the UK is the only member state using medical Deviations.
The UK’s wording was accepted i.e. ‘Issued as a Deviation in accordance with JAR-FCL 1.015’, with an addition to 1.015 (and 3.015, which is a repetition of 1.015) that reference to the Deviation shall also be made on the medical certificate, if appropriate.
It was agreed that a harmonised use of Deviations for medical certification purposes should be proposed to the LST.
The administrative difficulties posed by pilots holding more than one JAR licence, potentially requiring oversight by more than one aviation Authority, should be discussed by the LST. It was agreed that Central JAA would draft a proposal for the Licensing Sectorial Team to discuss this issue.
The Group were informed that the UK will only accept JAA medical certificates for UK-JAR licence issue and will not accept national medical certificates, even if the issuing state has been ‘mutually recognised’ by Central JAA.
Following a presentation on a proposal for the medical certification of pilots with Type 2 insulin dependent diabetes mellitus, according to specified criteria and strict monitoring, it was agreed that a ReDWiG proposal on the subject should be presented at the next LSST(M) meeting.
A draft algorithm was presented. It was agreed to expand the proposal to include the use of SSRIs by professional pilots to permit flying, under close monitoring, with OML limited Class One medical certification. A Working Group was set up to develop this concept further and represent a proposal in the ReDWiG format at the next LSST(M) meeting.
Chest x-ray for initial class 1(Proposal by the UK)Chest x-rays will now only be required at the initial class 1 medical if clinically indicated.
Colour vision testing at revalidation/renewal all classesTesting will only be required at initial examination. Retesting at revalidation/renewal will be on clinical grounds. (This supports the current UK practice)
Hearing(Proposal by the UK)Audiogram standards for the initial class 1 and initial instrument rating for class 2 There will be no difference between initial and revalidation/renewal class 1 audiogram requirements i.e. the requirement is now that there shall be no hearing loss in either ear tested separately of >35db in the 500-2000Hz range, and 50db at 3000Hz. This will also be the requirement for the issue of an instrument rating to a class 2 holder
Peak flow measurements and pulmonary function tests for all except initial class 1 applicantsThese special investigations will only be required if clinically indicated. (The UK CAA will adopt this change early in 2006).
Reduction in frequency of Class 1 medical examinations for pilots aged 40 – 59 years engaged in multi-crew operations(Proposal by the UK)
Reduction in frequency of electrocardiograms for pilots aged 50 – 59 years engaged in multi-crew operations (Proposal by the UK)These are very significant proposed changes to the requirements. The proposal is that the period of validity of the medical certificate and ECG for class 1 holders between 40 and 59 years old will be increased from 6 months to 1 year. The exception is if the pilot is engaged in single pilot commercial air transport passenger carrying operations; then the period of validity will remain at 6 months. For class 1 holders over 60 the period of validity of the medical certificate and ECG will remain at 6 months for both single and multi-crew operations. In all cases the option to reduce the period of validity when clinically indicated remains.The major practical effect of this is that age 40-59 multi-crew airline pilots and single crew flying instructors will only have to have their medicals and ECGs annually.
Increase in the validity periods for class 2 medical certificates Currently class 2 medical certificates are valid for 5 years under age 30, then the validity is 2 years for pilots aged 30 - 49 and then 1 year from age 50. The proposal is that class 2 medical certificates will be valid for 5 years under age 40, then 2 years for pilots aged 40 to 49, then yearly thereafter. Additionally, there will be the rule that a class 2 medical certificate issued before the age of 40 will not be valid after the holder’s 42nd birthday.
Leukaemia (Proposal by the UK)The proposal is that chronic leukaemias can be assessed as fit for initial class 1 certification after a period of demonstrated stability. Currently initial certification is not possible for chronic leukaemias.
Fitness assessment after caesarean sectionThe proposal is that it will be possible to re-certificate pilots less than 3 months after caesarean section if they have fully recovered from the operation.
Ophthalmology (Working Group Proposal includes UK membership)The proposed changes are that:Refractive error limits for class 1 initials – will become +5 to –6 dioptres.Refractive error limits for class 2 initials – will become +5 to –8 dioptres.Near esophoria limit for class 1 initials - will become 8 dioptres.Keratoconus for all classes - will no longer be disqualifying for initial class 1 if the applicant meets the visual acuity requirements. Additionally at revalidation/renewal the frequency of follow-up will be at the discretion of the AMS.Visual field defect for all classes – applicants may be considered fit if the binocular field is normal.Ambylopia - The visual acuity in the other non-amblyopic eye should be 6/6 with or without correction. (Previously the 6/6 acuity had to be achieved without correction)
Research and Development Working Group (ReDWiG)(Proposal by the UK)In recognition of the fact that JAR FCL-3 does not have a flexibility clause in the way that ICAO has, the intention of this paper is to introduce a mechanism into JAR FCL-3 whereby pilots who have been subject to new medical technologies, therapies or procedures can be certificated. The detail of the proposal is that a working group of LSST/M members will be set up to develop a trial protocol. Pilots in the trial will be closely monitored. The UK further proposed that by using this ReDWiG mechanism a highly selected group of type II diabetics on insulin could be granted class 1 certification. A strict monitoring procedure would be prescribed, as would a protocol for ingesting some carbohydrate if the monitored levels went below a certain level, or if monitoring could not be done. The UK plans to further refine this protocol OML for initial class 1 applicants (Proposal by the UK)It is proposed that it should be possible to issue an initial class 1 certificate with an OML limitation
