4/25/2020

Medical Flight Test

Claude Preitner – Senior Medical Officer 1

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:   Vision Hearing   Limbs 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 role

 Applicant 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 impairment  Vision    Hearing Limbs 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 only  Usually Class 2 certificate only  No Medical Flight Test, but  Regular instructor report   Update CAA on any problem Instructor aware of problem 4/25/2020 11

Vision impairment issues to consider

 Reduced vision in one eye    True monocular Visual fields impairment Double 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 audiogram Speech discrimination test Flight test

Important hearing issues for pilots

     Being able to fully understand and comprehend all radio communications Ability to hear all alarms in cockpit Being able to communicate effectively with other crew members Being able to communicate effectively with passengers Ability 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 Impairment

 Partial 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 injuries

Spinal cord injuries

 Loss of sensations  Loss of power  Loss of bladder control (self catheterisation)  Loss of bowel control (manual evacuation)  Urinary infections  Muscles spams  Loss or autonomic control (low tolerance to Gs) 4/25/2020 18

Spinal cord injuries

 Cessna 152  Cessna 172 Hand control for rudder and brakes

Examples

 Pilot reported to become confused  Penetrating eye injury  Deaf pilot with hearing aids  Weakness of left arm for pushing movements  Shoulder limitation  Amputee lower leg  Partial paralysis of lower leg (inability to flex down the foot)  Stiff ankle following fracture

Conclusion

 Functional in-flight testing is a useful assessment tool  It 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.” 4/25/2020 22

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 4/25/2020 23

 “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” 4/25/2020 24