Welcome to eClass 5:

Aviation Health Exposed…


Here we go…

WARNING – INSIST ON A FULL AIRLINE TRANSPORT MEDICAL (OR EQUIVALANT) FROM YOUR VERY FIRST MEDICAL IF YOU INTEND TO MAKE A CAREER OUT OF FLYING. It is no good finding out that something renders you unable to hold an Airline Level Medical once you have already spent some money.


PART 1: Understanding the Process

Luckily, I’ve made this bit easy for you! Phew!

Each country’s regulator will have a set of aviation medical guidelines to adhere to. We have provided a list of these guidelines in the ‘Aviation Health Info Pack’.

What you need to understand is that passengers get into an aircraft with you and don’t want you to pass out from a medical problem. They put their faith in the Aviation Medical Regulator to police this so that they don’t have to try and land the plane like in the movies!

Regular Medicals

To ensure this pilot medicals are taken regularly usually yearly or every six month’s as you get older and risk of health problems increase.

Medical Certificate

You will be issued with a medical certificate, which is to be carried on you at all times. It is illegal to operate an aeroplane without a valid medical certificate.

There are different levels of medical depending upon the type of flying you are involved in and therefore risk to the general public. If you are flying privately for fun the risk is less. However if you are carrying passengers for reward (they are paying for a ticket) you will be medically given the ‘once over’ to reduce the chance of a medical issue in flight.

D.A.M.E. = Designated Aviation Medical Examiner

The older you are, the more extensive the examination becomes. Obviously not everyone’s health is perfect so a risk analysis template has been created to give people the best chance to hold a pilot medical. If a condition can be ‘managed’ or ‘corrected’ you will find that generally your D.A.M.E should be able to assist you in attaining/maintaining a pilot medical.

{D.A.M.E. = Designated Aviation Medical Examiner or equivalent in your region}



The Aviation Health Info Pack is not something you “need to know”, more it was compiled to give you an understanding of the requirements each region expect of you when you complete an aviation medical examination.

PART 2How to GET a pilot medical.

Whatever country you are in, the regulator will have an aviation medical department.  They will issue accreditation to a number of doctors to act on their behalf.  In Australia these doctors are called Designated Aviation Medical Examiners (commonly referred to as D.A.M.E’s).

A list of these can be attained from your regulators website, or the regulator directly.  The names and website addresses of the regulators are contained in our ‘Aviation Health Info Pack’.

A pilot medical examination generally takes 1-1.5 hours.

 EYESIGHT – checked on an eye chart, vision correction generally allowed as long as certain criteria are met. There may be an “electronic” ophthalmology examination conducted also as part of the process.  Often the question is asked about color blindness.  Suitability will depend upon the level of the problem and your regulator’s rules.  Although possibly disappointing, it is better to find out you have this condition from the start.

 HEARING – this is checked either by using headphones or in a sound proof booth with a series of sounds of differing frequencies.  This to ensure that safety is not compromised due to a loss of communication from hearing.

 HEART RISK – you will be given an Electro Cardiogram (ECG) to assess the chance of a heart attack in flight.  Not good.  Fairly self-explanatory! Some regulators may also require a Stress ECG (on a treadmill) for initial issue or after a certain age, or if deemed necessary by the examiner.

 LUNG CAPACITY – this is tested by blowing into a machine with a big name! (Spirometer) This is important to know if you will be operating in a pressurized aircraft, which any airline pilot will. (So that the aeroplane can fly higher).  If the aircraft becomes unpressurised for whatever reason you will need to go onto oxygen.  Therefore the capacity of your lungs is measured.

Obviously, smoking reduces lung capacity over time and will show up with this test.

BLOOD TEST – blood is tested at designated intervals to screen cholesterol and in some cases drugs.  If I was your passenger I need to know that you are not under the influence of anything that may impede your judgement or performance.

{Some regulators have enforced mandatory random Drug and Alcohol testing of flight crews}

 PSYCH TESTING – for obvious reasons.  Also a measure of your ability to work as part of a team under a high stress environment. This is not in all countries as part of the medical but most airlines will test at the interview stage.

It can be a straight forward single test, or a half-day comprising of a series or tests and scenarios.


PART 3How to KEEP a pilot medical.

A small percentage of pilots do lose their medical for various reasons.  If you work your hardest to make it in aviation to then be told you’re not allowed to fly anymore would be devastating.  We personally know some pilot’s that this has happened to.

Some things are unavoidable and life happens and we can’t do much about that.  Many pilots get a ‘test’ or a scare at some stage which makes them soul search about the importance of their chosen career.  For me, it is deciding whether to get back on my horse after I was thrown off.  When creating this system, I injured my shoulder and am currently unable to fly.  Whilst this is temporary it is still annoying.


So what can we do to reduce the risk of losing a medical?


LIVE AN ACTIVE LIFESTYLE – use your career as an excuse to have a balanced diet and exercise.

Everything in moderation. 

Sometimes I am not perfect in this but it does help to keep us on track.  Listen to your mother – don’t do drugs!  Many drugs stay in your system longer than you may think.  Use this knowledge and ask yourself the question ‘Is it worth losing my career over?’  Remember in the long run you will get far more of a rush from taking off in a jet – the feeling of flying is like a drug.

Being in charge of an aeroplane, even the smallest one, requires a higher level of maturity than many others the same age.

Use this maturity to do things that you want to, not because the peer group thinks its cool.  Remember if you have chosen this path at a young age and your mates haven’t, they may not understand your need to look after yourself.

PART 4Interview with a D.A.M.E. 


–         We have chosen you to interview as you are the obvious expert – could you explain to prospective pilots what your qualifications and experience are?


–         I was a “flying doctor” in Alice Springs for a year (1955) and learned to fly there on a Tiger Moth.  I have been an Australian DAME since 1964, and I am a Class 1 New Zealand Medical Examiner.  While Associate Prof at Monash University I initiated and set up the Australian Certificate of Civil Aviation Medicine in 1990 , collaborating with CASA, TAA, Ansett and the RAAF who all contributed to its structure.  In 2000 I wrote and still teach in the Edith Cowan University Certificate course as Adjunct Professor in Postgraduate Medicine.



–         What would be your advice regarding medicals to someone starting out their pilot training? I.e. should they do a complete ATPL medical from the outset?

–         If a young man/woman aspires to train as a Professional Pilot it would be very prudent to undergo the full Medical Examination requirements  before embarking on an expensive and fairly lengthy training program towards obtaining a Class 1 Flying licence. Unlikely hindrances to a career as a Professional Pilot (eg, Colour vision confusions) may be discovered that would suggest a change of career plans.


–         Can you outline the requirements for Australian Airline Transport Pilot Licence(ATPL) medical? I.e. schedule under and over 40 years. Sight, hearing, bloods, ECG etc

–         These are outlined on the CASA web site under Medicals. They vary in different jurisdictions (eg Australia and new Zealand). They are triggered at different ages in different jurisdictions.  In principle, a number of significant tests and examinations must be performed initially, and then at regular intervals.  These tests all aim to detect any possible medical condition that could lead to an insidious or a sudden incapacitation during flight, especially during the most critical phases, such as takeoff and landing.  

–         The initial tests include General medical examination, Electrocardiogram, Audiogram, Sprirometry, Chest Xray, Fasting blood lipids (Cholesterol, HDL, LDL Cholesterol, Triglycerides, Fasting blood glucose.) and Eye Specialist. I also recommend a dental

 Orthopantogram (full mouth Xray) and a Cogstate computer-assisted cognitive function screen.


–         Is there much difference between the medical requirements of a Private Pilot, Commercial and ATPL medical?

–         The Commercial and Airline Transport categories are both professional licences and require Class 1 Medical certificates.  Class 2 or Private pilot licences have similar medical requirements initially, but are a little less stringent in the frequency of re-examinations and in the requirements.   This is to say that the public does not expect the same level of medical fitness in a private recreational pilot as in an Airline pilot responsible for the lives of 200 passengers.

Recreational pilots such as Gliders and Ultralights etc have their own medical standards set by their Federation, and not set by CASA. 

They generally require a Class 2 Student pilot licence


–         Can you summarize the cost involved for a pilot medical, initially and annually? 

–         The costs vary from examiner to examiner and are not set by CASA – except in the case of the paperwork processing fee (presently $75-00).

Historically, the cost of the medical examination for Class 1 certificate is about the same as the cost of one hour of flying with an instructor, and it is still about the same.  Extras, such as ECG, Audiogram, Lipids, Eye Specialist, Chest Xray etc add some costs, but are not required at every medical examination.


–         In broad terms, can you explain the CASA point system?

–         All jurisdictions require an initial and ongoing monitoring of a pilot’s fitness to fly, and to meet the appropriate medical standard.  Approximately half of loss of licence incidents are related to Cardiovascular diseases, heart attacks and stroke.   The risks are usually monitored by regular assessment of blood lipids (fats such as cholesterol and triglycerides), glucose, blood pressure, body weight (body mass index) and other serious risk factors such as smoking, diabetes, or regular and excessive ethyl alcohol intake (or other ‘recreational’ drug use.)   Random testing for these substances commenced in May 2009 and hopefully will reduce the risks in the safety sensitive employees in the Aviation industry (– including pilots, who probably had the least problems in this area). For CASA, the overall risk of CVD is summed from

Age risk + HDLC + Total C +SBP + Smoker + Diabetes +ECG (LVH) = Points Total.   From this the probability of a heart attack or stroke can be calculated as a % risk over 5 or 10 years.



–         What are some of the things that a pilot would gain risk points for?

–         These include age, high cholesterol or triglycerides or body mass index, elevated blood pressure, the presence of diabetes, smoking, ethanol over-usage, and family history of cardiovascular disease (because genes play a role). One must explain that the “points” are simply indicators of cardiac risk, and the fewer points you acquire, the better!


–         What actions pilots can take to reduce the chance of losing his/her medical?

–         Healthy diet, exercise regularly >3 x per week, maintain physical fitness level. If the DAME is also the family doctor for the pilot, then a stronger “preventive medicine” bond of pro-active advice can be built up.  No pilot has a lifetime job.  Every year (for Class 1 certificates) the pilot must once again be examined, tested , and meet the medical standard.


– If a pilot loses his/her medical, what happens next in terms of regaining medical? 

– The pilot and his/her DAME must work together to obtain the appropriate treatment to return to a fitness level of meeting the Medical Standard, without the persistence of any Safety-relevant medical incapacity or disability.


– Do you have any knowledge of other countries Aviation Medical requirements? If so which ones?

– Yes, I am a Class 1 Medical Examiner for the CAA of New Zealand, and also for Fiji.



PART 5: List of Local D.A.M.E’s.

Ctrl + Click to follow links below…


Civil Aviation Safety Authority – Search for a medical examiner

New Zealand

CAA medical directory – New Zealand



Find an Aviation Medical Examiner (AME)



Medical Examiners Database Search | Medical | Safety Regulation



Civil Aviation Medical Examiners (CAME) – Search



PART 6:   Medical FAQ’S. 

–        How much does it cost to get a pilot medical?

Follow the links above to get actual cost for your medical and it will depend on your age as to what is required.  As an example the cost of a medical in Australia is including an Electrocardiogram (ECG) in August 2010 was $198AUD to the doctor plus $75AUD to the Civil Aviation Safety Authority for processing.

–        Can I hold a medical if I wear glasses?

Yes, however you will have to multiple pairs of glasses with you.

–        If I have a medical condition that I am unsure of, what should I do?

Many conditions as long as they can be corrected so as not to impair you in any way can be assessed on an individual basis.  Go and see your local medical examiner to be assessed.


Next week’s preview… ’Pre Flying Training need to knows…’


Congratulations on completing this Eclass.  Check out below the Eclass calender to see what’s in store!

If you have any questions or comments please send them to info@ouraviationsecrets.com

Look forward to speaking with you at the Webinar.





Captain Craig Baker

Airline Pilot and Professional Pilot Mentor