Aviation Medical Examiner

Dr Justin Carter

Aeromedical examinations and Covid-19

Is it safe to attend hospital for a medical examination?

Yes - it's probably safer than going to the shop for a pint of milk! Through the Covid lockdown period, the general public have become understandably fearful of attending hospital for assessment - often resulting in life limiting conditions going undiagnosed or untreated. Hospitals are putting in huge effort to counter fear of attending hospital (as you'll see in this video).
The risks of attending these clinical areas (especially in an outpatient setting) is negligible and generally speaking, where clinical assessment is warranted, attending for assessment is the right thing to do based on the 'risk / benefit analysis'. The regional 'R' number at present is very low and at the present time and particularly in the summer months, the risks of viral spread are lower than will likely be the case in the winter now is a window of opportunity for assessment.
Specific measures are in place to make coming to hospital for any reason as safe as possible and taken together, that's why I'm confident attending for an appointment carries less risk than any other interaction you'll have outside your own household.

Specifically, when you attend for your aeromedical assessment you will:
  • Be seen in a 'Covid Green' (clinical areas specifically designated for the care of those without Covid-19) outpatient area outside office hours.
  • You will have interaction with a single individual (the AME) who is subject to intensive covid screening (recurring swab or Antibody testing for Covid-19).
  • Everyone in the hospital environment is wearing facemask protection.
  • You will be the only patient in the clinical area (besides the AME).
  • Social distancing will be observed except when the requirements of the physical examination dictate otherwise.
  • At all times, both candidate and AME examiner will wear a facemask.
  • The medical can be cancelled at short notice in the event that either the candidate or the AME (or household members) have symptoms of Covid-19 or are demonstrated to have Covid-19.
  • The surfaces and equipment in the clinic room are cleaned with viricidal decontaminants and surface cleanser between each candidate.
  • Contact details of all attendances are kept for contact tracing purposes.

Essentially, I've observed a natural nervousness about attending Hospital amongst the public. However particular efforts are being made to keep Covid Green areas of the Hospital Covid free and safe for you to attend. It's my opinion that taken together, these measures amount to less risk than you're likely to encounter going to the shops for a lint of milk. Medicals will need to resume at some point, and this summer period if a 'good' time to resume rather than waiting for the 'bow wave' of applicants anticipated at the end of the CAA extension periods (see below) from October and November into the winter months.

Are Aeromedical examinations available?

Yes, medical examinations remain available and according to CAA guidance, I will individually risk assess each medical taking into account:
  • the requirement of the applicant to hold a medical certificate.
  • the revalidation/renewal status of existing medical certificates
  • the status of the national 'lockdown' (prohibiting non-essential travel) prevailing at the time of the medical
  • the applicant's health status (presence of fever, cough, breathlessness, malaise, sore throat or loss of sense of taste or smell)
  • the health status of the applicants co-habitees (are any family members self-isolating)
  • assessments of any available information about the prevalence of Covid-19 in the background population in the area in which the applicant resides
  • the travel distance for the applicant between home and the medical examination centre
  • the availability of a 'clean' (non Covid-19) clinical area in which the medical will be conducted
  • the health status of the examiner (and the examiners co-habitees)
  • the availability of adequate PPE for the examination to be conducted using Public Health England PPE guidance.

Essentially each medical will be individually assessed balancing the need for a medical at this time, with the risks to the applicant and AME taking into account all of the features in the list above. Applicants will be asked to complete a questionnaire to help in this assessment at initial email contact.

Do I need to have a revalidation medical examination?

The CAA have issued extensions applicable to the medical certificates of most professional pilots, ATC officers and recreational pilots provided that the previous certificate was valid on the 23rd of March 2020. The Extension applies until the 22nd of November 2020. The extensions are intended to apply to holders of existing certificates who remain in good health who don't have access to routine medical exams especially during the lockdown period.

A summary of the extension for professional certificate holders is that:
  • To take advantage of the exemption, the medical certificates or cabin crew medical reports must have been valid on the 23rd of March 2020 and not beyond 31st of October 2020.
    • So certificate holders whose certificate expired before the 23rd of March cannot use this exemption and must have a renewal medical to exercise licence privileges.
  • The exemption ends on 22nd of November 2020 and therefore no certificate validities can be extended beyond this date.
    • So certificate holders who use this exemption must have a renewal medical before the 22nd of November 2020 to exercise licence privileges after the 22nd of November 2020.
  • Certificate holders with medical conditions should still comply with the requirements for provision of medical reports that support their medical fitness.
    • For certificate holders who experience difficulties in provision of reports, AMEs can extend the requirement date for up to 3 months. Further extensions may be granted by the CAA.

How do I comply with the extension provisions?

For certificate holders operating in an AOC / Part ORO (EASA Air Operations) environment (ie most Commercial aviation activities) please see this document.
For certificate holders operating on a non AOC / Part ORO (EASA Air Operations) environment (ie most training and recreational aviation activities) please see this document. Note that the applicability dates for this group are different to those outlined in the summary above.
In either group, to demonstrate compliance with Part MED, aircrew / ATCOs / Cabin Crew should carry their (expired) medical certificate and a copy of the exemption notice (linked above) as part of their licence.

Practically, how does this affect booking my next medical?

  • If you have an aviation medical certificate which was valid in mid March and your health status hasn't changed, and you wish to make use of the CAA extension, I suggest you review the CAA documents linked above and carry a copy of the relevant extension notice with your expired certificate to automatically 'extend' it.
  • If your certificate had already expired before the extensions came into force (ie mid March depending on your certificate type) and hence you need a renewal medical examination (rather than a revalidation) and you require a medical certificate (principally for occupational reasons), contact me by email with your circumstances and I'll arrange a medical if required subject to an individual risk assessment outlined in the section above.
  • If your health status has changed (irrespective of the validity of your medical certificate or any extension) contact me by email with your circumstances and I'll review the information and if necessary, arrange a medical with you subject to an individual risk assessment outlined in the section above.
  • If you don't have a valid medical certificate for instance due to some medical condition, these will need to be worked through to conclusion (if necessary with relevant specialist reports) under my guidance.
  • If you are a new Class 2 / LAPL certificate applicant (ie you are new to recreational flying) there is the option of an initial examination subject to an individual risk assessment outlined in the section above, so please get in touch.