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taxi and corporate flying. This category has not faced such important changes as has airline transport. It
must be noted that helicopters now perform a significant part of these operations.
Private air transport and pleasure flight. The majority of the world’s pilots belong to this category. The
operations are not conducted for remuneration and generally involve small aircraft. In this category, glider
pilots form an important subgroup. During the last two decades, a new dimension has been added to this
category with the fast-growing popularity of the ultralight aircraft. (Presently Annex 1 does not include
provisions for ultralight licensing).
Very different operating situations result from these various activities. There is a real gap between the
bush pilot flying a rugged aircraft solo in a deserted area and the pilot-in-command of a complex
aeroplane on one of the major air routes with comprehensive ground support. This difference, which also
affects licensed ground personnel, used to increase as technological progress became more involved in
airline operations than in other categories, but is now decreasing as advanced and sophisticated
electronics and computer-based equipment are becoming available even to the private pilot. The medical
examiner, when making an assessment, must be familiar with the various operating environments.
The concept of licensing
Since the early days of aviation, States have recognized the necessity to check the competency of
personnel who perform activities which, unless performed properly, could jeopardize aviation safety. The
recognition of this competency was generally made by issuing a licence. This concept has remained valid
throughout the years, and the whole of Annex 1 may be considered as an evolution of this basic idea.
However, civil aviation is very different today from what it was when the first licences were issued, and
the provisions of Annex 1 have been established and then regularly updated to manage the increasing
complexity of civil aviation. The personnel licensing system, as implemented in Annex 1, is now built on
the following principles:
• The licence is the authorization which allows the holder to perform specific activities,
which otherwise would be prohibited.
• A licence is issued by a State when the applicant has demonstrated an acceptable degree of
competency. The right to issue a licence is reserved to States either directly or through a
body with delegated authority. When the term “ICAO licence” is used, it indicates that the
licence is issued by a Contracting State in compliance with the provisions in Annex 1.
ICAO does not itself issue licences.
• There are different types of licences. Each one grants specific privileges to the holder.
Ratings can be added to the licence to extend the basic privileges.
Annex 1 has provisions for other licences than those listed below (aircraft maintenance mechanic,
aeronautical station operator and flight operations officer). However, these licences have no medical
fitness requirements due to the nature of duties.
Different types of licences
Some licence types are described below. Detailed descriptions can be found in Annex 1, Chapter 2.
Pilot’s licences
a) Student pilot. While it is not formally a licence, many Contracting States issue an authorization for
a student pilot, allowing such a pilot to fly solo before licensing as long as the applicant is
medically fit. In some States, the Medical Assessment itself, when issued as a certificate, functions
as the student pilot’s licence. The medical fitness required is the least restrictive of all pilot licences
(Class 2). Therefore the medical examiner should be prepared to counsel the applicant against
further time and expense in pursuance of piloting ambitions if a medical condition is established
which might prevent his acquisition of a more senior pilot licence, if this is his ambition.
b) Private pilot licence – aeroplane (PPL - aeroplane). The most commonly held licence permitting
the holder to fly an aeroplane other than professionally. Private pilots usually fly small aeroplanes
in visual meteorological conditions (VMC). It is, however, not unusual to add an instrument rating
to a PPL.
c) Private pilot licence – helicopter (PPL - helicopter). This is the helicopter licence equivalent to the
PPL – aeroplane.
d) Glider pilot licence permits the holder to act as pilot-in-command of any glider.
e) Free balloon pilot licence. The holder of this licence is permitted to act as pilot-in-command of any
free balloon.
f) Commercial pilot licence – aeroplane (CPL - aeroplane). The CPL is the junior licence permitting
the holder to perform professional duties either as a pilot-in-command of an aeroplane certificated
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Manual of Civil Aviation Medicine 1(5)
