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requirements of medical fitness”. To avoid confusion and mistakes, the term “licence” is used solely
about the document that guarantees the professional competency of the holder, and the term “Medical
Assessment” is used about the medical certificate (in cases where such a document is issued), about
endorsement of a licence to the effect that the holder meets the medical requirements, or about the
aviation licence when medical fitness is implied in holding a valid licence (see also Note 2 to 1.2.4
below).
The issue of a licence
An applicant who seeks a licence must complete a multi-step process which can be divided into three
major parts: prerequisites, training and demonstration of competency.
Prerequisites
a) Age. A minimum age is specified for each licence.
b) Experience. A minimum level of experience depending on the licence is required for all personnel
to be licensed. The unit of measurement of experience is flight hours for flight crew, and years of
duty for ground personnel. For pilots, experience requirements range from 40 flight hours for PPL
to 1 500 flight hours for ATPL.
c) Medical fitness. Most of the licences require compliance with medical fitness standards. Complete
guidance on this matter is provided in this manual.
Training
Training is obviously one of the most important parts of the licensing system. For several licences, an
applicant may choose to take an approved training course instead of a regular course and thus be eligible
for reduced experience requirements. It is expected that even more emphasis will be placed on training in
the future. The advent of the multi-crew pilot licence has provided a new method of training of
individuals intending to operate only multi-pilot aircraft.
Demonstration of competency
Each licence has its specific skill and knowledge requirements, and each applicant must demonstrate
compliance with the requirements pursuant to the licence he seeks. Contracting States generally use a
written examination and a practical test to check the competency of an applicant. Some other methods are
also used concurrently, such as acceptance of a military licence.
Currency of licences
As outlined above, basically two different types of licences can be found, depending on the issuing State.
Some licences (expiring type) have a period of currency which is limited to a defined period. At each
renewal, the holder must give evidence of his competency and his medical fitness. Competency is usually
judged by considering the recent flight experience and sometimes by an examination. The other type of
licence (continuous type) is not limited to a defined period of currency. The holder is allowed to exercise
licence privileges as long as he holds a current Medical Assessment and complies with the regulations
detailing the actions necessary to ensure maintenance of competency.
Medical provisions for licensing
The detailed medical requirements appear in Chapter 6 of Annex 1. Other chapters of the Annex, mainly
Chapter 1, contain a number of general administrative provisions which are important for the organization
and conduct of the medical examination and medical certification. These are given in the following
extracts from Chapter 1 of the Annex, together with explanatory remarks.
The designated medical examiner
1.2.4.4 Contracting States shall designate medical examiners, qualified and licensed in the practice
of medicine, to conduct medical examinations of fitness of applicants for the issue or renewal of the
licences or ratings specified in Chapters 2 and 3, and of the appropriate licences specified in Chapter 4.
1.2.4.4.1 Medical examiners shall have received training in aviation medicine and shall receive
refresher training at regular intervals. Before designation, medical examiners shall demonstrate
adequate competency in aviation medicine.
1.2.4.4.2 Medical examiners shall have practical knowledge and experience of the conditions in
which the holders of licences and ratings carry out their duties.
Note.— Examples of practical knowledge and experience are flight experience, simulator
experience, on-site observation or any other hands-on experience deemed by the Licensing Authority to
meet this requirement
1.2.4.4.3 Recommendation.- The competence of a medical examiner should be evaluated
periodically by the medical assessor.
As stated in 1.2.4.4.2, designated medical examiners must be familiar with – “have practical knowledge
and experience of” - the operating environments of the various licence holders. Such practical knowledge
and experience should include, whenever possible, actual flight deck experience in aircraft engaged in
commercial operation as well as experience in the operational working conditions of air traffic
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Manual of Civil Aviation Medicine 1(7)
