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controllers. This is an effective way to promote the medical examiner’s understanding of the practical
demands, both physiological and psychological, that the licence holder’s task and duties impose. An
accumulated total of at least ten hours per year of flight deck time might be considered desirable. Practical
difficulties may be encountered in the implementation of this recommendation for all designated
examiners, but it is desirable that, as a minimum, medical assessors (physicians evaluating the medical
reports submitted to the Licensing Authority) be afforded the opportunity of attaining such experience.
The medical assessor
The medical assessor is defined in the Definitions section of Annex 1 as follows:
Medical assessor. A physician, appointed by the Licensing Authority, qualified and experienced in
the practice of aviation medicine and competent in evaluating and assessing conditions of flight
safety significance.
Note 1.– Medical assessors evaluate medical reports submitted to the Licensing Authority by medical
examiners.
Note 2.– Medical assessors are expected to maintain the currency of their professional knowledge.
The role of the medical assessor and the evaluation of medical reports are further outlined in Chapter 1 of
Annex 1:
1.2.4.7 Contracting States shall use the services of medical assessors to evaluate reports submitted
to the Licensing Authorities by medical examiners.
1.2.4.7.1 The medical examiner shall be required to submit sufficient information to the Licensing
Authority to enable that Authority to undertake Medical Assessment audits.
Note.— The purpose of such auditing is to ensure that medical examiners meet applicable standards
for good medical practice and aeromedical risk assessment. Guidance on aeromedical risk
assessment is contained in the Manual of Civil Aviation Medicine (Doc 8984).
Medical assessors, because of their functions as employees of or consultants for the Licensing Authorities
and as supervisors for the designated medical examiners, will normally have advanced training in the
specialty of aviation medicine and extensive experience in regulatory and clinical civil aviation medicine.
In addition to evaluating medical reports submitted to the Licensing Authority and making final
assessments in border-line cases, the medical assessor will normally be in charge of Accredited Medical
Conclusions (see 1.2.4.8 below). An important duty of the medical assessor is the safeguarding of medical
confidentiality, although pertinent medical information may be presented by the medical assessor to other
officials of the Licensing Authority when justified by operational concerns or when an Accredited
Medical Conclusion is sought. Also the audit of medical reports by designated medical examiners and
refresher training of medical examiners will usually fall within the remit of the medical assessor.
Applicant’s medical history
1.2.4.5 Applicants for licences or ratings for which medical fitness is prescribed shall sign and
furnish to the medical examiner a declaration stating whether they have previously undergone
such an examination and, if so, the date, place and result of the last examination. They shall
indicate to the examiner whether a Medical Assessment has previously been refused or suspended
and, if so, the reason for such refusal or suspension.
1.2.4.5.1 Any false declaration to a medical examiner made by an applicant for a licence or rating
shall be reported to the Licensing Authority of the issuing State for such action as may be
considered appropriate.
It is desirable that such declaration be incorporated in the medical examination form or be a part of the
national regulations, as a reminder to the applicant of the consequences of any false declaration. The
examiner should be aware that deception may be a problem in aviation medical certification and the
potentially serious consequences of any false declaration should be stressed to the applicant.
The medical examination
1.2.4.6 Having completed the medical examination of an applicant in accordance with Chapter 6,
the medical examiner shall submit a signed report, or equivalent, to the Licensing Authority, in
accordance with its requirements, detailing the results of the examination.
Note.— The medical report may be submitted to the Licensing Authority in electronic format,
provided adequate identification of the examiner is established.
1.2.4.6.1 If the medical examination is carried out by two or more medical examiners,
Contracting States shall appoint one of these to be responsible for coordinating the results of the
examination, evaluating the findings with regard to medical fitness, and signing the report.
Medical confidentiality
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Manual of Civil Aviation Medicine 1(8)
