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general flight safety level within the country, but may also be expected to favour increased international
recognition and reciprocity with regard to medical fitness requirements of personnel licences.
In some Contracting States medical examiners are encouraged to become involved in the medical aspects of
aircraft accident investigation. However, for examiners to function effectively in this role, it is desirable that
they receive formal instruction on fundamental procedures. Whilst such training may be included in an
aviation medical examiner training course curriculum, normally additional, specific, training is required.
In addition to ICAO-sponsored seminars, several Contracting States offer post-graduate programmes in
aviation medicine. Information on some of these programmes can be found in ICAO Training Directory,
available at www.icao.int.
— — — — — — — —
ICAO Preliminary Unedited Version — May 2010 V-1-3
COMPETENCY-BASED TRAINING FOR
MEDICAL EXAMINERS
The objective of this section is to provide guidance to States to assist with implementing competency-based
training for medical examiners who may anticipate designation by a Licensing Authority. It provides
guidance for providers of training as well as States who are implementing such training or assessing such
training for acceptability. The aim is to encourage States to better harmonize the approach taken to train
medical examiners and to ensure that medical examiners demonstrate appropriate levels of expertise.
The competency-based approach to training has been adopted by ICAO in a number of areas, including the
multi-crew pilot licence and training of government safety inspectors; it is designed to achieve consistent and
standardized outcomes from training. As stated in ICAO document 9868 (Procedures for Air Navigation
Services – Training), Chapter 2, paragraph 2.2:
“The development of competency-based training and assessment shall be based on a systematic
approach whereby competencies and their standards are defined, training is based on the
competencies identified, and assessments are developed to determine whether these competencies
have been achieved.
The ICAO document further states that competency-based approaches to training and assessment shall include
at least the following features:
a) the justification of a training need through a systematic analysis and the identification of indicators
for evaluation;
b) the use of a job and task analysis to determine performance standards, the conditions under which the
job is carried out, the criticality of tasks, and the inventory of skills, knowledge and attitudes;
c) the identification of the characteristics of the trainee population;
d) the derivation of training objectives from the task analysis and their formulation in an observable and
measurable fashion;
In a competency-based training approach:
- training is outcome-oriented. It is what trainees can do and how well they can do it that matters
(rather than their level of knowledge about a particular subject);
- training materials clearly state what is expected of trainees in terms of performance, in given
conditions, and to what standards;
- training is material-dependent as opposed to trainer-dependent;
- assessment during and after training measures the performance of the trainee against a specified
standard in a valid and reliable fashion; and
- trainees are provided with regular and immediate feedback during training.
Scope
ICAO Preliminary Unedited Version — May 2010 V-1-4
This document relates primarily to examiners of professional pilots (ICAO Class 1 Medical Assessment).
Accordingly, the discussion which follows will refer mostly to this group and their work environment.
However, most of the principles are also applicable to the other categories of applicant. Some comments on
Class 2 and Class 3 applicants follow.
ICAO Class 2 (primarily private pilots): Most of the same principles for Class 1 apply, although the overall
level of fitness is lower, and there is likely to be greater flexibility applied by Medical Assessors. In some
States, the process for medical certification for Class 2 applicants differs from other classes: there may be
greater authority delegated to examiners of Class 2 applicants and there may be greater numbers of examiners
involved in their evaluation. However, the processes undertaken by examiners are broadly similar and while
the requirements of the regulator in terms of training and competency for designated medical examiners
(DMEs) examining only Class 2 applicants may be less stringent, they may also be comparable or even
identical.
ICAO Class 3 (Air traffic controllers): While there may be differences in Standards and application of
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Manual of Civil Aviation Medicine 2(145)
