1. Medical Flight Test Claude Preitner – Senior Medical Officer 5/9/20151

2. Civil Aviation Rules, Part 67 General An applicant must – (1) have no medical condition that is of aeromedical significance; and (2)Without limiting paragraph(b)(1),have no history or diagnosis of any of the following specific medical conditions, to an extent that is of aeromedical significance:

3. FLEXIBILITY (27B2) The Director may, relying on flexibility, issue a medical certificate to the applicant Flexibility means the use of medical judgment to issue a issue a medical certificate if the following conditions are fulfilled : (a) An Accredited Medical Conclusion indicates that in special circumstances the applicants failure to meet any medical standard prescribed in the rules is such that the exercise of the privileges to which the medical certificate relates is not likely to jeopardise aviation safety; and

4. Flexibility (b) the relevant ability, skill and experiences of the applicant and operation conditions have been given due consideration; and (c)the medical certificate is endorsed with any conditions, restrictions or endorsements when the safe performance of the applicants duties is dependent on compliance with those conditions, restrictions or endorsements

5. What is of aeromedical significance? Elevated risk of incapacitation Cognitive impairment Functional impairment: Vision Hearing Limbs function (muscular, neurological, amputations) Mobility (joints, paralysis, obesity)

6. How to determine if condition safe ? Medical Flight testing can assist the decision making process as to whether a medical condition is or not likely to jeopardize flight safety.

7. Purpose of practical flight testing with regard to medical certification To ascertain impaired individuals ability to perform the required tasks of a pilot safely without significantly greater risk than an able bodied person Answer the question: Is the condition likely to jeopardize flight safety – Answer may be aircraft type or operation specific

8. Flight examiner role Applicant requested by CAA to provide Medical Flight test Applicant may be requested to ask the flight examiner to contact CAA for a briefing Conduct Medical Flight test following briefing or according to protocol Report to CAA or other medical experts conducting the AMC

9. What is of aeromedical significance? Elevated risk of incapacitation: No role for Medical Flight Test Cognitive impairment (i.e. aging, head injury) Behavioural / mental problems (i.e. Attention deficit, Asperger) Functional impairment Vision Hearing Limbs function (muscular, neurological, amputations) Mobility

10. Cognitive impairment Simulator flight test: Usually a reliable tool BFR, Instrument renewal etc. are demanding enough if well conducted However routine tasks last affected so needs to include decision making and unusual situations.

11. Behaviour issues Very mild case only Usually Class 2 certificate only No Medical Flight Test, but Regular instructor report Update CAA on any problem Instructor aware of problem 5/9/201511

12. Vision impairment issues to consider Reduced vision in one eye True monocular Visual fields impairment Double vision with certain eye movements Near vision issues Colour vision deficiency is not suitable for in flight testing

13. Hearing impairment Applicants need to demonstrate a hearing performance sufficient for the safe exercise of their licence and rating privileges. Screening audiogram Speech discrimination test Flight test

14. Important hearing issues for pilots Being able to fully understand and comprehend all radio communications Ability to hear all alarms in cockpit Being able to communicate effectively with other crew members Being able to communicate effectively with passengers Ability to hear sounds of safety significance eg. In flight hearing test according to protocol if concern with hearing or use of hearing aids

15. Musculoskeletal Impairment Degenerative conditions – hands, feet, knees, spine – with pain and limitation of movement of the affected joints i.e. difficulty turning their head sufficiently to gain all round good vision as a consequence of neck arthritis

16. Musculoskeletal Impairment Partial or complete amputation of a limb Muscle weakness – usually due to nerve damage Paralysis due to spinal fracture (i.e. after helico accident)

17. Spinal cord injuries

18. Loss of sensations Loss of power Loss of bladder control (self catheterisation) Loss of bowel control (manual evacuation) Urinary infections Muscles spams Loss or autonomic control (low tolerance to Gs) 5/9/201518

19. Spinal cord injuries Cessna 152 Cessna 172 Hand control for rudder and brakes

20. Examples Pilot reported to become confused Penetrating eye injury Deaf pilot with hearing aids Weakness of left arm for pushing movements Shoulder limitation Amputee lower leg Partial paralysis of lower leg (inability to flex down the foot) Stiff ankle following fracture

21. Conclusion Functional in-flight testing is a useful assessment tool It is not a test to flight standards, rather a test of physical ability to do the task When asked to conduct such test, please liaise with CAA medics to learn about the functional concern and what answers are sought Report accordingly

22. Statement on line by www.freedomintheair.org www.freedomintheair.org “Pilots with a range of disabilities are able to fly all kinds of airplanes; for example: Cessna: 150, 172, 182, 210, 337, Cardinal, Cutlass. Piper: Cherokee 140, 180, 235, Warrior, Arrow, Six, Saratoga, Lance Beechcraft: Bonanza, Debonair, A-36, Baron, Duke. All of these planes have been successfully equipped with a hand control for pilots with reduced lower limb mobility.” 5/9/201522

23. 5/9/2015 23 More information about Pilots with Disabilities The British Disabled Flying Association - www.bdfa.netwww.bdfa.net Accessible Aviation - www.accessibleaviation.comwww.accessibleaviation.com Thirty-Thousand Feet - www.thirtythousandfeet.com/pilots.htmwww.thirtythousandfeet.com/pilots.htm Today - www.airventure.org/news/2008/3tue29/ableflight.html Citation: Disabled World News (2009-04-10) - Many times pilots with disabilities train alongside non-disabled pilots at local flying clubs: http://www.disabled-world.com/entertainment/hobby/pilots- disabilities.php#ixzz23eTWayDn http://www.disabled-world.com/entertainment/hobby/pilots- disabilities.php#ixzz23eTWayDn

24. “Suzi Duncan, creator of the Vision air hand control for pilots with lower limb disabilities, a Commercial Pilot & Flight Instructor who herself has a disability. She is a pioneer in the world of disabled aviation and our inspiration”Vision air hand control 5/9/201524