APPENDIX C

Standardized Curriculum for Designated
Aviation Medical Examiners

 

183.ac.1          In relation to the above curriculum, the following reference material is utilized

(a)    ICAO Annex 1, as amended.

(b)   ICAO Annex 13, as amended.

(c)    ICAO Manual of Civil Aviation Medicine (Doc 8984) ICAO Manual of Aircraft Accident Investigation (Doc 6920)

(d)   A standard textbook in aviation medicine

The following program could be conducted in one week at a very intensive pace.  On several occasions, it has been used as a two-week training program.

 

183.ac.2 Lecture units

(a) Introduction; course organization and curriculum:

(1) Human factors in the aviation system; responsibility of the designated medical examiner in air safety;

(2) Aviation medicine: history and evolution;

(3) International and national regulations: Chicago Convention - Annex 1; and

(4) ICAO Manual of Civil Aviation Medicine: origin, objectives and contents.

(b)Medical requirements:

Basic principles in the assessment of fitness for aviation duties:

(1)  General medical requirements;

(2)  Physical and mental requirements for licenses;

(3)  Visual requirements for licenses;

(4)  Color perception requirements for licenses;

(5)  Hearing requirements for licenses;

(6)  Aviation physiology; basic principles;

(7)  Operational and environmental conditions;

(8)  Barometric pressure; hypoxia: hypobaria; decompression, pressurization;

(9)  Accelerations; basic principles: effects on human beings; and

(10)      Respiratory system; Annex I requirements; assessment of applicants with respiratory problems; lung infections; tuberculosis; post-surgical conditions; asthma and its treatment.

(c) Cardiovascular system; basic principles of cardiovascular physiology:

(1)   Relation to aviation duties: risk of sudden incapacitation;

(2)   Examination procedures: laboratory and special examinations;

(3)   Specific cardiovascular conditions: hypertension and its treatment;

(4)   Ischemic heart disease: ECG findings;

(5)   Angina pectoris;

(6)   Assessment of satisfactory recovery from myocardial infarction;

(7)   Cardiomyopathies: pericarditis; rheumatic heart disease;

(8)   Arrhythmias; conduction defects; and

(9)   Congenital heart disease: post-surgical conditions.

(d) Digestive system; basic principles:

(1)     Abdominal pain; gastrointestinal and biliary post surgical conditions;

(2)     Gastritis; uncomplicated peptic ulcer and its treatment; complications: recurrence, bleeding and perforations;

(3)     Biliary tract disorders;

(4)     Pancreatitis;

(5)     Irritable colon; and

(6)     Hernias.

 (e) Endocrine diseases; hyperthyroidism; hypothyroidism:

(1)    Pituitary Disease: anterior pituitary; growth hormone.  Posterior pituitary: diabetes insipidus; Addison's Disease: phaeochromocytoma;

(2)    Diabetes mellitus: basic principles; definitions; aetiology; symptomatology;

(3)    Diagnostic criteria;

(4)    Glucose tolerance tests;

(5)    Classification;

(6)    Anti-diabetic therapy;

(7)    Operational aspects in aviation;

(8)    Licensing considerations; and

(9)    Satisfactory control criteria for aviation duties.

(f)   Hematology; polycythaemia; anaemias, leukaemias; lymphomas:

(1)   Platelet disorders;

(2)   Haemoglobinopathies; geographical distribution; classification; sickling conditions; and

(3)   Assessment of medical fitness for aviation duties.

(g)  Urinary system; basic principles; risk of sudden incapacitation; urine findings; haematuria; albuminoidal:

(1)  Nephritis; pyelonephritis; obstructive uropathies; and

(2)  Tuberculosis.  Lithia sis: single episode; recurrence; post-surgical conditions.

(h)  Gynecology-obstetrics; basic principles; performance of aviation duties:

(1)  Risk of sudden incapacitation;

(2)  Menstrual disorders;

(3)  Pregnancy and aviation duties; and

(4)  Abortion.

 (i)  Mental fitness and neurological disorders:

(1)  Assessment of mental fitness for aviation duties;

(2)  Normal mental development; psychological testing of intelligence and personality;

(3)  Psychiatric disorders in aviation personnel: neurosis; personality disorders; psychosis; organic mental illness;

(4)  Diseases of the nervous system; inflammation; intoxication; vascular diseases; tumors; head trauma; post-traumatic states; disturbance of consciousness; epilepsy; and

(5)  Electro-encephalography in aviation medicine.

(j)    Tropical diseases; basic principles; general sanitation; diseases transmitted by vectors; food and water-borne diseases; parasitic diseases.  Hygiene and sanitation in relation to aviation; prevention of spread of diseases; disinfections of aircraft; vaccination; general health principles; food poisoning; incapacitation; catering services; food, water.

(h)   Oto-rhino-laryngology; the external ear; the tympanic membrane; the middle ear.  Post-surgical conditions. The vestibular system; hearing assessment; audiometric; nose and Para-nasal sinuses; pathological conditions; special testing on the ENT system.

(i)     Ophthalmology; examination techniques; visual acuity assessment; visual aids; visual fields; ocular muscle balance; assessment of pathological eye conditions; glaucoma; color vision.

(j)     Cockpit crew fatigue; flight duty time; flight time limitation; circadian rhythms.  General health status; basic principles; operational and environmental conditions.

(k)   On-duty incapacitation; Sudden; subtle; complete; partial; medical aspects; operational aspects.

(l)     Flexibility, waivers; Consideration of knowledge, skill and experience; trained versus untrained crews; medical flight test.

(m) Accident investigation and prevention; The human factors aspect; the role of the medical examiner; identification of the victims; determination of the causes, circumstances and events.

(n)   Hazards of medication and drugs in aviation medicine.

(o)   General course revision; appraisal and evaluation.