Addressing Transport Canada Medical
Issues

COPA continues to support members on a case-by-case basis, helping them obtain updates on the status of their medical files when needed. While COPA cannot intervene in individual medical diagnoses or assessments, it has established a formal understanding with CAM: upon request, CAM will provide file status updates for COPA members.

At a broader level, COPA maintains regular policy discussions with CAM to support ongoing improvements within the aviation medical system. This includes monitoring efforts to modernise process, digitise records, and address internal staffing issues that affect certificate processing times. COPA is also advocating for the adoption of a medical category similar to the FAA’s “Basic Med”, to reduce internal medical processing times and remove restrictions on pilots.

The Civil Aviation Medicine (CAM) Branch is one of several branches of the Directorate General of Civil Aviation in Transport Canada. The Director of Civil Aviation Medicine reports to the Director General of Civil Aviation.

The mandate of CAM is to provide medical advice and assistance in setting out physical standards for Civil Aviation personnel; to advise in all problems connected with the health of travellers by air.

The mission is to ensure aircrew and air traffic controllers are medically fit, to close gaps in scientific knowledge of Canadian aviation medicine, to promote health and safety in the field of aviation and to prevent aircraft accidents due to medically related human factors.

There are currently four Regional offices across Canada located in Montreal, Toronto, Edmonton, and Vancouver. The Edmonton, Toronto, and Montreal offices are under the direction of a Regional Aviation Medical Officer (RAMO) while the office in Vancouver is staffed by an Aviation Medical Officer (AMO). The RAMOs are responsible for the selection and training of CAMEs, for reviewing the medical examination reports of pilots, flight engineers, and air traffic controllers, and for approving an appropriate medical category for aviation personnel.

Civil Aviation Medical Examiners (CAMEs) are appointed on the basis of need, by the RAMO or AMO on behalf of the Minister of Transport. Interested physicians apply to the CAM office in their region and are interviewed by the RAMO prior to appointment. If accepted as a designated CAME, they must await the receipt of the official letter of appointment before performing any aviation medical examinations.

A CAME may renew Medical Certificates, for the full validity period, of licensed aviation personnel for renewal medical examinations only. Initial medical reports, category upgrades and removal or addition of restrictions to a Medical Certificate must be sent to the RAMO for assessment.

All CAME appointments are valid for a period of four years, renewable upon the recommendation of the RAMO. Re-appointment will depend on the quality and timeliness of reports, demonstrated continuing interest in aviation medicine, and feedback from the aviation community. There must also be a continuing requirement for services in the CAME’s designated geographic area.

All pilots, flight engineers, and air traffic controllers must be licensed by Transport Canada, General Aviation Branch. After completing such requirements as flight training, written examinations, and flight tests, an applicant is granted a licence by the department.

Civil Aviation Medicine does not issue licences, it issues Medical Certificates (MCs).

Licences do not have a validity period, but must be validated by a current MC which has a limited duration. There are four medical categories shown on the medical certificate, each of which validates a different type of licence. The types, the required medical categories and the validity periods of the licences are shown in the Medical Examination Requirements Table.

A small percentage of applicants will have medical issues that place them outside the medical standard. In those cases, their medical information may be reviewed by the Aviation Medical Review Board. The Review Board—a group of specialists in neurology, cardiology, psychiatry, ophthalmology, internal medicine, otolaryngology and aviation medicine—meets regularly in Ottawa to review complex cases and make recommendations to the regional aviation medical officer (RAMO).

If a medical certificate is refused, suspended, cancelled or not renewed, the applicant or permit/licence holder may wish to discuss and review their medical assessment with the RAMO. Via teleconference and/or at a meeting, the RAMO will review, with the applicant or permit/licence holder, the medical information relevant to the assessment. As a general rule, the applicant or permit/licence holder may see these documents in the presence of the RAMO and ask questions concerning the content of the documents relative to the medical standards. In the case of sensitive or complicated medical information, the RAMO may elect to refer questions of a more clinical nature to the applicant or permit/licence holder’s personal physician, who can better explain the implications. In such cases, the applicant or permit/licence holder will be asked to sign a Consent to Release Form to designate a physician who will receive these reports.

The applicant or licence/permit holder may invoke the provisions outlined in the Canadian Aviation Regulations (CARs) regarding reconsideration of assessment.

CAR 404.12 states that:

“(1) An applicant for the renewal of a medical certificate who is assessed by the Minister as not meeting the requirements referred to in subsection 404.11(1) may, within 30 days after the date that the applicant receives the notification referred to in subsection 404.11(2),

(a) request the Minister to reconsider the assessment; and

(b) submit additional information to the Minister regarding the medical fitness of the applicant in support of the request.

(2) Where the Minister is requested to reconsider an assessment pursuant to subsection (1), the Minister shall

(a) take into consideration any additional information regarding the medical fitness of the applicant; and

(b) immediately notify the applicant in writing of the result of the reconsideration of the assessment.”

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