Aviation medicals

Designated Aviation Medicine Examiner/Designated Aviation Ophthalmologist
DAME Newsletter February 2001

Acknowledgment

DAMEs / DAOs should confirm receipt of this Newsletter, notating their DAME stamp number, per return email to dame.liaison@casa.gov.au Alternatively, please fax confirmation of its receipt to CASA AvMed at (02) 6217 1640.

Distribution

DAMEs / DAOs should read and digest the contents of this Newsletter, retain it for future reference, and make relevant sections of it available to locums or to other staff members who have dealings with CASA on behalf of practice principals.

ATPL medical examinations for applicants aged 40-plus

Recipients were previously notified of some procedural differences between ICAO's Standards and Recommended Practices for Aviation Personnel Licensing and CASA's equivalent practices, particularly concerning requirements for frequency of medical examinations. This matter is summarised in the DAME Handbook at Section 2.14.2.

Following extended negotiations over this matter, Qantas now requires its international pilots aged 40-plus to comply with the ICAO requirement to complete medical examinations every six months. Note that, on each occasion a medical examination and report is received from an affected pilot, CASA will continue to issue medical certificates valid for 12 months. This measure is intended purely to ensure that pilots have the correct medical certification for international operations, but does not affect operations in Australian airspace. Similarly, there is no change intended for the frequency of other routinely required investigations / reports / assessments. (This is true also for ATPL aged 60-plus, whom CASA require to have a medical examination every six months, but to have other investigations only at the frequency specified for each).

In particular, pilots aged 40-plus will continue to require only an annual ECG (ie the test will only be required at alternate examinations). Details of the date of the last ECG (and other required tests) appear on CASA's new-style medical certificates. These matters are explained in the DAME Handbook at Sections 1.2.3, 1.2.4 and 1.4.6.

The principal implication for DAMEs in all this will be the need to recertify medical fitness in ATPL applicant holders of still-current medical certificates. This should be done by signing and stamping the medical certificate in the usual way, inserting the date of the medical examination in the usual place, and printing a date two calendar months later on the line marked valid until. (CARs limit DAMEs' delegation to revalidation of medical certificates for a maximum of two months).

Reminder of DAMEs' Responsibilities under the Civil Aviation Regulations

Recipients are invited to review Section 1.1.7 of the DAME Handbook for an explanation of this matter. A long-running investigation of the practices of selected authorised examiners for another (non-Australian) Regulator has found that some of them have failed to perform their duties in an acceptable and responsible manner. This may lead to civil and possibly criminal prosecution of those concerned, and similar outcomes should be expected in Australia were similarly deficient medical reports to be received from DAMEs.

From time to time, CASA's Aviation Medicine Section receives disturbing allegations that licence holders have significant disqualifying medical conditions which certainly should be detected by means of an adequate medical examination and assessment of the applicant's history. While many of these allegations are unfounded or the result of an informant's misunderstanding of a condition or of its effects on the individual reported to CASA, the Authority must investigate each case to ensure that the safety of air navigation is not compromised. Initially, CASA routinely takes the part of the DAME in these investigations, assuming the professional competence and honesty of its delegates. Where any DAME is found to fall short of this standard, cancellation of appointment would be the expected result.

Technical matters affecting CASA Medical Examination and Questionnaire Forms

Electronic lodgement should replace the current paper-based system during calendar 2001. Meanwhile, we are forced to make do with an increasingly 'creaking' system. DAMEs can assist greatly by ensuring that the OCR images captured from the forms they submit are legible. To this end, please:

• PRINT comments / values if your penmanship has ever caused anyone difficulty;
• use BLACK ink and a HEAVY touch at all times (a number of forms have had to be returned because the blue ink used was not visible on scanned images of the forms; and
• do not write below the word 'CONFIDENTIAL' at the end of the 'Comments' section on the forms, as such entries will not be captured. (For longer entries, please provide a continuation sheet with applicant's ARN to accompany the medical form).

Future DAME Seminars

CASA has determined minimum initial and continuing educational standards for its DAMEs, in accordance with ICAO requirements. DAMEs are appointed on the basis of having received adequate initial formal training in aviation medicine, and are required to sign undertakings to participate in regular, relevant continuing educational activities. With appropriate update training more readily available from 2001, DAMEs should be aware that their participation in continuing education will be monitored and that repeated failure to meet minimum requirements, without good cause, will lead to termination of appointment.

CASA no longer has the resources to conduct the required training itself, but will continue to participate when possible in programs conducted by other organizations and will individually accredit such programs for the purpose of DAMEs' maintained currency requirements. Certain educational activities of known worth will be approved automatically, but DAMEs must ensure that CASA's Aviation medicine Section is notified of their participation.

The local seminars to be run throughout this year by Flight Medicine Systems Pty Ltd constitute a readily available means for DAMEs to meet the requirement, but available places on these courses are limited. Details are available under "training" at <www.flightmed.com.au> Forthcoming dates and locations for these are:

There will be other opportunities to ensure currency through attendance at programs run by the Aviation Medical Society of Victoria, NSW Branch of AMSANZ, the AMSANZ Annual Scientific Meeting, and so on. Details will be published periodically on the CASA website under 'Information for DAMEs and DAOs'.

Ophthalmological paper

The following recent paper from Canada's DCIEM is likely to interest DAOs and DAMEs alike, particularly with regard to counselling their affected pilots re flying after ophthalmic surgery.

Michael D.Mills et al. 'An assessment of intraocular pressure rise in patients with gas-filled eyes during simulated air flight', Ophthalmology 2001; 108: 40 - 44

New procedures for obtaining medical examination stationery

DAMEs and DAOs are reminded that the Authority has discontinued direct supply of form 97 (Medical Questionnaire and Examination Form - R), form 98 (Medical Questionnaire and Examination Form - O) and form 99 (Eye Examination Report - V). Effective immediately, DAMEs / DAOs should order required numbers of these forms directly from the supplier, who will charge for these forms.

To place orders, DAMEs / DAOs should access the CASA website's forms and manuals section and select 'order paper forms' OR J. S. McMillan Pty Ltd, Locked Bag 206, Lidcombe NSW 1825, telephone: (02) 9648 3333, fax : (02) 9648 4209.

Upgrade to Office 2000

In late February and early March 2001, CASA's software will be upgraded from Office95 to Office2000. This means that all our documents will be produced in the latest version of Microsoft Word and Excel. If your word processing software or spreadsheet software cannot read these new formats you can obtain the Word 97 - 2000 Converter from the Microsoft web site <www.microsoft.com>. This allows users who have earlier versions of Word to import documents created in either Word 97 or Word 2000

If you have queries about this, please contact the DAME Liaison Officer at dame.liaison@casa.gov.au or 6217 1624.

Additional Support for DAMEs and DAOs

Jeanette (Netty) Coan has been appointed as CASA's new DAME Liaison Officer. She can be contacted at dame.liaison@casa.gov.au by telephoning (02) 6217 1624, or by fax to (02) 6217 1640. When on-line lodgement of medical examinations begins later this year, CASA will appoint an additional DAME Liaison Support Officer within Aviation Medicine Section to assist examiners to make the transition.

Feedback

Aviation Medicine Section welcomes comments, suggestions and advice from DAMEs and DAOs. All will be carefully considered and acknowledged - such insights into the realities of aeromedical practice in "the real world" are welcomed by those of us labouring here in the Nat Cap.

2001 appears certain to be a busy year for Australian aviation medicine. I will do my best to provide frequent updates on relevant matters as they arise.

Peter Wilkins
Director of Aviation Medicine / Principal Medical Officer