ICAO requires states to include health promotion activities in the medical assessment process, with the aim of reducing longer-term health risks. [Annex 1: 18.104.22.168] By the identification of remediable and treatable risk factors and conditions, it is possible to reduce the long-term health risks to pilots and controllers.
It is therefore a requirement that at the conclusion of the medical, DAMEs provide feedback to applicants on their health status. Advice should be given about any modifiable risk factors identified. MRS provides trend data on matters such as blood pressure and weight and should be used to support recommendations.
DAMEs are not expected to become involved in treatment (unless the applicant is also a patient), but should provide a referral for the applicant, to attend their regular treating doctor. This should explain the areas of concern.
Note: Referrals or other actions taken must be recorded at the end of the medical in MRS. It is recommended to use the MRS templates, which will ensure a record is kept and available for future applications. This is an ICAO Standard, and will therefore be auditable.