CASA CLASS 5 Medical self-declaration - from 9 FEB 2024

[thunderbird five]

https://www.casa.gov.au/licences-and-certificates/aviation-medicals-and-certificates/class-5-medical-self-declaration#Eligibility
Online applications will open 9 February 2024
There's an online course to do via Aviationworx.
Let's see who gets the first one and how long it takes. I'll be there.

Pleasantly surprised Update Thurs 5pm 8th Feb.
The course is there, and I've just done it. It takes about an hour. Have not completed the assessment part just yet.
So congrats to CASA for actually coming through with the required course, on time.

Update - later on 8th Feb.
Completed the online quiz - carefully, I got 100%. Took just under an hour to go through it carefully.
It's not super complicated, it is 100% possible to get 100% first go. DON'T GUESS the answers, prove them to yourself, it is 100% possible.

Good luck folks. I shall apply for my Class 5 tomorrow. I will report back again on how it goes. I might even dial in at 12:01am! Nah- screw that.

UPDATE 9 FEB:
I HAVE MY CLASS 5 MEDICAL CERTIFICATE!
I honestly did not think I would ever see this, at all, let alone so early into this year.
Congrats to CASA, a small step in the right direction.

[Aussie Bob]

Of course there’s a course. How uniquely Australian. There’s an effing course for just about everything. What could possibly be in this course? Oh wait, ai forgot, simple **** everyone knows anyway.

I mean really?

[Clinton McKenzie]

In fairness to CASA, the US BasicMed system includes a course and quiz, after which the candidate has to complete and submit a form to the FAA.

But US BasicMed allows up to 6 POB (including pilot), MTOW of 6,000 pounds and IFR...

[Possum1]

"The fact that Australia is the first jurisdiction where pilots will not have to see a doctor or medical practitioner made it difficult to find comparative data on the likelihood of impairment or a related accident." - CASA Briefing February 2024. Why is Pip Spence and CASA continuing to lie about this "fact"?

[PiperCameron]

In fairness to CASA, the US BasicMed system includes a course and quiz, after which the candidate has to complete and submit a form to the FAA.

But US BasicMed allows up to 6 POB (including pilot), MTOW of 6,000 pounds and IFR...

The FAA BasicMed system also requires a physical exam with a state-licensed physician, using the Comprehensive Medical Examination Checklist, hence, to me, seems more closely aligned with the existing Class 2 Basic.
https://www.faa.gov/licenses_certificates/airmen_certification/basic_med

Class 5 requires no check-up with any medical professional of any kind - not even a GP! I realise that's the same as RAAus, but isn't this a step too far? Perhaps designed to fail so CASA can say to GA in general "we gave you what you asked for and look what happened!"??

[PiperCameron]

"The fact that Australia is the first jurisdiction where pilots will not have to see a doctor or medical practitioner made it difficult to find comparative data on the likelihood of impairment or a related accident." - CASA Briefing February 2024. Why is Pip Spence and CASA continuing to lie about this?

Maybe because (a) it's true and (b) no other country would be so stupid as to not require at least a check-up by a doctor every year or five?

[Possum1]

UK CAA Pilot Medical Declaration.

[Clinton McKenzie]

Possum1 is correct.

My view is that the UK PMD system is currently better than US BasicMed. UK PMD is, in essence, a declaration that the pilot reasonably believes that the pilot meets the medical requirements for a Group 1 (Car) licence. The pilot doesn't even have to be the holder of that licence.

We're so "stupid" as to not require at least a check-up by a doctor every year or five to hold a driver's licence in Australia. We all need to try harder not to pretend that being an ordinary pilot is so special as to require 'special' medical requirements. There are always bureaucrats standing by to help in that regard.

[PiperCameron]

Possum1 is correct.

My view is that the UK PMD system is currently better than US BasicMed. UK PMD is, in essence, a declaration that the pilot reasonably believes that the pilot meets the medical requirements for a Group 1 (Car) licence. The pilot doesn't even have to be the holder of that licence.

Well, Class 5 doesn't even require that:
The new scheme allows many private and recreational pilots to self-assess and self-declare without the need to see a doctor. We believe our Class 5 medical self-declaration scheme sets a new benchmark in terms of trusting pilots to decide on their own fitness without seeing a doctor. This represents an innovative step towards streamlining the medical certification process, and we are dedicated to ensuring that the scheme is robust, equitable and reflective of the community's needs.

Class 5 webpage (https://updates.communication.casa.gov.au/link/id/zzzz65c1858676688778Pzzzz5f6d2a99ae654955/page.html).

[Emphasis mine] That's like trusting a truck driver to not be sleep-deprived and high on drugs before he crashes, killing four police officers... but never mind. Let's go!

[Cloudee]

Well, Class 5 doesn't even require that:


[Emphasis mine] That's like trusting a truck driver to not be sleep-deprived and high on drugs before he crashes, killing four police officers... but never mind. Let's go!
WTF has that got to do with assessing yourself before flying? It’s what you do now except you don’t have go to a doc every few years. Works perfectly well for RAAus and gliding and they don’t have to do a course.

[Rec aviator]

"The fact that Australia is the first jurisdiction where pilots will not have to see a doctor or medical practitioner made it difficult to find comparative data on the likelihood of impairment or a related accident." - CASA Briefing February 2024. Why is Pip Spence and CASA continuing to lie about this "fact"?
Maybe the scrip writers who produce her "briefings" are setting her up to fail? She won't be the first!

[Mach E Avelli]

I'm with Piper on this issue. If you have nothing to hide you have nothing to fear (though if CASA Avmed can be kept out of the process, there would be less to fear). What's wrong with seeing a GP every couple or so years to run a basic assessment and issue a piece of paper to insert in your licence?
Seeing a GP occasionally may even identify an issue that could ultimately prolong your life.
I would also be quite comfortable with all road users having to do a basic medical for intitial issue of a drivers licence and another medical examination at some later stage in life. Where I live we don't even do an eyesight test at age 80, which is all in the name of 'no age discrimination'. I am rapidly approaching that age, and right now my eyesight is borderline Class 2 medical standard, which means it's also marginal for driving, so I am getting it fixed at considerable expense. Many drivers don't, because the law does not mandate a test, and so put others at risk every time they are on the road.
Same with some pilots - if they are not compelled to do something, they'll go into denial mode. With these types the whole 'self assessment' thing is a crock.
The first time some fat fool concealing or unknowingly having a medical condition carks it in flight and takes his grandkids out with him, or plows into the local school, CASA will scrap this and serve up something we really won't like.

[Clinton McKenzie]

That's like trusting a truck driver to not be sleep-deprived and high on drugs before he crashes, killing four police officers... but never mind. Let's go!So are you saying that:

(1) the truck driver was not the subject of any compulsory periodic medical examination requirements, and

(2) if the truck driver had been subject to compulsory periodic medical examination requirements, the accident wouldn't have happened?

My understanding is that it's possible for a person who's been medically examined and certified as complying with a medical standard to be "sleep-deprived and high on drugs" a week after certification. Or the week after that. Or a day after that.

I do hope that those advocating for compulsory, periodic medical examinations are not so hypocritical as to take the risk of flying in Class G. There are plenty of 'self declared' pilots flying in G already - well, for decades actually - and they could be "sleep-deprived and high on drugs". (Don't tell anyone, but the same applies in some Class D.)

[43Inches]

[Emphasis mine] That's like trusting a truck driver to not be sleep-deprived and high on drugs before he crashes, killing four police officers... but never mind. Let's go!

There's been several cases of class one holders testing positive to drugs, alchohol and I can say many pilots have flown fatigued just to 'get home' or 'get the job done'. I know several class one holders that have had cardiac events within months of having ECGs. Class one medicals do nothing to stop these events they only control what happens afterwards once the case is known. Which is usually after the problem is solved so AvMed need not get involved. Heavy vehicle drivers are under the same scrutiny, you have to notify your local licence issuer if you have certain conditions and they will possibly notify you of licence cancellation until certain tests are complete. If you drive with a known prohibited condition you will be punished heavily and if someone dies as a result you will be charged with manslaughter. It's just with pilots you have to notify AvMed of your condition or you can choose to hide it and hope your medical professionals don't dob you in.

What stops a airline pilot flying severely affected by drugs or alchohol, not just damp, but the multitude of other people they have to work with who will notice the condition. What stops an outback Chieftain freight pilot from the same, nothing, the same as the truck driver.

The best person to assess your medical fitness is YOU!

The rules should be self certification with heavy penalties for not following disclosure rules.

There's only one area I disagree with full self certification and that is fatigue, as airlines can weasel the rules to make it difficult and almost punitive to use fatigue leave. So the rules need to be tight around mandatory rest periods and lengths of duty. FRMS as it is is a joke, compared to truck driving duty limits.

PS, just remember every time you take that overtime payment and extend into overtime tired, that data is captured by your companies FRMS which then extends the parameters by which they can roster you. Every time you call in fatigued within a normal roster cycle it shrinks the parameters. So doing lots of overtime tired is really going to count against you in the long run, so think about how much that OT is really worth over a long career.

[mustafagander]

i have many doubts about whether any organisation is likely to allow their aircraft to be hired by a pilot with essentially no medical clearance at all. I think it highly unlikely that any insurer would approve.

[Cloudee]

i have many doubts about whether any organisation is likely to allow their aircraft to be hired by a pilot with essentially no medical clearance at all. I think it highly unlikely that any insurer would approve.
Really? RAAus schools have been doing that for over 40 years, and gliding clubs for even longer. Insurers go by the stats and the stats don’t show RAAus aircraft and gliders falling out of the sky due to medical issues.

[Clinton McKenzie]

Meanwhile, the UK CAA has just finished consulting (https://www.helihub.com/2023/11/10/uk-caa-proposes-changes-to-pilot-medical-declaration-system/) on proposals to further simplify its Pilot Medical Declaration system. That system was introduced in 2016. Insurance has been a non-issue.

[Xeptu]

I think the biggest overlooked problem today is blood pressure medication. The very first thing to go is sensitivity in your feet. I am in no doubt that this medication is responsible for the wrong pedal, too much accelerator events we are experiencing almost every day and at an age we wouldn't normally expect that to occur.

[Possum1]

"The new scheme allows many private and recreational pilots to self-assess and self-declare without the need to see a doctor. We believe our Class 5 medical self-declaration scheme sets a new benchmark in terms of trusting pilots to decide on their own fitness without seeing a doctor. This represents an innovative step towards streamlining the medical certification process, and we are dedicated to ensuring that the scheme is robust, equitable and reflective of the community's needs."

"Many private and recreational pilots" are still weasel words if they are not going to permit pilots who may have had their Class 1,2 or 3 medical cancelled in the distant past to participate in this scheme, which, as the Technical Working Group pointed out to CASA last year, the Class 5 medical standard is a different standard to the Class 1,2 or 3 medical. It follows that someone who cannot pass the Class 1, 2 or 3 medical may easily qualify for a Class 5. It also follows that a pilot's health situation may have improved in the years since his medical was cancelled.

"... we are dedicated to ensuring that the scheme is ... equitable ..." Oh, really?

[PiperCameron]

What stops a airline pilot flying severely affected by drugs or alchohol, not just damp, but the multitude of other people they have to work with who will notice the condition. What stops an outback Chieftain freight pilot from the same, nothing, the same as the truck driver.

The best person to assess your medical fitness is YOU!

The rules should be self certification with heavy penalties for not following disclosure rules.

There's only one area I disagree with full self certification and that is fatigue, as airlines can weasel the rules to make it difficult and almost punitive to use fatigue leave. So the rules need to be tight around mandatory rest periods and lengths of duty. FRMS as it is is a joke, compared to truck driving duty limits.

Exactly. So if self-declared Class 5 medicals become a thing and are deemed by all to pose no risk to safety vis-a-vis Class 1 and 2 then what's the point of seeing a DAME over your local GP? And why not get rid of the Avmed oversight and ditch Class 1 and 2 altogether?

Shouldn't Class 2 Basic be good enough to cover commercial ops and let everyone else go free??

[43Inches]

Exactly. So if self-declared Class 5 medicals become a thing and are deemed by all to pose no risk to safety vis-a-vis Class 1 and 2, why involve Avmed at all and ditch Class 1 and 2 altogether?

Shouldn't Class 2 Basic be good enough to cover commercial ops and let everyone else go free??

Softly, softly catch a monkey... Can't expect the beast to roll over in one sitting and give up all it's power.

[Clinton McKenzie]

Apart from astronauts, fighter pilots and (maybe) aerobatic pilots, there’s nothing special about ordinary pilots that cannot be comprehended and dealt with by a competent GP. AvMed has created its own faux speciality and club, off the back of ICAO and the cognitive bias of average members of the public.

Objective data is slowly prevailing over damaging AvMed overreach, but there are plenty of egos and pockets milking aviation medical certification. The path to enlightenment continues to be a long, expensive and stressful slog.

(I was looking again at ICAO Annex 1 Chapter 6 (medical requirements) the other day and was reminded of gems like paragraphs 6.3.2.6.1, 6.4.2.6.1, 6.5.2.6.1, which say for class 1, class 2 and class 3 respectively:Electrocardiography shall be included in re-examination of applicants after the age of 50 no less frequently than every two years. I’m sure there remain zealots out there who would love to inflict that requirement to the letter in Australia, but fortunately the objective data has (mostly) prevailed.)

[43Inches]

I think the biggest overlooked problem today is blood pressure medication. The very first thing to go is sensitivity in your feet. I am in no doubt that this medication is responsible for the wrong pedal, too much accelerator events we are experiencing almost every day and at an age we wouldn't normally expect that to occur.

There's several types of medication for blood pressure, with several different mechanisms of operation. If you are getting side effects like loss of sense ask your GP for a change.

[gupta]

https://www.casa.gov.au/licences-and-certificates/aviation-medicals-and-certificates/class-5-medical-self-declaration#Eligibility
Online applications will open 9 February 2024
There's an online course to do via Aviationworx.
Let's see who gets the first one and how long it takes. I'll be there.

Update 4pm:
Is the CASA online course in Aviationworx available today? NOPE. "Course currently under development"
Will it be there ready to go on Friday? I say "not a chance in hell."
I'll be back here early Friday.
I've just done the online course (successfully thank god) so go for it

[PiperCameron]

I've just done the online course (successfully thank god) so go for it

Having completed the course, are you sure you're safe to fly?!? No high blood pressure? Anxiety?? Profuse sweating during the test??

Maybe you need to see a GP.. or I'm sure there are a bundle of under-appreciated DAMEs out there who would be happy to charge you a bucket-load of your hard-earned instead. :E

[cogwheel]

Where are these listed:
Does not have any of the listed excluded conditions.

[mcoates]

Someone told me the answers were more accurate on Google than Chat GPT.

[Mach E Avelli]

Where are these listed:
There’s 142 pages just published by CASA entitled Guidelines - Medical Assessment for Aviation. Most of it is devoted to exclusions.
One of the obvious is dementia, with a comment that someone with dementia may not realise that they have it. So, how could such an unfortunate pilot self declare fitness to fly?
An observant GP would pick that up in a short conversation.

[43Inches]

There’s 142 pages just published by CASA entitled Guidelines - Medical Assessment for Aviation. Most of it is devoted to exclusions.
One of the obvious is dementia, with a comment that someone with dementia may not realise that they have it. So, how could such an unfortunate pilot self declare fitness to fly?
An observant GP would pick that up in a short conversation.

In theory you could develop symptoms of dementia 10 seconds after you walk out of your class 1/2 medical and for the next year or two be self certifying fit to fly with dementia as well. That goes for most medical conditions. Pilots already self certify on a daily basis, it's just every one or two years AvMed has to issue a piece of paper saying they took a 5 minute look at some papers and found you fit in that space of time.

BTW I know of at least one pilot who was flying with dementia, class one medical and chief pilot. It took several months of reports and a lost airplane (he forgot where he left it) to get his medical pulled.

[Clinton McKenzie]

Among the many illogical aspects of an endeavour that should be driven by pure logic and cold data is the assumption that compulsory medical examinations are the primary way in which risks caused by medical conditions are 'trapped' and, conversely, that having identified some 'exclusionary' condition in a person, the person is somehow prevented from flying. How is someone with dementia capable of remembering and carrying out all of what's necessary to commit aviation? Assuming someone with dementia has enough remaining capacity to be dangerous, how does identifying their condition (and even revoking their medical certificate if they have one) of itself stop the person doing dangerous things with aircraft?

The substantive 'trap' for risks caused by medical conditions is personal responsibility and checking and training and flight reviews and colleagues and family and friends and other contextual factors. An observant GP would indeed pick up a patient with dementia in a short conversation, but in most cases the GP (or DAME) will be the last person in the patient's life to find that out. In circumstances in which those contextual factors are lacking, no medical examination or certificate revocation is going to stop someone from flying if they are minded to, whether due to demented confusion or clear headed intent. There are people who go flying, deliberately, without the medical certificate required by law. Most of them survive, and the ones that don't survive usually spear in through a lack of competence rather than some medical condition.

[43Inches]

Yep, a dementia sufferer could simply forget they have no medical and go flying in their own airplane even with mandated medicals. If you were to tighten medical requirements because of the extremely rare events of non compliance, then you end up like speed limits. That is, a stretch of road has several high speed accidents where cars traveling in excess of 200kph crash and cause deaths, so the limit is reduced from 100kph to 80kph. Will that have any effect on the road toll, no, because if the rate of excessive speeders remains the same on that stretch there will still be accidents. Or totally unrelated the excessive speeders may have already killed themselves so a reduction of deaths occurs on that stretch with no relation to the limit.

[Clinton McKenzie]

My primary concern with the current class 1 and 2 certification systems is the perverse incentive not to tell CASA anything or - worse - not to seek medical advice when in doubt, for fear of CASA's damaging overreaction if it finds out. Ms Spence said, straight-faced to a Senate Committee, that she believes no such incentive exists. Her PMO is aware of studies of thousands of pilots that demonstrate otherwise.

[PiperCameron]

Yep, a dementia sufferer could simply forget they have no medical and go flying in their own airplane even with mandated medicals. If you were to tighten medical requirements because of the extremely rare events of non compliance, then you end up like speed limits. That is, a stretch of road has several high speed accidents where cars traveling in excess of 200kph crash and cause deaths, so the limit is reduced from 100kph to 80kph. Will that have any effect on the road toll, no, because if the rate of excessive speeders remains the same on that stretch there will still be accidents. Or totally unrelated the excessive speeders may have already killed themselves so a reduction of deaths occurs on that stretch with no relation to the limit.

The difference being that reducing the speed limit in the above example actually does achieve something: it makes someone somewhere feel good that they've (a) recognised the problem and (b done something about it. Maybe not anything useful and probably pissed a whole lot of people off in the process.. but they've done something nonetheless.

[43Inches]

My primary concern with the current class 1 and 2 certification systems is the perverse incentive not to tell CASA anything or - worse - not to seek medical advice when in doubt, for fear of CASA's damaging overreaction if it finds out. Ms Spence said, straight-faced to a Senate Committee, that she believes no such incentive exists. Her PMO is aware of studies of thousands of pilots that demonstrate otherwise.

That is the main problem, I could think of a great deal of pilots I've known over the years that have kept details from AvMed, some with grounding medical conditions, or at least would require thousands of dollars of tests to prove what we all know just by working with them, that they are 100% safe. I think the answer to alcohol and sleep questions is probably fudged on 90% of forms, or the other stupid questions that no one would ever answer yes to, but most of us, if not all have done.

[Clinton McKenzie]

Before every medical renewal I anticipate that something new and crazy will come out of ‘left field’ and, true to form, AvMed delivered again: The new question about the applicant’s ethnicity.

When CVDPA met with CASA to discuss AvMed’s return to the dark ages on colour vision deficiency, we touched on the unrelated issue of the ethnicity question. The PMO said that the question was about the assessment of the applicant’s cardio-vascular disease risk – ironically, another ‘CVD’ – and that the question was voluntary. When I asked what the consequences would be to the assessment if an applicant chose not to answer, I don’t recall getting a precise answer.

Last Tuesday I went to the DAME for my medical certificate renewal examination. At the point at which the DAME asked the new ethnicity question in the MRS, I said:

“I find that question offensive. What if I don’t answer it?”

The DAME said:

“Then we can’t finish the questionnaire and renew your certificate.”

There was nothing on the MRS screen stating or even hinting that the question is voluntary. And given that there was nothing on the MRS screen to that effect, it’s unsurprising that there was also nothing about the implications of not answering.

I am therefore not surprised at the DAME’s interpretation in the circumstances. The DAME proceeded to guess my ethnicity and answer the question for me.

The answer to the question, or a non-answer, must affect CASA’s assessment of the applicant’s cardio-vascular disease risk, otherwise asking the question would be a nonsense. In short, CASA will assess otherwise identical applicants (age, sex etc) as having different cardio-vascular risks on the basis of ethnicity alone. Therefore, the outcome must be that some applicants will, for example, be required to undergo tests that otherwise identical applicants would not be required to undergo, because of the applicant’s ethnicity.

My amateur research of Australian aviation accident and incident data does not indicate that pilots of particular ethnicities had a higher rate of accidents or incidents due to undetected cardio-vascular disease in the many decades before the ethnicity question was added to AvMed’s questionnaire. My amateur research of studies of cardio-vascular disease risk indicate that there are no biological differences between different ethnicities which cause different cardiovascular disease risk. There’s a correlation, because in many societies ethnic minorities end up in deprived socio-economic circumstances – unemployed, bad diet, substance abuse, inadequate or no medical care – which circumstances are the actual cause of cardiac disease. I’ll leave all that to the Australian Human Rights Commission to consider.

Meanwhile, my FOI request for access to documents recording how the different answers to the ethnicity question affect CASA’s assessment of applicants’ cardio-vascular disease risk returned no documents. Presumably the MRS was changed on ‘a nod and wink’, just like there’s no record of the decision - or of the implementation of the decision - to delete the offensive material from the appalling and now disappeared AvMed Form 420 about ASD and ADHD.

And just like there’s no record that CASA can find of the CAD ever having been determined as a ‘third tier’ colour vision test by someone with the power to do that, despite the CAD being used to destroy careers and career aspirations for years. The CAD has now been disappeared as a purported ‘third tier’ test, with no replacement, which means CASA is now preventing applicants with colour vision deficiency from complying with the CASRs which prescribe the means by which compliance with the colour vision criterion in the medical standard must be demonstrated. Read that twice: CASA is now preventing people from complying with CASR, by not doing its one job on CVD, which is to determine one or more tests that simulate an operational situation for the purposes of CASRs 67.150(6)(c) and 67.155(6)(c).

CASA’s response to my FOI request also revealed that the decision to add the ethnicity question was not made by any individual but was instead the “consensus” of senior medical officers at their annual group hug. There’s a novel approach to regulatory decision-making: Have a vote.

You couldn’t make this stuff up. But it’s what happens when regulatory authorities are left to their own devices for decades.

[mullokintyre]

What if you identify as Chinese, and female even if your ethnicty is actually Inuit and you were born a biological male and have had no hormone treatment nor surgery?
Can the DAME override your choice of ethnicity and gender?
So many ethical and moral questions to ponder.
Not sure if I can cope.
Mick

[Clinton McKenzie]

You'd have to ask CASA, but don't expect an answer.

In the wake of the addition of the ethnicity question, I wrote to CASA and asked: Given the legion of studies which have produced data showing that sexual minority groups are at greater risk of suicidality than heterosexuals, when will CASA add questions about an applicant’s sexual preferences and gender identity to the medical certificate application questionnaire?The AvMed questionnaire is, after all, supposed to be about safety risk assessment, isn't it?

Unsurprisingly, silence continues to be the stern reply.

And for the record, my view is that those questions, and the ethnicity question, are offensive, unnecessary and probably unlawful if - as seems to be the inevitable consequence of the different answers to the ethnicity question - otherwise identical applicants are assessed as having different cardio-vascular disease risks and subjected to different testing requirements/certificate conditions/refusal to certify because of the applicants' different answers to the question.

[Hoosten]

Class 5 requires no check-up with any medical professional of any kind - not even a GP! I realise that's the same as RAAus, but isn't this a step too far? Perhaps designed to fail so CASA can say to GA in general "we gave you what you asked for and look what happened!"??

So what are you going to say when it doesn't fail?? Besides the fact that CASA would NEVER give the industry something for nothing and wait for it to fail so they could take it back.

​​​​​​​That's like trusting a truck driver to not be sleep-deprived and high on drugs before he crashes, killing four police officers... but never mind. Let's go!

​​​​​​​You need to loosen the grip a little mate.

[43Inches]

Meanwhile overseas. UK PMD allows you to self certify in aircraft up to 5700kg (additional restrictions for above 2000kg) and carry up to 3 passengers (4 on board). USA BasicMed allows self certification up to 2700kg and 5 passengers (6 on board). And we argue about the pittance that CASA/AvMed throw at us as possibly being to loose? Again another example of Aussies making life hard for themselves, when places like the USA with an aviation industry size and density so far higher than us it's just pathetic how tight our laws are.

[thunderbird five]

There's another insidious thing or seven in CASA medicals Clint, more "do not pass go, do not collect $200":

Applicant's declarations: I authorise:
1. CASA to seek medical information in relation to me from any medical practitioner who has treated me, from medicare health records, and so on.
There is no option to proceed with your application without agreeing to this. Is that some sort of blackmail or coercion?
And what happened to Doctor-patient confidentiality?
I'm sure if any doctor was asked by CASA "giz a look at their file" would say - "you know what, how does NO sound?"
I'm sure the Dr would ask your consent to hand it over first, to which you'd say "you know what, how does NO sound?"
What happens then? Or if the doctor says sure CASA, but let me prepare an estimate for you, or, MY costs will be $300 an hour to do this for you, (seek patient permission) with a minimum 4 hours payable. Cash or Card?

And the next one:
All information provided by me in this application is true and correct and that I have read and understood the Guidelines – Medical Assessment for Aviation and the operational limitations.
These guidelines are 142 pages long and the only ethnicity mention (but not by that word) is the acknowledgement of country.
I very much doubt declaring your "ethnicity" is a criteria within CASR Part 67. Just like declaring your height and weight isn't in there either (last time I looked).

[Mach E Avelli]

There's another insidious thing or seven in CASA medicals Clint, more "do not pass go, do not collect $200":

Applicant's declarations: I authorise:
1. CASA to seek medical information in relation to me from any medical practitioner who has treated me, from medicare health records, and so on.
There is no option to proceed with your application without agreeing to this. Is that some sort of blackmail or coercion?
And what happened to Doctor-patient confidentiality?
I'm sure if any doctor was asked by CASA "giz a look at their file" would say - "you know what, how does NO sound?"
I'm sure the Dr would ask your consent to hand it over first, to which you'd say "you know what, how does NO sound?"
What happens then? Or if the doctor says sure CASA, but let me prepare an estimate for you, or, MY costs will be $300 an hour to do this for you, (seek patient permission) with a minimum 4 hours payable. Cash or Card?

And the next one:
All information provided by me in this application is true and correct and that I have read and understood the Guidelines – Medical Assessment for Aviation and the operational limitations.
These guidelines are 142 pages long and the only ethnicity mention (but not by that word) is the acknowledgement of country.
I very much doubt declaring your "ethnicity" is a criteria within CASR Part 67. Just like declaring your height and weight isn't in there either (last time I looked).
Which sums up perfectly why we would be better off with ABSOLUTELY NO CASA Avmed involvement but instead have CASA accept that a pilot could be examined and certified fit by a GP. It’s good enough for certain commercial road transport and maritime tickets. The State and National authorities of those sectors don’t question GPs but trust in their integrity.
Instead we still have CASA’s hands all over this.
I am reminded of that ancient Chinese curse: “Be careful what you wish for….”

[Sandy Reith]

C5, perhaps the most stupid ‘reform’ you could imagine, is based, according to Ms. Spence, on the success of RAAUS 40 years no problem. No mention of GFA 70 yr plus.

And she says it’s a ‘world first?’ How can you quote 40 yr RAAUS, currently c. 10,000 members, with no medicals to justify your ‘world first?’

It beggars belief.

Next look at 2000kg, you can fly your early model (just under 2000kg) C337 but not the later models just over. Seneca 1 but not the later model Senecas. Beech twin TravelAir but not your Baron, nearly identical systems.

But then really blow your mind you own a four or six seater and you can only carry 2POB. Why? Because RAAUS doesn’t crash due medical incapacitation and that must surely be due to only having 2POB.

By the way your four and six seat aircraft are less useful and therefore to some extent devalued.

This really is all so logical as long as you don’t think about it.

More ramifications for GA :- disincentive for IFR training and IFR X-country flights therefore more VFR into IMC accidents. Less work for instructors and flying schools, less experience in the safest form of flying which is the IFR environment.

Similarly C5 bans formation flying and aerobatics, again disincentive to improve skills.

And according comment here CASA require to access all you medical records. Question, what about human rights to privacy? Can ‘Big Brother’ ever be satisfied? Imagine all your records, over maybe 60 years, and allowing AVMED to troll through the lot. It’s obscene and there’s zero evidence that aviation specific medical examinations make one iota of difference to the safety of flight. Yes you might have instance of medical help to an handful of individuals.

The previous ‘reform,’ the C2 Basic was supposed to be the answer to the USA’s BasicMed. Read the fine print and note that ‘unconditional’ heavy commercial vehicle means that you can drive a truck load of avgas through any city on your conditional truck licence but not fly your Cessna privately with a Basic C2.

That makes sense doesn’t it? My head is being done in again.

If medical incapacitation is such a threat why not at least the same treatment to the drivers of motor vehicles? Surely we are all at far more risk on our crowded roads than flying over mostly sparsely populated areas?

You have to be disgusted at what CASA has done to GA, I’ve watched hundreds of flying schools and charter operators go out of business Australia wide. I see airline pilots come in on 457 visas. Aviation engineering and manufacturing go O/S and thousands of Aussie pilots squeezing into 600kg AUW RAAUS aircraft, not because those aircraft are suited to Australian conditions, but because there’s no AVMAD medicals.

Yes I know that RAAUS is going up to 760kg and it would be better not to have the weight and administration split, the whole lot should be through a Department of Government which follows the democratic principle of responsible government in the Westminster system.

[mikewil]

I see airline pilots come in on 457 visas. Aviation engineering and manufacturing go O/S .

Not to mention that hundreds maybe thousands of qualified Australian pilots are heading to the USA because the American system values their skills. The fact that we have airline pilots brought in on 457 visas while Australia is hemorrhaging pilots to the USA is utterly disgusting. Whenever we have airlines crying about "pilot shortages" in the media, someone ought to rebut them with this inconvenient truth.

[Clinton McKenzie]

Applicant's declarations: I authorise:

1. CASA to seek medical information in relation to me from any medical practitioner who has treated me, from medicare health records, and so on.Among the reasons for that are:

(a) We are all presumptive liars so far as CASA AvMed is concerned. I am aware of cases in which medical practitioners involved in Basic Class 2 have been called by CASA AvMed to check whether the candidate had told the medical practitioner about some particular issue which CASA AvMed considered to be some dreadful risk.

(b) CASA AvMed wants to be in a position to second guess everyone, because CASA AvMed has grandiose delusions of superior expertise. (CASA AvMed has been encouraged in these delusions, through the CASA executive's failure to impose adequate governance around AvMed's activities.)

There is no option to proceed with your application without agreeing to this.One of many examples, in the CASA AvMed system, of involuntary 'consent'.

[Sandy Reith]

Pilot health would improve markedly through lack of stress if AVMED was abolished. Car driver standard is sufficient.

Safety of commercial flight would, if anything, improve due to increased competition by virtue of ease of entry and lower cost of training if the CASA regulatory environment was better standardised to the USA, logical, timely and at lower cost.

Reform can only happen if CASA is moved into a Department of Government.

[Clinton McKenzie]

Pilot health would improve markedly through lack of stress if AVMED was abolished. Car driver standard is sufficient.

Safety of commercial flight would, if anything, improve due to increased competition by virtue of ease of entry and lower cost of training if the CASA regulatory environment was better standardised to the USA, logical, timely and at lower cost.In my opinion the primary reason for the substantial improvement in safety would come from pilots being more willing to have more frequent and frank discussions with medical professionals, without the fear of damaging AvMed overreactions.

Reform can only happen if CASA is moved into a Department of Government.Not the solution in the current socio-political context, IMO.

[Clinton McKenzie]

On the issue of 'consent', I've complained to the OAIC about CASA's use of our sensitive medical information in studies. (You know that we 'acknowledge' that it happens each time we complete our medical applications/renewals/examinations, don't you.) CASA says it's allowed to do that, because the information is 'deidentified'.

I made an FOI request for access to documents showing CASA's procedures for de-identification, records of audits of compliance with those procedures and of 'penetration testing' of the system, consistent with OAIC guidance. Not a single document was produced. We are talking here about the most sensitive of our personal information: medical information.

And this assumes CASA's functions include doing or arranging medical studies using the information. I can't find that function in the CA Act. My fitness to fly is not affected by what CASA does with the information I submit.

But CASA doesn't care. We're just AvMed guinea pigs.

Have a look at what the DVA was discovered to have been doing with veterans' information, and the dishonest way in which DVA responded: Government shared veterans’ confidential medical data (https://www.adso.org.au/government-shared-veterans-confidential-medical-data/)

[Clinton McKenzie]

Meanwhile, the lack of corporate integrity at the Bureau of Meteorology has been revealed in the Federal Circuit Court, in this judgment (https://www.austlii.edu.au/cgi-bin/viewdoc/au/cases/cth/FedCFamC2G/2024/100.html). Key paras of the judgment: Dr Stone’s evidence is dealt with further on in this judgment. [Dr Stone is the BoM’s ‘Chief Customer Officer’ and ‘Group Executive Business Solutions.] The Court found his evidence unsatisfactory and not credible or reliable. He sought to explain away issues with his evidence. His explanations were unconvincing. The lack of credibility of Dr Stone’s evidence however not only impacts upon his evidence. It impacts on the entire narrative being put forward by the Bureau. It invites negative findings as to the whole of the narrative, despite the evidence of other witnesses.
...
In his oral evidence Dr Stone was an unsatisfactory witness. When pressed, he acknowledged that at [28] of his first Affidavit was untrue, when he said there was “no decision to be made about recruiting or not recruiting”. However, the Court is satisfied that the claim by Dr Stone that until after 1 July 2021 he did not have a budget for the GM-IR role and that was the reason for continually delaying recruitment action was a deliberate attempt to mislead the Court.
...
Dr Stone had worked with Dr Johnson [the BoM’s CEO] for an extended period of time (approximately 15 years) and had followed Dr Stone from the CSIRO to the Bureau. Given the close and detailed style of management that I have found was exercised by Dr Johnson, it is inconceivable that Dr Stone would have taken any action in relation to the applicant without the knowledge and approval of Dr Johnson. The lack of credibility in relation to the majority of Dr Stone’s evidence, in the Court’s view, must be considered when considering the denials of Dr Johnson that the applicant’s exercise a workplace rights was not a substantial and operative factor in the adverse action that was taken against the applicant. This view is supported further by the failure of the Bureau to take reasonable steps to assign the applicant new duties or to allocate her to a lower classification position with income maintenance.

The Court is reasonably satisfied that the redeployment action was taken with the aim of managing the applicant out of the Bureau. That decision not to map the applicant to the position of GMID was taken by Dr Johnson (Transcript 1 November 2023, page 672). The decision reflected a desire to manage the applicant out of the Bureau. It was taken because she was a difficult senior employee who had actively and successfully exercised her workplace rights. On the available evidence, the Court is not satisfied that the Bureau has rebutted the evidentiary presumption contained within s 361 of the Act.

[Sandy Reith]

Quote Clinton McKenzie:-

“In my opinion the primary reason for the substantial improvement in safety would come from pilots being more willing to have more frequent and frank discussions with medical professionals, without the fear of damaging AvMed overreactions.”

I think that the only evidence (statistics) about in flight medical incapacitation events causing unsafe flying is without evidence.

It could be held that generally pilot health might be improved, there’s zero evidence of the safety of flight angle.

[Clinton McKenzie]

I take your point and agree with it, Sandy. My words you quoted were not well expressed. I should have said: In my opinion the primary benefit of AvMed being abolished would come from pilots being more willing to have more frequent and frank discussions with medical professionals, without the fear of damaging AvMed overreactions. Whether that would causally change accident and incident rates would remain to be seen.

There's lots of evidence to show that people who don't currently need or hold AvMed certificates, and the medical professionals from whom those people seek advice, are capable of producing an outcome that doesn't include pilots suffering sudden incapacitation from undiagnosed and untreated medical conditions at a rate higher than the holders of Class 1 or Class 2 medical certificates. (I always take any opportunity to remind everyone: Passenger jets share the uncontrolled skies with aircraft that are not certified by CASA, and piloted by pilots who are not licensed by CASA nor medically certified by CASA, and that's gone on for decades; as has the operation of aircraft inside controlled airspace by pilots without CASA medical certification.)

[43Inches]

The problem with a confusing system of over regulation is that people start to ignore the law and do things their own way. That then breeds an environment of non compliance and leads to other behaviors that may be actually dangerous. A good example (going back to the roads again) is over use of 40 kph zones, people get sick of them on highways and arterial when they are just not needed, normalize speeding through them, and then forget and speed through a school zone and run over somebodies kids. Of course they can be then charged for the act afterwards, but the whole point of the 40 kph zone was to slow people in dangerous areas and stop the accident from happening. So you may not think that over zealous AvMed play a part in accidents, but when you earn distrust from the pilot body in general they will also ignore the important laws and points that are warranted.

[Xeptu]

what annoys me is the subtle changes in wording. For example The holder of an ATPL still holds a Commercial Licence and a Private Licence or at least always did. Some of the wording in particularly in Medical regulations may imply we don't, even though I don't believe that is the intention of it.
So reading the Medical regs alone can the holder of an ATPL fly his Kingair in private ops on a class 2 medical certificate with 10 people on board.

[Sandy Reith]

Xeptu:- “So reading the Medical regs alone can the holder of an ATPL fly his Kingair in private ops on a class 2 medical certificate with 10 people on board.”

You can hire a mini bus and drive a party of more than 20 anywhere across Australia with no medical.

[Clinton McKenzie]

I don't think the 'medical regs' say what licence requires what class of medical certificate. That's done elsewhere in the regs.

The answer to your question is discussed in this thread (https://www.pprune.org/pacific-general-aviation-questions/650183-ppl-passenger-limit-australia-2.html). But you'll need sustenance.

[Clinton McKenzie]

I’m still recovering from the giddy-spin caused by contemplating the implications of the factual errors and the illogicality of the puff piece about Class 5 in the latest Australian Flying. (Does CASA pay for advertising in Australian Flying?) The text within quotation marks in the article is attributed to the Principle Medical Officer of CASA:"It doesn't do much for our safety system to be spending a lot of time on the private pilot who's flying from A to B on a Sunday afternoon."

That attitude has been informed and reinforced by the experience of RAAus; then CEO Matt Bouttell was on the Technical Working Group (TWG) that placed Class 5 recommendations in front of CASA. RAAus supported Class 5 even though it stood to benefit them none.Say what? I think the tortured sentence asserts that Class 5 is of no benefit to RAAus.

Doesn’t the implemented Class 5 protect RAAus’s commercial interests in fact? If an equivalent of UK PMD had been implemented in Australia - as it should have been - a whole fleet of more capable aircraft would have become available to the many RAAus members who could satisfy UK PMD requirements. UK PMD has higher MTOW and higher POB limits than apply for RAAus, and self-certification. With a POB 2 limit, I reckon many potential Class 5 applicants are likely to skip the rigmarole and stay Class 2 or go RAAus.

"One of the things the group looked at was whether RAAus experienced any safety issues that could have contributed to medical conditions as a result of not having a doctor assess a pilot," Manderson said.

"If an RAAus aircraft had a safety incident like an airspace incursion or flight into terrain, it wasn't because the pilot hadn't seen a doctor; it wasn't a medical certification issue. It wasn't because they had a seizure, their blood sugar was low or they had a heart attack, so we considered a lot of that data and information."This is Alice In Wonderland stuff.

Who’s investigating the medical circumstances of pilots involved in RAAus incidents? Not ATSB. Not CASA. Where is this “data and information” published? If it comes from coronial inquiries – coroners are now the metaphorical ‘last man standing’ on investigation of RAAus fatalities – coroners inquire into ‘traditional GA’ fatalities as well.

But, this, in the very next paragraph:CASA has admitted that they are operating without a lot of data on medical incidents, partly because the Australian Transport Safety Bureau (ATSB) collects no data on the medical class of a pilot involved, and partly because PPLs tend not to report incidents when they disqualified themselves from flying due to a medical issue.

Manderson has called on the GA community to start reporting medical incapacitation to give them measures to evaluate the effectiveness of Class 5.So CASA’s admits it is “operating without a lot of data on medical incidents”, but considered “a lot of data and information” about RAAus incidents was sufficient to come to the conclusion that RAAus airspace incursions or controlled flights into terrain incidents were not because "the pilot hadn't seen a doctor; it wasn't a medical certification issue. It wasn't because they had a seizure, their blood sugar was low or they had a heart attack.”

I don’t know what this is intended to mean: “PPLs tend not to report incidents when they disqualified themselves from flying due to a medical issue.” Does that mean not reporting incidents in which they are involved after the pilot disqualified themselves from flying due to a medical issue? How can a pilot be involved in a reportable incident if they aren’t flying?

I suspect it is intended to mean that PPLs tend not to report to CASA circumstances in which pilots have disqualified themselves due to a medical issue. I’ll post the regulation on the matter below, but the ‘bottom line’ is that the holder of a class 2 medical certificate is not obliged to "report" a medical issue to CASA unless, among other things, the issue “continues for longer than 30 days”.

And where is the call for the RAAus ‘community’ to start reporting medical incapacitation to CASA to give CASA measures to evaluate the “effectiveness” of the RAAus arrangements? I know: absence of evidence of incapacitation due to medical issues in the RAAus community is treated by CASA as evidence of absence, but the absence of evidence of incapacitation due to medical issues in the GA community is not treated by CASA as evidence of absence. This is typical ‘cherry picking’ by AvMed.

The assertion that: “the Australian Transport Safety Bureau (ATSB) collects no data on the medical class of a pilot involved” is just bullsh*t. Plain and simple. You can google this stuff. I plucked one ATSB report that has a whole section headed: “Medical and pathological information”: The instructor held a class 1 aviation medical certificate…

The student held a Class 1 aviation medical certificate …

The examiner held a class 2 aviation medical certificate …

The controller held a Class 3 medical certificate…

The autopsy of the examiner … identified a level of ischaemic heart disease capable of causing death in isolation from other factors, but there was no evidence of an acute cardiac event having occurred at the time of the incident.

No other significant medical issues were identified in any of the remaining pilots. Further, the toxicology results did not identify any substance that could have impaired the pilots’ performance or that were not noted in their aviation medical records.The PMO seems seriously to be suggesting that CASA has lots of data and information about of RAAus incidents, sufficient for CASA to draw conclusions about the causes of those incidents at least so far as medical issues are concerned, notwithstanding that the ATSB and CASA leave RAAus and coroners to investigate those incidents, but CASA doesn’t have sufficient data to draw the same conclusion in relation to the people who hold certificates issued by CASA over many decades and whose incidents are actually investigated by ATSB occasionally.

On "reporting" of medical issues, here’s what the law says: 67.265(4) If:

(a) the holder of a class 2 or class 3 medical certificate and a licence:

(i) knows that he or she has a medically significant condition; and

(ii) is reckless as to whether the condition has been disclosed to CASA; and

(b) the condition continues for longer than 30 days; and

(c) the condition has the result that his or her ability to do an act authorised by the licence is impaired;

he or she must tell CASA or a DAME about the condition as soon as practicable after the end of the 30 days.The first thing to note about that regulation is the “and” at the end of each paragraph. The criteria are cumulative. That means the obligation to report under that regulation does not arise unless all of the criterial are satisfied, and one of those criteria is the continuation of the condition for more than 30 days.

Further, whilst it is true that the definition of “medically significant condition” is Orwellian – it literally includes the words “no matter how minor” - the condition must result in the certificate or licence holder being impaired in his or ability to do an act that’s authorised. Not “might” result, not “could” result and not “probably” result. The words are “has the result”.

The next reg says:(5) If the holder of a medical certificate and a licence:

(a) knows that he or she has a medically significant condition; and

(b) is reckless as to whether the condition has been disclosed to CASA; and

(c) the condition has the result that his or her ability to do an act authorised by the licence is impaired;

he or she must not do the act until a DAME certifies that the holder can safely do such acts.Again, an “and” at the end of each paragraph and the condition must be such that it “has the result” of impairing the holder’s ability to do an act that’s authorised. And note: It’s not an obligation to report anything to CASA. It’s an obligation not to do the specified act until a DAME says the holder is safe to do it. (No doubt DAMEs are under an obligation to ‘tell all’ to CASA. That might partly explain pilots' reticence to raise issues, lest they get back CASA. And on that subject...)

To be clear, we're not going on a witch hunt for the pilot," Manderson stressed. "We don't want their ARN; we don't want to know exactly who they are, we just want to know if they were Class 1 or 2, BC2, RAMPC or Class 5.Unfortunately, CASA ‘has form’ in saying one thing but doing another. The circumstances in which CVD pilots now find themselves, after 2 years of CASA not doing what it said it was going to do about the OCVA, is a typical example. All on Manderson's watch.

[43Inches]

To be fair road vehicle drivers have the same requirements for disclosure of medical conditions. I would say that the rate of disclosure for road users would be a lot less than 50%, probably no different in Aviation, especially among PPLs. Autism has been on the road safety hit list for a while now, at least in some states. As with the recent Daylesford crash, if you are aware of a medical condition, and it is part causation of a fatal accident, you will be charged with manslaughter. It can be just as frustrating if you are disqualified from driving on medical grounds with tests and reports required at your own cost. Considering how many drivers continue tod rive unlicenced or disqualified shows the system is a joke as it only punishes those that are doing the right thing anyway. Thousands of dollars in medical fees to prove fitness, or possibly the same in fines IF you get caught, as far as the threat of manslaughter charges, if you thought you would actually kill people you wouldn't do it anyway. Proves the point that education is far more valuable than punishment after the fact, or sitting on the ones doing the right thing pushing those that like taking chances under the RADAR.

I know several pilots that had un-diagnosed conditions (that they were unaware of) that led to more serious conditions later. Had they been educated enough to seek professional help earlier the more complicated results would have been avoided. Considering the aviation medicals did not pick up these conditions, most including cardiac issues, then the medicals were useless in ensuring aviation safety as intended. If these pilots were more engaged with their own medical professionals they would probably have recognized and corrected the conditions before they became a problem, without any need for CASA, AvMed or anyone else being involved. So my view is that the current situation of medical requirements actually is more dangerous than self certification, as it pushes pilots to be less likely to seek medical opinions in the formative stage of a condition for fear of huge consequences of just saying they had tests.

My point is that CASA should focus education in the early stages of flight training that pilots need to have a good medical team behind them and consult regularly for their own health and safety. Then have very strict penalties for pilots that willingly fly with known disabilities that are dangerous to air navigation. And not an arbitrary list, but after an incident, accident an investigation to see if that condition contributed. If it didn't who cares.

[Sandy Reith]

43inches, with respect, not sure why PPLs would be less likely to disclose medical conditions, CPLs and ATPLs would have more to lose and generally fly far more hours than the PPL who only flys when the spirit moves.

Be that as it may, making comparison to the risks of driving v. flying, consider that most PPLs would be in cars a lot more hours than flying. I think we all accept the incalculably small risk that we might be harmed due to someone’s medical incapacitation on or near our roads, noting that medicos and the system do prevent some people from driving.

I think it’s also AVMAD’s intention to protect the public from falling Cessnas due to medical incapacitation. I have a better idea, install meteor shields over all public spaces.

[43Inches]

43inches, with respect, not sure why PPLs would be less likely to disclose medical conditions, CPLs and ATPLs would have more to lose and generally fly far more hours than the PPL who only flys when the spirit moves.

Be that as it may, making comparison to the risks of driving v. flying, consider that most PPLs would be in cars a lot more hours than flying. I think we all accept the incalculably small risk that we might be harmed due to someone’s medical incapacitation on or near our roads, noting that medicos and the system do prevent some people from driving.

I think it’s also AVMAD’s intention to protect the public from falling Cessnas due to medical incapacitation. I have a better idea, install meteor shields over all public spaces.

The nature of commercial flying in itself brings most obvious conditions to light. Most commercial aviation is two crew with a multitude of support staff, if somebody is not able to perform their duties due to a condition it will be reported fairly soon. Private operations there is no one in general involved other than yourself, like driving in cars. I would agree there's probably a lot of CPL/ATPL that have been less than honest with some answers on the medical applications, wrt to smaller things.

I think there are many that do not realize how much non compliance occurs in aviation, especially away from cities. It wasn't long ago that a station owner was killed flying home, basically unlicensed with a stomach full of alcohol and got caught out by last light and crashed. Had he not crashed, no one would have known he was doing it regularly.

I knew of several AFR where a candidate turned up in their own aircraft from the country with an expired AFR, one argued about the price and flew home without conducting said AFR. Another was operating as a flight instructor for several years without a medical and so on, only got caught out because they turned up for an interview at a city school and when asked his medical expiry he said he hadn't had one for years.

[Sandy Reith]

Agreed your airline pilot will get attention for obvious symptoms that might have bearing on fitness to fly. In the other hand a big percentage of private flying is with passengers who may judge their pilot’s fitness also.

The real question has to be is it such a problem of magnitude that’s a great worry in the first place?

In regard to AFRs that requirement is a latter day invention and though opinion seems to be all for the idea I disagree on this blanket requirement, and like so many opinions around aviation matters there’s no empirical supporting evidence of the overall efficacy of such regulation. The three takeoffs and landings no pax rule is one additional measure regarding recency.
In my view at least aircraft owners, CPL holders and instructors should be exempt from the AFR, and this would boost GA in those areas leading to more flying and overall safety.
In regard to instructors and medicals, sensibly no medical is required in the USA where the student has soloed.
And again when was this ever some problem that will be solved by an AVMAD medical?

[43Inches]

The problem is over-regulation. Too many laws and then people just don't follow them, creating a less safe environment, you have to either then rule with an iron fist and force compliance, or how it is now, the vast majority just get away with it. Very similar to speeding on the roads, the daily rate of non compliance with speed limits on roads would be huge, the government collects a tax on that instead of stamping it out.