It's certainly a minefield. I've just had to get a LAPL medical certificate as the class II I went for this month (and passed including ECG) is not valid until I jump through several hoops at great cost because of a recent pacemaker implant which was for bradycardia (slower than normal heartbeat), which I've had for all of my sixty years. It was an hour's job under a local, hardly open heart surgery.

So, I am now fitter than last year when I renewed my class II with no problem and bradycardia. But now I don't have bradycardia I can only get a LAPL medical...I feel like I'm in the middle of a Lewis Carroll novel...

By the way my AME charges £100 for a class II including ECG and £60 for a LAPL.

Hip Hooray! it has been fixed. If you are fit to drive, you are fit to fly 2000Kg.

I am glad its getting sorted out and common sense prevails although we have all seen drivers who are clearly unfit drive and then crash.

Lodems
"It would be easy to assume there is an AME agenda behind all this. Could one of them perhaps be persuaded to comment to dispel that terrible thought"
So here goes
A lot of AME's are pilots too and try to help people fly.
You should understand that constantly changing criteria and rules make things difficult. Contrary to what you might think class1 medicals tend to be easier to perform, lapl's nppl"s can be extremely difficult but if you put a signature to something you can be held to account.
A mono-ocular 70yr old with multiple pathologies yet a lack of information rocking up for a simple signature was not easy. Guidance is limited and as has been pointed out varies depending on where you look. For this reason some AME's do not do LAPL medicals.
Please be sensible in your comments
The CAA is being decimated in general and that includes the medical department as you would have noticed. We all need to be constructive.
PS Enjoy your flying as this is what it is about!

Not fully fixed. Non-EASA only.

Opinion elsewhere is that a Self declaration is ok with a uk national licence and EASA aircraft until April 2018
(LAPL privileges only, and within U.K. Only)

......... but most Clubs/Rental outfits will not allow because of insurance concerns...........

Why should that be? Any details of clubs/renters you actually know who do that?

All this talk about what insurers will and won't let US do is very tiring:ugh:

As stated, I suspect this is largely hearsay.
Insurers have no business inventing their own legislation which does not exist in real life.
There is no significant causal link between accidents and medical incapacitation and indeed the CAA initiative is based on that very lack of evidence.

Perhaps that's because, until recently, all pilots had medicals of one form or another?

:rolleyes:

NPPL was a self declaration requiring no medical examination, and plenty of proven safe history behind it, and similarly AOPA America see fit to make the following observation;

Oh and by the way.......

:rolleyes:

To you too.

Is there a driver's licence medical in the UK, for non-commercial car drivers?
I've been driving for almost 57 years, and don't recall ever having had such a medical.
(All I have is a current EASA Class 2.)

No routine medical as such, but there are medical requirements for car drivers and should there be ambiguity about whether or not you meet them... a medical.

Personally speaking I have mixed feelings about it. I suspect the medical is overkill for most, but then how else do you ensure a ready supply of medical professionals who understand aviation and can advise when required? I'm not sure that the risks are as low as all that.

1) psychiatric - suicide by light aircraft is not all that uncommon.
2) medical - an epileptic seizure or collapse in a car is more likely to hurt a bystander; in an aircraft it's likely to prove fatal to the pilot and any occupants.
3) sensory - good sight and vision are quite important
4) general wellbeing - the number 1 cause of accidents is stupidity. We're more likely to be stupid when we're under the weather.

Stereotypical incapacitation accidents are probably quite uncommon, but a 'medical' contribution to aviation incidents is probably much more widespread.

Thousands of pilots have been flying without medicals on NPPL GP declarations for the last 10 years and gliders pilots always have.

Having had a heart attack 20 years ago, three weeks after my Class 2 with ECG, they are not infallible.

Indeed although clearly had the heart attack occurred during flight you'd likely not be in a position to have posted. So its perhaps less an endorsement of greater freedoms and more a question over why the focus is on the ECG and, for example, no Lipid test.

Does anyone keep any data? Opinion is great but wouldn't be nice if we had actually captured data on these things. One issue that isn't helpful is that in a case when unwell pilot blogs impacts the ground the cause of death is often focused upon that impact because to dig deeper costs somebody some money and even if that money is spent the results are not necessarily 100% conclusive such that the initial cause is changed.

Really? do you have any statistical evidence of this?

Whether you have a medical or not, if you feel you are not fit to fly due to "being under the weather" then you should not. I don't think stupidity was assessed by any AME I ever went to

In the 1972 Trident crash, Captain Keys had a Class 1 medical. I assume an ECG would have been taken. I believe it to be the case that a resting ECG is a poor indicator of potential problems compared to an exercise ECG, but have exercise tests never been mandated for Class 1?

Yet still people are alive to post things like you did.

In one post you have a "suspect"; a "not sure"; a "not all that uncommon"; a "more likely"; a "likely"; a "quite important"; another "more likely"; a "probably quite uncommon"; and a "probably" but not one fact.

The number one cause of accidents, as far as I believe is mistakes.

That is not the same thing as stupidity.

I don't know whether exercise tests have been mandated for class 1 medicals - not an AME. I gather they're falling out of favour in general medicine now that tests such as angiography and perfusion scanning are considered safer and more informative.

I have no expert knowledge regarding any of these issues. But a quick 'Google Scholar' will show up a number of links suggesting they're significant issues. I haven't digested the papers in sufficient detail to fully appraise them, and don't have the time to do so. On the other hand, it's not so hard to get some kind of an overview of the context in which aviation medicals are justified.

Going back to the headings I used:

1) Suicides - a difficult thing to assess for multiple reasons such as a frequent reluctance amongst coroners to recognise suicide where there is any doubt and the ultimate unknowability of what was going through somebody's mind prior to an accident. If they haven't written a note, it's hard to know for certain.

Analysis of NTSB Aircraft-Assisted Pilot Suicides: 1982?2014 - Politano - 2015 - Suicide and Life-Threatening Behavior - Wiley Online Library identifies 51 pilot suicides 1982 to 2014 but there are almost certainly likely to be a lot more.

https://www.ncbi.nlm.nih.gov/pubmed/25199127

Estimated the rate of pilot suicide at 0.33%. Again, I'd wager that the true rate will be considerably higher.

2) Sudden incapacitation

https://crashstats.nhtsa.dot.gov/Api...ication/811219

states that 84% of people in passenger vehicle crashes who were suddenly incapacitated (e.g. faints, hypoglycemia) had suffered previous episodes. That would imply that similar accidents are by and large preventable.

4) I could have worded this a lot better. I don't mean to call people who make mistakes stupid (I've survived a fair amount of my own stupidity, as I suspect we all have), but a lot of aviation accidents are the sort of lapses that in retrospect are going to seem dumb. I don't mean helicopter-towing-speedboat accidents, but regular everyday things like EFATO turnbacks or landing gear-up or proceeding into bad weather. They're going to be classed as 'pilot error' on any accident report but could there be a medical contribution?

The US emphasis on sleep apnoea (and its potential to be an issue with anyone with a high enough BMI) is the sort of thing I'm getting at. If you have significant sleep apnoea, your cognition and ability to make sensible decisions suffer, but because you may always be impaired, your insight into it is likely to be limited.

The full blood count you get as part of a medical will give information on anaemia (may cause reduced performance at moderate altitudes), alcoholism, vitamin deficiency (B12, Folate are important for cognition and deficiencies change the size of your blood cells). Your BMI is easy enough to measure.

It may be that these issues contribute to more accidents than the obvious all-or-nothing medical incapacitation events.

I've heard figures such as 5% of private pilot accidents being due to medical factors - obviously these are 'failures' of aviation medicals. The question is, how many 'successes' are there where people have not died because their AME either stopped them from flying or resulted in them being treated such that it no longer posed a risk to them (e.g. swapping Piriton for a non-sedating drug).

As I mentioned before, I'm on the fence. I think there's a strong argument for solo pilots to do pretty much what they want - perhaps anyone who flies in airspace should have a hearing test and you might have some caveats for some personality disorders and flying over cities. If an ex-WWII pilot with a dodgy heart wants to take a risk, I'm all for that. But for grandparents who want to give joy-rides to their grandkids I'm not certain. I can see that AMEs and aviation medicine really do have something to offer, even for PPLs.

It would be really interesting to see an AME argue the case for their continued existence, head to head with someone arguing for deregulation. Perhaps the editors of Pilot or Flyer could take note?

As far as I am aware, a Class 2 medical does not include a full blood count.