The military also distinguishes medical requirements for aviators versus aircrew or other individuals within the aviation community. The FAA lays out slightly different regulations for airline transport pilots and commercial pilots versus private pilots, with private pilots having less rigorous requirements. This article will discuss the major medical statutes as laid out by the FAA and any differences in requirements in the Navy, Army, and Air Force. In general, military aviators have to be physically fit for duty as military officers as well as passing requirements for aviation. The Federal Aviation Administration (FAA) governs the standards in the United States for civilians, and the military has a separate set of directives for active-duty aviators, with military rules generally being more stringent. Member states, therefore, often have different interpretations of the guidelines and therefore different regulations.
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While some research has been done in the field of pilot incapacitation, there is not a significant evidence base for many recommendations, but rather it is a consensus of professional opinion. Mental health is also extremely important given mishaps like Germanwings Flight 9525 and other cases of suicide by aircraft. Less common but more dangerous debilitations such as alcohol intoxication and sudden cardiac death have been implicated in mishaps, so screening for these risks carries high importance.
Gastrointestinal issues, earaches, faintness, headache, and vertigo are the most common causes of incapacitation. After evaluation of available data and the potential risks at different times during a flight, ICAO set a goal of less than 1% risk of pilot incapacitation per year to guide the standards for medical examinations.
In subsequent annexes to the original convention, the regulations that standardize personnel licensing and rules of the air were established that guide the medical requirements for pilots and aircrew today. The International Civil Aviation Organization (ICAO) agreed at the Chicago Convention in 1944 to standardize practices where uniformity would improve air navigation. Medical standards are put in place to prevent hazards during a flight that could be caused by the physical, medical, and psychological conditions held by the pilot or the crew.
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