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Order Fom/1267/2008, Of April 28, That Amending The Order Of 21 March 2000, And Order Fom/2157/2003, Of July 18, Which Govern Different Requirements Of Aircraft And Civil Helicopters Flight Crew Licences, Re...

Original Language Title: ORDEN FOM/1267/2008, de 28 de abril, por la que se modifican la Orden de 21 de marzo de 2000, y la Orden FOM/2157/2003, de 18 de julio, que regulan diversos requisitos de las licencias de la tripulación de vuelo de aviones y helicópteros civiles, re...

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TEXT

Royal Decree 270/2000 of 25 February, determining the conditions for the exercise of the functions of the civil aircraft flight staff, was developed by Order 21 March 2000, for which the adopt, and incorporate into national law, the joint aviation requirements for flight crew licences relating to the medical-aircraft organisation, class 1 and class 2 medical certificates and medical requirements Aircraft and civil helicopter flight personnel, approved by the Aeronautical Authorities, shall be required to Joint Aviation Authorities (JAA), an organ associated with the European Civil Aviation Conference (ECAC), coincident with the rules emanating from the International Civil Aviation Organization (Annex I to the Aviation Convention). International Civil). In order to obtain and maintain in force the licences established by Royal Decree 270/2000, the said order provides that the applicants or, where appropriate, holders thereof, undergo certain medical tests leading to the obtaining of the of the aeronautical medical certificate of fitness provided for in Article 4 of that royal decree. The issuing of such certificates is for the medical-aircraft centres and the medical examiners approved in accordance with the provisions of Order FOM/2157/2003 of 18 July 2003 determining the requirements and the the procedure for the designation and approval of medical-aircraft centres and medical examiners, issued to complete the regime of the civil aircraft flight crew established by the said royal decree, in respect of related to the medical-aeronautics organization. As a result of successive technological developments and best clinical practices, and in particular, the amendments made to the matter by the International Civil Aviation Organization in Annex I to the Convention on Civil Aviation International, the Joint Aviation Authorities (JAA) have agreed, by means of the approval of amendment 5, to amend the aforementioned joint requirements relating to the medical-aeronautical organisation (hereinafter JARs-FCL 3) in various content, of a technical-medical type, such as the disappearance of electroencephalograms in initial class 1 medical examinations, the limitations established for female pilot with a medical certificate of class 1 pregnant, the operational limitation for flight mechanics or the suppression of medical examinations of Class 1 extended. Pursuant to the final provision of Royal Decree 270/2000 of 25 February 2000, the purpose of this order is to amend the Order of 21 March 2000 to incorporate in its Annex the amendments resulting from amendment 5 of the JAR-FCL 3 approved by the Joint Aviation Authorities (JAA). However, given the significant number of these amendments, a new Annex is published, which will replace the one contained in the order of 21 March 2000, in order to facilitate their knowledge and implementation. Also, as a result of the changes made to the international standards indicated above, the Order FOM/2157/2003 of July 18, in aspects relating to the compulsory presence of the entire medical team, is partially modified. during the conduct of the medical examinations that require it. In its virtue, according to the State Council, I have:

Article first. Amendment of the Order of the Ministry of Public Works of 21 March 2000 laying down the joint aviation requirements for flight crew licences, relating to the medical-aircraft organisation, medical certificates Class 1 and Class 2 and the medical requirements for aircraft and civil helicopter flight personnel.

The Annex to the Order of the Ministry of Public Works of 21 March 2000 adopting the joint aviation requirements for the licences of the flight crew relating to the organisation is replaced by the following: medical-aeronautics, class 1 and class 2 medical certificates and medical requirements for aircraft and civil helicopter flight personnel, for which it is listed as an annex to that order.

Article 2. Amendment of Order FOM/2157/2003 of 18 July determining the requirements and procedure for the designation and approval of medical and aeronautical centres and medical examiners.

Article 4 (2) of Order FOM/2157/2003 of 18 July 2003 determining the requirements and the procedure for the designation and approval of medical and aeronautical centres and doctors is amended examiners, which is worded as follows:

" 2. It shall have one or more medical teams, each of which shall be composed of at least the following optional: (a) Medical examiner.

b) Medical specialist in cardiology. c) Medical specialist in otolaryngology. d) Medical specialist in ophthalmology. e) Medical specialist in radiodiagnosis. f) Medical specialist in psychiatry. (g) Optional clinical analysis specialist. h) Licensed in Psychology or declared equivalent by the Ministry of Education and Science.

You can also count on other specialists and medical assistants.

The medical equipment must be present in its entirety during the conduct of medical examinations for the issuance of a medical-aeronautical certificate, when required by the nature of the medical tests to be carried out. carry out, and always, in the case of medical-aeronautical examinations intended for the issuance of an initial class 1 medical-aeronautical certificate. The medical team shall be led by one or more authorised medical examiners who shall coordinate the equipment, unify the medical criteria and diagnoses provided by the rest of the practitioners, sign the reports and issue, where appropriate, the resulting certificates. It shall also be equipped with the necessary health and administrative staff. "

Final disposition first. Implementation and implementation.

The State Aviation Safety Agency and the Directorate-General for Aviation, within the scope of their respective powers, shall take the necessary measures for the implementation and enforcement of this order.

Also, the Directorate General of Civil Aviation will order the publication in the "Official State Gazette" of the guidelines or criteria agreed by the Joint Aviation Authorities (JAA) for the application and interpretation. uniform of the joint aviation requirements for flight crew licences relating to the medical-aircraft organisation, class 1 and class 2 medical certificates and the medical requirements for flight crew members of the flight crew civil aircraft and helicopters.

Final disposition second. Entry into force.

This order will take effect the day following your publication in the "Official State Bulletin".

Madrid, April 28, 2008. -Minister of Development, Magdalena Alvarez Arza.

ANNEX Aviation Sets (JAR) Requirements

JAR -FCL 3

INDEX

Flight Crew License

Medical Requirements

Subpart A. General Requirements

JAR-FCL 3.035

Psychophysical aptitude.

JAR-FCL 3.040

Decrease of medical fitness.

-FCL 3.045

JAR-FCL 3.060

Restriction of license privileges to 60-year-old holders or more.

-FCL 3.065

Status that issues the license.

JAR-FCL 3.080

Aeronautical Medicine (AMS)

JAR-FCL 3.085

Aeronautical Medical Centers (AMC)

-FCL 3.090

Authorized Examiners (AME).

-FCL 3.091

Examining and Evaluation Aeromedical-Generalities.

-FCL 3.095

Aeronautical Medicine Acknowledges.

JAR-FCL 3,100

Medical Certificates.

JAR-FCL 3.105

The validity period of the medical certificates

JAR-FCL 3.110

Requirements for medical evaluation

-FCL 3.115

Usage of medication, drugs, or other treatments.

-FCL 3.120

Applicant Responsibilities.

JAR-FCL 3.125

Variations and policy review

1 to JAR-FCL 3.105

Validity of medical certificates.

Subpart B. Medical Requirements Class 1

JAR-FCL 3.130

Cardiovascular System-Recognition.

JAR-FCL 3.135

Cardiovascular System-Blood Pressure.

JAR-FCL 3.140

System Cardiovascular-Coronary Disease

-FCL 3.145

Cardiovascular System-Arrhythmias/alterations of Driving

JAR-FCL 3.150

Cardiovascular System-General.

JAR-FCL 3.155

General-Respiratory System

-FCL 3.160

Respiratory System-Alterations.

JAR-FCL 3.165

General Digestive System.

JAR-FCL 3.170

Digestive-Alter System.

-FCL 3.175

metabolic, nutritional, and endocrine diseases

JAR-FCL 3.180

Hematology.

-FCL 3.185

Urinary System.

JAR-FCL 3.190

sexually transmitted diseases and other infections.

-FCL 3.195

Gynecology and Obstetrics

JAR-FCL 3,200

Muscle and skeletal requirements

-FCL 3.205

JAR-FCL 3.210

Neurological Requirements

JAR-FCL 3.215

Oftalmological Requirements.

JAR-FCL 3.220

Visual Requirements.

-FCL 3.225

Perception Colors.

-FCL 3.230

Otorhinolaryngological Requirements.

JAR-FCL 3.235

Hearing Requirements.

JAR-FCL 3.240

Psychological Requirements.

-FCL 3.245

Requirements Dermatological.

JAR-FCL 3.246

Oncology.

Subpart C. Medical Requirements Class 2

JAR-FCL 3.250

Cardiovascular System-Recognition.

-FCL 3.255

Cardiovascular System-Blood Pressure.

JAR-FCL 3.260

Cardiovascular System-Coronary Disease.

-FCL 3.265

Cardiovascular System-Driving Arrhythmies/alterations.

JAR-FCL 3.270

Cardiovascular System -General.

JAR-FCL 3.275

General-Respiratory System

-FCL 3.280

Respiratory System-Alter.

JAR-FCL 3.285

General Digestive System.

-FCL 3.290

System Digestive-Alterations.

JAR-FCL 3.295

Metabolic, nutritional and endocrine diseases

JAR-FCL 3,300

Hematology.

JAR-FCL 3.305

Urinary System.

JAR-FCL 3.310

sexually transmitted diseases and other infections.

JAR-FCL 3.315

Gynecology and Obstetrics

-FCL 3.320

Requirements muscle and skeletal

-FCL 3.325

Psychiatric Requirements.

-FCL 3.330

Neurological Requirements.

JAR-FCL 3.335

Oftalmological Requirements.

-FCL 3.340

Requirements Visuals.

-FCL 3.345

Perception of Colors.

-FCL 3.350

Otorhinolaryngological Requirements.

JAR-FCL 3.355

Hearing Requirements.

JAR-FCL 3.360

Requirements Psychological.

JAR-FCL 3.365

Dermatological Requirements.

-FCL 3.370

Oncology.

Appendix 8.

B and C

Appendix 1.

Cardiovascular System.

2.

System respiratory.

3.

Appendix 4.

Metabolic, nutritional, and endocrine alterations

Appendix 5.

Hematology.

6.

System urinal.

7.

8.

Gynecology and obstetrics

Appendix 8.

Appendix 8.

Appendix 9.

musculoskeletal requirements

Appendix 10.

Psychiatric Requirements.

Appendix 11.

neurological requirements

12.

ophthalmological requirements.

Appendix 13.

Visual Requirements.

14.

Color Perception

Appendix 15.

16.

requirements.

Appendix 17.

Psychological Requirements.

Appendix 18.

Requirements dermatology.

19.

Oncologists.

Subpart A. General Requirements

Paragraphs 3.001 to 3.030, 3.060 and 3065 are the same as Part 1 and 2 of the JAR-FCL, incorporated as an annex to the Order of the Ministry of Public Works of 21 March 2000, and Order FOM/3811/2004 of 4 November 2004, for which the adopt the joint aviation requirements for flight crew licences (JAR-FCL) relating to the conditions for the exercise of the functions of aircraft pilots and civilian helicopters respectively. That is why they are not included in this part.

JAR-FCL 3.035. Psycho-physical fitness.

(a) Psychophysical state. The holder of a medical certificate must be mentally and physically healthy for the safe exercise of the privileges of the licence in question.

(b) Requiring a medical certificate. In order to request or exercise the privileges of a licence, the applicant or holder thereof shall be in possession of a medical certificate issued in accordance with the provisions of the JAR-FCL Part 3 (medical requirements), appropriate to the privileges of the license. (c) Aeromedical disposal. After the medical examination, the applicant shall be informed of whether he is fit or unfit or shall be referred to the Authority. The authorised examiner (AME) shall inform the applicant of any condition or condition (medical, operational or other) that may restrict the flight teaching and/or the privileges of the issued licence. (d) Operational limitation for multiple crew (OML-class 1).

(1) Multi-pilot limitation "valid only as or with qualified pilot" applies when the applicant for a CPL or ATPL does not fully meet the requirements of the class 1 medical certificate but is considered to be at risk of intraining is acceptable. This limitation is applied by the Authority in the context of a multi-pilot environment. This limitation can only be issued or removed by the Authority, except in the case of class 1 pregnant pilots with a temporary OML limitation during the first 26 weeks of gestation [see JAR-FCL 3.195. 3.315 and Appendix 8 (1)].

(2) The other pilot will be qualified in the type and will not be over 60 years old.

(e) Operational limitation for Flight Engineers (OFL-valid for flight engineer functions exclusively)

The OFL-valid limitation for flight engineer functions exclusively-applies when the holder of an F/E (onboard Mechanics) license does not fully satisfy the requirements of a Class 1 medical certificate but is considers that your risk of incapacitation is acceptable. This limitation can only be issued or removed by the Authority. (e) Safety pilot limitation (OSL-only for class 2). A safety pilot is a pilot qualified to act as PIC on an aircraft of the class/type concerned and is carried on board the aircraft. The latter shall be equipped with duplicate controls for the purpose of the safety pilot taking over when the PIC, holder of this restriction in the medical certificate, is incapacitated. An OSL can only be issued or removed by the Authority.

JAR-FCL 3.040. Decrease in medical fitness.

(a) Medical certificate holders should not exercise the privileges granted by their licenses, or the corresponding entitlements or authorizations at any time, if they are aware that there has been a decrease in their medical fitness which could render them unable to safely exercise such privileges.

(b) Medical certificate holders shall not take any prescribed or non-prescribed medicinal product or drug, nor should they receive any other treatment, unless they are completely certain that such medicinal product, or treatment is not going to have an adverse effect on their ability to safely perform the tasks entrusted to them. In case of any doubt, they should consult with the AMS, with an AMC or an AME. (c) The holders of medical certificates should consult the AMS without delay, with an AMC or an AME provided that:

(1) your hospitalization or admission has taken place in a clinic for more than 12 hours, or

(2) have undergone surgical intervention or any medical procedure of an invasive nature, or (3) use medications on a regular basis, or (4) need to regularly use glasses with corrective lenses.

(d) (1) Medical certificate holders with knowledge of:

i. any significant personal injury resulting in your functional incapacity as a member of a flight crew, or

ii. any disease involving an inability to act as a member of a flight crew for a period of 21 days or more, or iii. be pregnant,

must inform the AMS or the QAME in writing, which will inform the AMS, of any injury or pregnancy as soon as the 21-day period has elapsed in the case of illness. The medical certificate should be considered to be suspended after the onset of the disease, or after the period of illness, or to the confirmation of pregnancy, and: (2) In the case of injury or disease the suspension shall be lifted. after the holder of the licence is medically assessed by the AME in consultation with the AMS and is assessed fit to act as a member of a flight crew, or after the Authority has distracted the holder of the examination requirement medical, subject to the conditions it deems appropriate.

(3) In the case of pregnancy, the suspension may be lifted by the AME in consultation with the AMS for such a period and subject to the conditions it deems appropriate to see JAR-FCL 3.195 (c) and 3.315 (c)). If an AME evaluates a pregnant class 1 pilot as fit class 1, it will record an OML limitation. The suspension will cease after the holder is medically assessed by an AME-after the pregnancy is over-and is assessed fit. And this case the OML limitation can be lifted by the Ame which will inform the AMS.

JAR-FCL 3.045. Special circumstances.

When a new medical technology, medication or procedure is identified that can justify a positive assessment of applicants who otherwise would not meet the requirements, the Authority, in cooperation with at least one other Authority, can form a Research and Development Task Force (REDWIG) to develop and evaluate a new certification protocol for evaluation. The protocol shall include a risk assessment. It will be endorsed by the LST on the recommendation of the Sub-Sectoral Licensing Team (Medicine). The exercise of the privileges of the License based on the Protocol shall be limited to flights of registered aircraft in the States that permit it. The corresponding license and the medical certificate, if applicable, shall be noted in item XIII with the phrase "issued as deviation according to JAR-FCL 3.046".

JAR-FCL 3.080. Section for Aeronautical Medicine (AMS).

(a) Establishment. Each Member State of the JAA shall include one or more medical experts in the practice of aviation medicine within its Aeronautical Authority. These doctors shall be part of that Authority or shall be duly authorised to act on behalf of the Authority. In any case, they will be known as the Aeronautical Medicine Section (AMS).

(b) Medical confidentiality. Medical and psychological confidentiality will be respected at all times. The Authority shall ensure that all reports, oral or written, and the electronically stored information on medical and psychological subjects of the holders/applicants for a licence are only available to the AMS, AMC or AME that handle the application and to carry out medical or psychological evaluations. The applicant, or his/her physician, shall have access to all this documentation in accordance with national laws.

JAR-FCL 3.085. Aeronautical Medical Centers (AMC).

The Medical-Aeronautics (AMC) Centers shall be designated and authorized, or renewed their authorization, at the discretion of the Authority, for a period of time not exceeding three years.

AMC will meet the following conditions:

(a) being located within the geographical boundaries of the Member State and linked to a hospital or medical institution;

(b) engaging in clinical aviation medicine and associated activities; (c) being led by an authorised examiner (AME) physician responsible for coordinating the results of the assessment and signing of the reports and (d) equipped with medical technical means to carry out extensive medical examinations in the air environment, and will have a team of doctors with higher education and experience in aviation medicine. The Authority shall determine the number of required AMCs.

JAR-FCL 3.090. Licensed medical examiners (AMEs).

(a) Designation. The Authority shall designate and authorize, within the geographical limits of its State, medical examiners (AME), licensed and qualified in the practice of medicine. Physicians resident in non-JAA States who wish to become AME for the purposes of JAR-FCL may apply to the Authority of a Member State of the JAA. Upon designation, the AME shall inform the Authority of that State and shall be supervised by the Authority. In respect of applicants for an authorisation for Class 1, they shall be limited to regular regular assessments of revalidation/renewal.

(b) The number and location of the examiners. The Authority shall determine the number and location of the required examiners, taking into account the volume and geographical distribution of the pilot population of their State. c) Access to the documentation. An AME, responsible for the coordination of the evaluation of the results and the signature of the reports, will be authorized to access any previous aeromedical documentation saved by the AMS and related to those medical examinations. that you are doing. (d) Training. The AME shall be licensed in medicine and shall have received training in aviation medicine accepted by the Authority. They should acquire practical knowledge and experience of the conditions under which licence holders and ratings make their activity.

(1) Basic training in aviation medicine. i. The basic training of doctors responsible for the selection and medical recognition of Class 2 flight staff shall consist of a minimum of 60 hours, including practical work (medical examination techniques). This basic training will be accepted by the Authority.

ii. The basic training course will conclude with a final examination. A certificate will be awarded to the approved candidates. iii. Possession of a basic certificate in Aviation Medicine does not constitute a legal right to be authorized by the AMS as an AME to do Class 2 recognitions.

(2) Advanced Training in Aviation Medicine.

i. Advanced training in Aviation Medicine for physicians responsible for medical examinations, assessments and supervision of Class 1 flight staff shall consist of a minimum of 120 teaching hours (60 additional hours for basic training) and practical work, complementary training and visits to aeromedical centers, clinics, research centers, ATC, simulators, airports and Industrial Facilities. This basic training will be accepted by the Authority.

Add-ons to training and visits will be available for three years. Basic training in aviation medicine will be a mandatory entry requirement. ii. The Advanced Aviation Medicine Training Course will conclude with a final exam and a certificate will be awarded to the approved candidates. iii. Possession of an advanced training certificate in Aviation Medicine does not constitute a legal right to be authorized by the AMS as an AME to do Class 1 or Class 2 recognitions.

(3) Soft drink courses in Aviation Medicine. The AME shall be present during the authorisation period to a minimum of 20 hours of update training accepted by the Authority. At least 6 hours must be done under the direct supervision of the AMS. The AMS may approve, for this purpose, scientific meetings, congresses and flight deck experience, to satisfy a specific number of hours. (e) Authorisation. The AME shall be authorised for a period not exceeding three years. The authorization to perform medical examinations may be for Class 1, Class 2 or both, at the discretion of the Authority. In order to maintain competence and authorisation, an AME shall perform at least ten aeromedical examinations each year. For the renewal of the authorisation the AME shall perform an appropriate number of aeromedical examinations to the satisfaction of the AMS and shall also have received the required training during the authorisation period.

(f) Application. A member state of the JAA may, at any time and in accordance with its national procedures, revoke any authorisation it has issued in accordance with the requirements of the JAR-FCL, if it has been demonstrated that the AME does not satisfy, or not satisfy, the requirements of the JAR-FCL or the applicable national legislation of the State issuing the authorisation.

JAR-FCL 3.091. Aeromedical-General examination and assessment.

(a) Compliance with the JAR. The examinations and evaluations shall be carried out in accordance with the appropriate requirements of the JAR-FCL, Part 3 and associated procedures.

(b) Reference material. Subparts B and C contain the requirements for applicants to Class 1 and Class 2, respectively. The Appendices to Subparts B and C contain the requirements for those aspirants outside the limits set out in Subparts B and C. The JAA Manual of Aeronautical Medicine is not mandatory but contains elements of good practice aeromedical and medical procedures and procedures that can be applied in aeromedical examinations and evaluations.

JAR-FCL 3.095. Aeromedicine acknowledgements.

(a) For Class 1 medical certificates. The initial examination for Class 1 medical certificates will be performed on an AMC. Recognition and renewal recognition may be delegated to an AME.

(b) For Class 2 medical certificates, initial, renewal or revalidation for Class 2 medical certificates will be performed on an AMC or an AME. (c) Report of the aeromedical examination. The applicant shall complete the appropriate form. Upon completion of a medical examination, the AME shall, without delay, transmit the complete and signed report of all Class 1 and 2 recognitions to the AMS. The only exception is the AMC, whose director can sign the reports and certificates according to the assessments made by the AMC doctors. (d) Regular requirements. The summary of the specific tests required for initial recognition, revalidation or periodic renewal, and extensive revalidation and renewal are included in the medical certificate form.

JAR-FCL 3,100 Medical Certificates.

(a) Content of the certificate. The medical certificate shall contain the following information: (1) Reference number.

(2) Certificate class. (3) Full name. (4) Date of birth. (5) Nationality. (6) Date of expiry of the medical certificate.

a) For class 1:

i. Date of expiry (air transport operations with a pilot carrying passengers);

ii. Date of expiry (other business operations); iii. Date of expiry of the previous medical certificate

b) For class 2:

i. Date of expiry of the medical certificate;

ii. Date of expiry of the previous medical certificate.

(7) Date of the previous medical examination.

(8) Date of last electrocardiogram. (9) Date of last audiometry. (10) Limitations, conditions and/or variations. (11) Name of the AME/AMC/AMS, number and signature. (12) Date of recognition. (13) Signature of the applicant.

(b) Initial medical certificate issue. Initial Class 1 medical certificates will be issued by the AMS. The issuance of the initial Class 2 certificates shall be made by the AMS or may be delegated to an AMC or AME.

(c) Revalidation and renewal of medical certificates. Medical certificates of Class 1 or 2 may be renewed by an AMS, or delegated to an AMC or AME. (d) Availability of the certificate.

(1) After completion of the recognition as a result of fit, a medical certificate shall be issued, in duplicate if necessary, to the person who has undergone recognition.

(2) The holder of a medical certificate, if required, will submit it to the AMS for further action. (3) The holder of a medical certificate shall submit it to the AME at the time of the revalidation or renewal of the certificate.

(e) Annotation, limitation, or suspension of the certificate.

(1) When a revision has been made and a certificate has been issued in accordance with the JAR-FCL 3.125, any limitation that may be required shall be stated in the medical certificate.

(2) After recognition for the renewal of a medical certificate, the AMS may limit or suspend a medical certificate issued by an AMC or an AME, for duly justified and notified medical reasons. applicant and to the AMC or AME. (f) Refusal of the certificate.

(1) The applicant who has been refused a medical certificate shall be informed of this in writing and of its right of review by the Authority,

(2) The information concerning that refusal shall be reviewed by the Authority within 5 working days and shall be available to other Authorities. The medical information that supports this refusal will not be transmitted without prior consent of the interested party.

JAR-FCL 3.105. Period of validity of medical certificates.

(See Appendix 1 of the JAR-FCL 3.105). (a) Period of validity. The medical certificate shall be valid from the date of the initial general medical examination to the following time limits: (1) Medical certificates of Class 1, 12 months, except for applicants who: a. Are conducting commercial air transport operations with a single pilot carrying passengers and have turned 40 years, or

b. Have been 60 years old,

the validity period is reduced to 6 months. This frequency increase after the age of 40 does not apply to flight engineers.

(2) Medical certificates of Class 2, 60 months up to the age of 40 years, 24 months up to the age of 50 years and 12 months from this age.

(3) The expiry date of the medical certificate shall be calculated on the basis of (1) and (2). The period of validity of a medical certificate (including any extended examination or special study) shall be determined by the age of the applicant for the medical certificate. (4) Notwithstanding the above (2), the medical certificate issued before the holder is 40 years old, shall not be valid for Class 2 privileges after he has been 42 years old. (5) The period of validity of the medical certificate may be reduced when clinically indicated.

(b) Revalidation.

(1) If the revalidation of the medical certificate is performed within 45 days prior to its expiration date, calculated according to (a), the expiration of the new certificate is calculated by adding the period specified in (a) (1) or (2), as the case may be, to the date of expiry of the previous medical certificate.

(2) A revalidated medical certificate before its expiry is invalid since the issuance of the new certificate.

(c) Renewal. If the medical examination is not carried out within the 45-day period referred to in paragraph (b) above, the expiry date shall be calculated in accordance with paragraph (a), with effect from the date of the following extensive medical examination.

(d) Requirements for revalidation or renewal. The requirements to be met for the revalidation or renewal of the medical certificates are the same as for the initial issue of the medical certificate, except that it is specifically stipulated otherwise. (e) Reduction of the period of validity. The period of validity of the medical certificate may be reduced by an AME, in consultation with the AMS, when clinically indicated. (f) Additional recognition. Where the Authority has reasonable doubts as to the maintenance of the psycho-physical fitness of the holder of a medical certificate, the AMS may require its holder to undergo further examination, investigation or testing. The reports shall be forwarded to the AMS. See also Appendix 1 of the JAR-FCL 3.105.

JAR-FCL 3.110. Requirements for medical evaluation. (a) The applicant or holder of a medical certificate issued in accordance with JAR-FCL Part 3 (Medical Requirements) shall be without: (1) any abnormality, congenital or acquired,

(2) any active, latent, acute or chronic disability, (3) any injury, injury or sequel to an operation,

that may be a degree of functional incapacity that is likely to interfere with the safe operation of aircraft or with the safe execution of their functions.

(b) The applicant or holder of a medical certificate issued in accordance with JARs-FCL 3 (Medical Requirements) shall not suffer any disease or disability which may cause him to be suddenly unable to operate safely. aircraft or to safely perform the assigned tasks. JAR-FCL 3.115. Use of medication or other treatments.

(a) The holder of a medical certificate who is taking any prescribed medication or not, or who is receiving any medical, surgical or other treatment, will meet the requirements of the JAR-FCL 3.040.

(b) All procedures requiring the use of general or epidural anesthesia will be disqualifying for at least 48 hours. (c) All procedures requiring local or regional anesthesia will be disqualified for at least 12 hours.

JAR-FCL 3.120. Responsibilities of the applicant.

(a) Information to provide. The applicant or holder of a medical certificate shall demonstrate his identity and sign and provide the AME with a declaration of medical data on his/her person, family and hereditary history.

The statement will also include a reference to whether the applicant has previously performed another recognition, and if so, what was its outcome. The applicant shall be advised by the AME of the need to provide such a complete and accurate statement as his knowledge permits. (b) False information. Any statement made with intent to deceive shall be notified to the AMS of the State to which the license is requested or is to be requested. Upon receipt of such information, the AMS will take any measures it deems appropriate, including the transfer of this information to other JAA authorities (see JAR-FCL 3.080 (b). Medical confidentiality).

JAR-FCL 3.125. Delegation of the positive evaluation, review policy and secondary review.

(a) Delegation of the positive assessment. 1. If the applicant does not fully comply with the medical requirements prescribed in the JAR-FCL 3 for a given license, the AMC or AME shall not issue, revalidate or renew the medical certificate, but shall forward the decision to the AMS. If it is stipulated in the JAR-FCL 3 that the applicant can be assessed fit according to the Appendices B and C, the AMS can do so. The positive assessment can be done by the AMC or AME in consultation with the AMS.

2. An AMC or AME that evaluates an applicant as fit at the discretion of the AMS as set out in the preceding paragraph will inform the AMS of the details of this assessment.

(b) Review policy.

The AMS may issue, revalidate or renew a medical certificate after taking into consideration the requirements, acceptable means of compliance and guidance materials, opinions of medical experts and, if appropriate, the opinion of the other experts familiar with the operating environment and in cases of:

(1) medical deficiency in relation to the operating environment;

(2) the skill, expertise and experience of the applicant in the applicable operating environment; (3) a medical flight test, if appropriate; and (4) the requirements for the application of limitations, conditions or variations of the medical certificate and the licence. (See JAR-FCL 1,300 (e) (1).

When issuing a certificate requires more than one limitation, the AMS must consider the added and interactive effects on in-flight safety, before it is issued.

(c) Secondary review. Each Authority shall establish a secondary review procedure to consider and assess the conflicting cases, on the basis of independent medical advisors who are experts in aeronautical medicine.

Appendix 1 of JAR-FCL 3.105

Period of validity/transfer of medical records for renewal of class 1 and class 2 medical certificates.

(View JAR-FCL 3.105). 1. Class 1.

(a) If the holder of a licence permits his medical certificate to be expired for a period exceeding five years, the renewal of the licence shall require an initial or extended medical examination, at the discretion of the AMS, carried out on the AMC which has the appropriate medical records.

(b) If the holder of a license permits his or her medical certificate to be expired for a period of more than two years and less than five years, the renewal shall require an ordinary or extensive examination, to be carried out on the AMC have the appropriate medical records, or an AME, at the discretion of the AMS, provided that the records of the medical examinations made for the crew member's licence are available to the examiner. (c) If the holder of a licence permits his medical certificate to be expired for a period exceeding 90 days and less than two years, the renewal shall require an ordinary or extended examination, to be carried out by an AMC or an AME, at the discretion of the AMS. (d) If the holder of a licence permits his or her medical certificate to be expired for a period of less than 90 days, he may renew it under ordinary or extended medical examination, as established.

2. Class 2.

(a) If an instrument flight rating is added to the licence, a pure-tone audiometry must have been performed within the last 60 months if the licence holder is under 40 years of age, and within the last 60 months 24 months if the license holder is 40 or older.

(b) If the holder of a licence ceases to expire his medical certificate for a period of more than five years, the renewal shall require initial air medical recognition. The AME shall have the appropriate medical file before the issue of the certificate. (c) If the holder of a licence ceases to expire his medical certificate for a period of more than two years and less than five years, the renewal shall require the establishment of the established recognition. The AME shall have the appropriate medical record prior to recognition. (d) If the holder of a licence ceases to expire his medical certificate for a period of less than two years, the renewal shall require the establishment of the established recognition. It will always be considered that extensive aeronautical medical examinations always include the standard and therefore count as standard and extensive medical recognition.

Subpart B. Medical Requirements Class 1

JAR-FCL 3.130. Cardiovascular System-Recognition. (a) The applicant or holder of a Class 1 medical certificate shall not have any defect, congenital or acquired, in the cardiovascular system which may interfere with the safe exercise of the privileges of the licence (s) (s).

(b) In recognition to obtain the initial medical certificate, a standard electrocardiogram at rest of twelve derivations with a report is required; thereafter, it will be done at 5-year intervals until the age of 30, from 2 years to the 40, annually up to 50 years of age and in all subsequent revalidation and renewal examinations, or by clinical indication. (c) Ergometry (stress electrocardiography) is required only when clinically indicated, in accordance with Subpart B. (d) Subpart 1, Appendix 1, The electrocardiogram reports at rest or effort will be performed. by an AME or specialists accepted by the AMS. (e) In order to facilitate risk assessment, in recognition for the issuance of the initial medical certificate and in the first recognition after the age of 40 years, a serum lipid assessment, including cholesterol, will be required (see Paragraph 2 of Appendix 1 to Subpart B). (f) The holder of a Class 1 certificate, when arriving at the age of 65, in the first renewal/revalidation examination, shall be reviewed in an AMC or, at the discretion of the AMS, by a cardiologist accepted by the AMS.

JAR-FCL 3.135. Cardiovascular System-Blood pressure.

(a) Blood pressure shall be measured using the techniques provided in paragraph 3 of Appendix 1 of Subpart B in each examination.

(b) When the blood pressure exceeds 160 mmHg in the systolic and/or 95 mmHg in the diastolic, with or without treatment, the applicant will be evaluated as unfit. (c) Treatment for the control of blood pressure shall be compatible with the safe exercise of the privileges of the corresponding licence (s) (see paragraph 4 of Appendix 1 to Subpart B). The initiation of a medication requires that a period of temporary suspension of the medical certificate be established to determine the absence of significant side effects. (d) Applicants with symptomatic hypotension will be qualified as unfit.

JAR-FCL 3.140. Cardiovascular System-Coronary Disease.

(a) The applicant with suspected cardiac ischemia will be investigated. The applicant with mild and asymptomatic coronary heart disease, who do not require treatment, may be assessed as fit by the AMS, if the investigations in Subpart B's Appendix 1 of Appendix 1 have been satisfactory.

(b) Applicants with symptomatic coronary heart disease or with medication-controlled heart symptoms, will be qualified as unfit. (c) After an ischaemic heart event (defined as myocardial infarction, angina, significant arrhythmia or cardiac failure due to ischemia or any type of cardiac revascularization) certification will not be possible for class 1. The AMS may grant an assessment of fit for renewal and revalidation if the investigation referred to in paragraph 6 of Appendix 1 to Subpart B has been successful.

JAR-FCL 3.145. Cardiovascular system-Arrhythmias/conduction alterations.

(a) Applicants with significant disorders in the supraventricular rhythm, including synoatrial alteration, whether intermittent or continuous, will be qualified as unfit. The AMS may consider an assessment of fit in accordance with paragraph 7 of Appendix 1 to Subpart B.

(b) Applicants with asymptomatic sinus bradycardia or sinus tachycardia may be qualified as fit in the absence of significant underlying abnormalities. (c) Applicants with isolated uniform ventricular or supraventricular complexes that do not produce symptomatology do not need to be qualified as unfit. However, frequent or complex forms require a complete cardiological assessment in accordance with paragraph 7 of Appendix 1 of Subpart B. (d) In the absence of another abnormality, applicants with incomplete block or branch block deviated to the left in a stable way, they can be qualified as suitable. (e) Applicants with complete right branch block require a cardiologic assessment in the first presentation and thereafter, in accordance with Subpart B. (f) Appendix 1, paragraph 7, applicants with complete left branch block will be assessed as unfit. It may be considered the fitness by the AMS, in accordance with paragraph 7 of Appendix 1 of Subpart B. (g) Applicants with first-degree A-V blocking and Mobitz type 1 can be assessed as fit in the absence of noticeable abnormality. Applicants with Mobitz type 2 or full A-V lock will be assessed as unfit. The AMS may consider fitness in accordance with paragraph 7 of Appendix 1 of Subpart B. (h) Applicants who present tachycardia with both wide and narrow complexes should be considered unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 7 of Appendix 1 of Subpart B. (i) Applicants with ventricular pre-excitation will be assessed as unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 7 of Appendix 1 of Subpart B. (j) Applicants requiring an endocardial pacemaker should be considered unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 8 of Appendix 1 of Subpart B. (k) Applicants who have received ablation therapy shall be assessed as unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 7 of Appendix 1 of Subpart B.

JAR-FCL 3.150. Cardiovascular System-General.

(a) Applicants who have peripheral vascular disease intervening or not intervening should be considered unfit. As long as there is no significant functional alteration, an assessment of fit by the AMS may be considered subject to compliance with paragraphs 5 and 6 of Appendix 1 of Subpart B.

(b) Applicants who have an aneurysm of the thoracic or abdominal aorta, before or after surgery, should be considered unfit. Applicants with an aneurysm in the infrared abdominal aorta may be assessed as fit by the AMS for renewal or revalidation examination, subject to compliance with paragraph 8 of Appendix 1 of Subpart B. (c) Applicants that have a significant alteration in any of the heart valves should be considered unfit.

(1) Applicants with minor alterations to the heart valves may be considered fit by the AMS, subject to compliance with paragraph 9 (a) and (b) of Appendix 1 of Subpart B.

(2) Applicants carrying a valvular or well-operated prosthesis for the repair of a valve must be considered unfit. An aptitude assessment may be considered by the AMS, subject to compliance with paragraph 9 (c) of Appendix 1 of Subpart B.

(d) The systemic anticoagulant treatment is a reason for disqualification. Applicants who have received such treatment with a limited duration may be considered for an assessment of fit by the AMS, subject to compliance with paragraph 10, Appendix 1 of Subpart B.

(e) Applicants who present any alteration in the pericardium, myocardium or endocardium not referred to in the preceding paragraphs should be considered unfit. An assessment of fit by the AMS can be considered after the complete resolution of the table and after a satisfactory cardiological assessment, according to paragraph 11 of Appendix 1 to Subpart B. (f) Applicants who present Congenital heart disease, surgery or non-intervention, should be considered unfit. Applicants with minor-grade malformations may be considered eligible by the WHA following a detailed cardiological study, according to Subpart B, Appendix 1, paragraph 12 (g) Heart/lung transplantation is a reason for disqualification. (h) Applicants with a history of recurrent vasovagal syncope should be considered unfit. An assessment of fit by the AMS may be considered for applicants with a favorable record, subject to compliance with Subpart B.

, Appendix 1, paragraph 13.

JAR-FCL 3.155. Respiratory-General System.

(a) The applicant or holder of a Class 1 medical certificate shall not suffer any failure, congenital or acquired, in the respiratory system which may interfere with the safe exercise of the privileges granted to them by the (s) corresponding licence (s).

(b) An anteroposterior chest X-ray may be required in initial recognition, renewal or revalidation when indicated for clinical or epidemiological reasons. (c) Lung function tests (see paragraph 1 Appendix 2 of Subpart B) are required in initial recognition when clinically indicated. Applicants with a significant impairment of lung function (see paragraph 1 Appendix 2 of Subpart B) will be qualified as unfit.

JAR-FCL 3.160. Respiratory system-Alterations.

(a) Applicants suffering from chronic obstructive airway disease will be qualified as unfit. Applicants with minor impairment of their lung function may be qualified as fit.

(b) Applicants with asthma who require medication will be qualified in accordance with the criteria set out in Subpart B. (c) Subpart 2, Appendix 2. Applicants with active inflammatory system diseases Respiratory will be temporarily qualified as unfit. (d) Applicants with active sarcoidosis shall be qualified as unfit (see paragraph 3 of Appendix 2 to Subpart B). (e) Applicants with spontaneous pneumothorax shall be qualified as unfit for a complete assessment, in accordance with Subpart B. (f) Subpart 4, Appendix 2, applicants requiring a major surgical intervention the respiratory system shall be classified as unfit for a minimum of three months after the operation and until such time as the effects of the operation cannot interfere with the safe exercise of the privileges of the licence (s) corresponding (see paragraph 5 of Appendix 2 to Subpart B). (g) Applicants who present sleep apnea syndrome treated in an unsatisfactory manner should be considered unfit.

JAR-FCL 3.165. Digestive-General System.

The applicant or holder of a Class 1 medical certificate shall not suffer from any functional or structural disease of the gastrointestinal tract or any of its yeats which may interfere with the safe exercise of the privileges conferred on them. grant the corresponding license (s).

JAR-FCL 3.170. Digestive system-Alterations.

(a) Applicants with recurrent dyspeptic discomfort who require medication or pancreatitis will be qualified as unfit for evaluation in accordance with Subpart B, Appendix 3, paragraph 1.

(b) Applicants who present asymptomatic gallbladder stones discovered in an incidental manner should be evaluated as listed in Subpart B. (c) Subpart 3, paragraph 2. Current diagnosis or history of inflammatory bowel disease should be considered unfit (see Appendix 3, Subpart B, paragraph 3). (d) Applicants shall not present any form of hernia which may result in disabling symptomatology. (e) applicants with any sequel to diseases or surgical interventions in any location of the digestive system or their organs which may cause incapacity during the flight, in particular as regards the obstruction caused by stenosis or compression, should be considered unfit. (f) Applicants who have undergone surgical intervention in the digestive system or in their organs, with a total or partial division of either of these organs or with their referral, should be considered unfit for a a minimum period of 3 months or until such time as the effects of the intervention can no longer possibly interfere with the safe exercise of the privileges granted by the applicable licence (see paragraph 4 of Appendix 3 to Subpart B).

JAR-FCL 3.175. Metabolic, nutritional and endocrine diseases.

(a) The applicant or holder of a Class 1 medical certificate shall not suffer from any functional or structural metabolic, nutritional or endocrine condition, which may interfere with the safe exercise of the privileges granted to them. the corresponding licence (s).

(b) Applicants with metabolic, nutritional or endocrine dysfunctions may be qualified as fit according to Subpart B. (c) Subpart 1 and 4 of Appendix 4 (c) Applicants with diabetes mellitus may be qualified as fit, only in accordance with paragraphs 2 and 3 of Appendix 4 of Subpart B. (d) Applicants with diabetes requiring insulin shall be qualified as unfit. (e) Applicants with a body mass index ≥ 35 may be considered eligible only if excess body weight may not interfere with the safe exercise of the privileges granted to them by the corresponding licence (s) and provided that a satisfactory cardiovascular risk assessment has been carried out (see paragraph 1 Appendix 9 of Subpart B).

JAR-FCL 3.180. Haematology.

(a) The applicant or holder of a Class 1 medical certificate shall not suffer any haematological disease which may interfere with the safe exercise of the privileges granted to them by the corresponding licence (s).

(b) The haemoglobin concentration should be determined in all medical examinations. Applicants with abnormal hemoglobin will be investigated. Applicants with a hematocrit of less than 32% should be considered unfit (see Subpart B, Appendix 5, paragraph 1). (c) Applicants who have sickle cell anaemia should be considered unfit (see Appendix 5, paragraph 1, Subpart B). (d) Applicants who have a significant increase in the number of lymph nodes, located or generalised, or blood diseases should be considered unfit (see Appendix 5, Subpart B, paragraph 2). (e) Applicants who have acute leukaemia should be considered unfit. Following the establishment of a referral, applicants can be assessed as fit by the AMS. Applicants who have chronic leukaemia should be considered unfit. After a period of proven stability they can be considered eligible by the AMS. See paragraph 3 of Appendix 5 of Subpart B. (f) Applicants with a significant size increase of the spleen should be considered unfit (see Subpart B, Appendix 5, paragraph 4). (g) Applicants who present a significant polycythemia should be considered unfit (see Subpart B, Appendix 5, paragraph 5). (h) Applicants who have a coagulation defect should be considered unfit (see Appendix 5, Subpart B, paragraph 6).

JAR-FCL 3.185. Urinary system.

(a) An applicant or holder of a Class 1 medical certificate must not present any functional or structural alterations to the urinary system or its organs that may interfere with the safe exercise of the the privileges granted to them by the corresponding licence (s).

(b) Applicants who present any sign of organic kidney involvement should be considered unfit. The urinalysis should be part of any medical evaluation. Urine should not contain abnormal elements that may have pathological significance. Special attention needs to be paid to diseases affecting the urinary tract and the genital organs (see Appendix 6, paragraph 1 of Subpart B). (c) Applicants who present urinary calculations should be considered unfit (see Appendix 6, paragraph 2 of Subpart B). (d) applicants who have any type of sequelae of a disease or surgical intervention on the kidneys or the urinary system which may cause incapacity, in particular any form of obstruction due to stenosis or compression, they must be considered unfit. Applicants in whom a compensated nephrectomy has been performed and who do not have high blood pressure or uremia may be considered eligible (see Appendix 6, Subpart B, paragraph 3). (e) applicants who have undergone major surgical intervention in the urinary system or in the urinary tract, with a total or partial division of one of their organs or with a referral to them, should be considered unfit. for a period of at least 3 months and up to the time when the effects of such intervention cannot reasonably be caused by failure during the flight (see paragraphs 3 and 4 of Appendix 6 to Subpart B).

JAR-FCL 3.190. Sexually transmitted diseases and other infections.

(a) An applicant or a holder of a Class 1 medical certificate must not have a clinical history or at this time have any sexually transmitted disease or any other infection that may interfere with the exercise of the privileges granted to them by the corresponding licence (s).

(b) Special attention needs to be paid (see Appendix 7 of this Subpart) to the background or clinical signs indicative of:

(1) HIV positivity,

(2) immune system disorders, (3) infectious hepatitis, (4) syphilis.

JAR-FCL 3.195. Gynaecology and obstetrics.

(a) An applicant or holder of a Class 1 medical certificate must not present any functional or structural obstetrical or gynaecological alterations that may interfere with the safe exercise of the privileges granted to them. the corresponding licence (s).

(b) The applicant with a history of major menstrual discomfort, with little response to treatment, will be assessed as unfit. (c) Pregnancy implies intraining. If the obstetric assessment indicates a completely normal pregnancy, the applicant may be assessed as fit until the end of week 26 of gestation, in accordance with paragraph 1 of Appendix 8 of Subpart B, by the AMS, AMC or AME. You will be able to resume the privileges of the licence once the full recovery is confirmed after the birth or after the termination of the pregnancy. (d) The applicant who has undergone an important gynaecological surgical intervention shall be assessed as unfit for a period of three months or until there is no likelihood that the effects of the operation may interfere with the safe exercise of the privileges granted to them by the licence (s) (see paragraph 2 of Appendix 8 to Subpart B).

JAR-FCL 3,200. Muscle and skeletal requirements.

(a) The applicant or holder of a Class 1 medical certificate shall not have any abnormality, congenital or acquired, in the bones, joints, muscles and tendons that may interfere with the safe exercise of the privileges which give them the corresponding licence (s).

(b) An applicant must present sufficient stature in a sitting position, as well as the sufficient length of arms and legs, and the necessary muscle strength, for the safe exercise of the relevant privileges of the relevant (see paragraph 1 of Appendix 9 to Subpart B). (c) The applicant shall enjoy satisfactory functioning of the musculoskeletal system. The applicant with any significant sequin of disease, injury or congenital failure of the bones, joints, muscles or tendons, with or without surgery, shall be evaluated in accordance with paragraphs 1, 2 and 3 of Appendix 9 of Subpart B.

JAR-FCL 3.205. Psychiatric requirements.

(a) The applicant or holder of a Class 1 medical certificate shall have no history or established medical diagnosis of any disease or psychiatric disability or condition, acute or chronic, congenital or acquired, that may interfere with the safe exercise of the privileges granted to them by the corresponding licence (s).

(b) Special attention should be paid to the following tables (see Appendix 10 of Subpart B):

(1) schizophrenia, schizotypic and delirium disorders;

(2) mood disorders; (3) neurotic disorders, related to stress and somatomorphs; (4) personality disorders; (5) organic mental disorders; (6) mental and behavioral disorders due to the alcohol; (7) use or abuse of psychotropic substances.

JAR-FCL 3.210. Neurological requirements.

(a) The applicant or holder of a Class 1 medical certificate shall not have a history or established medical diagnosis of any neurological condition that may interfere with the safe exercise of the privileges conferred upon them. grant the corresponding license (s).

(b) Particular attention should be paid to the following (see Appendix 11 of Subpart B):

(1) progressive nervous system disease,

(2) epilepsy and other causes of consciousness disorders, (3) disorders with a high propensity to brain dysfunction, (4) head trauma, (5) spinal cord injury or the peripheral nervous system.

(c) An electroencephalogram is required when indicated by the applicant's or clinical reasons (see Appendix 11 of Subpart B). JAR-FCL 3.215. Ophthalmological requirements.

(See Appendix 12 of Subpart B). (a) The applicant or holder of a Class 1 medical certificate shall not have any anomaly in the eye function or its attachments or any active, congenital or acquired, acute or chronic pathological condition, or any subsequent eye surgery or trauma, which may interfere with the safe exercise of the privileges granted to you by the corresponding license (s).

(b) Ophthalmological recognition by an ophthalmologist or specialist in the care of the vision accepted by the AMS (all cases of abnormality or doubt will be referred to an ophthalmologist accepted by the WHA) is necessary. initial assessment, and must include:

(1) Clinical history;

(2) Visual acuity in the near, intermediate and distant vision: uncorrected; with the best possible optical correction, if necessary; (3) Objective refractive. Applicants with hyperopia, under 25 years of age, in cycloplegia; (4) Eye motility and binocular vision; (5) Vision of colours; (6) Visual fields; (7) Tonometry according to the clinical indication and in people over 40 years of age age; (8) Evaluation of the external part of the eyes, of the anatomy, of the refractive means (slit lamp) and of the bottom of the eye.

(c) Routine eye scan can be performed by an AME. It will be part of all revalidation and renewal acknowledgements (see Subpart B, Appendix 12, paragraph 2) and must include:

(1) Clinical history;

(2) Visual acuity in the near, intermediate and distant vision: uncorrected and with the optical correction better, if necessary; (3) Examination of the external part of the eye, of its anatomy, of the refractive means and of the bottom of the eye; (4) A more detailed examination according to the clinical indication (see paragraph 4 of Appendix 12 to Subpart B).

(c) In cases where the holder of a certificate presents functional performance standards (6/9 (0, 7), 6/6 (1, 0), N14, N5) only with corrective lenses, and the refraction error exceeds +/-3 dioptrias, it must provide to the AMS a report of the exploration performed by an ophthalmologist or by a specialist in the vision authorized by the AMS (see paragraph 3 of Appendix 12 of Subpart B).

If refraction error is within a range that does not exceed + 5 to -6 dioptrias, this recognition should be done within 60 months prior to extended medical recognition. If the refraction error is outside the range indicated, the test should be performed within 24 months before the test. The scan must include:

(1) Clinical history;

(2) Visual acuity in near, intermediate and distant vision: uncorrected; with a best optical correction if necessary; (3) Refraction; (4) Eye motility and binocular vision; (5) Visual fields; (6) Tonometry from 40 years of age; (7) Examination of the external part of the eyes, of its anatomy, of the means of refraction (slit lamp) and of the bottom of the eye.

This report should be referred to the AMS. In the event that any alteration that raises doubts about the suitability of the ocular system of the applicant is detected, a new ophthalmological examination will be required (see Appendix 12, Subpart B, paragraph 4).

(e) The holders of a class 1 certificate, after their age of 40 years, will undergo a tononometry every 2 years or report a tonometry performed within 24 months prior to the medical examination. (f) In cases where the examination by a specialist in ophthalmology is necessary for any significant reason, the relevant limitation must be stated in the medical certificate " Requires the examination carried out by a Specialist in ophthalmology-RXO '. This limitation can be applied by an AME but can only be removed by the AMS.

JAR-FCL 3.220. Visual requirements.

(a) Far visual acuity. The distant visual acuity, with or without correction, shall be 6/9 (0.7) or higher in each eye, and visual acuity with both eyes shall be 6/6 (1.0) or higher (see JAR-FCL 3.220 (g) below). No limitations apply to uncorrected visual acuity.

(b) Refraction errors. Refraction error is defined as the deviation from the metropy measure in dioptrias in the most ametropic meridian. Refraction will be measured by standard methods (see Appendix 13, Subpart B, paragraph 1). In relation to refraction errors, applicants shall be qualified if they meet the following requirements:

(1) Refraction error. i. In the initial recognition the refraction error shall be in the order of + 5 to -6 dioptrias (see paragraph 2 (a) of Appendix 13 of Subpart B).

ii. In recognition of revalidation or renewal, the applicant with sufficient experience to the satisfaction of the Authority and with refraction error not exceeding + 5 dioptrias or with a highly myopic refraction error exceeding 6% dioptrias can be qualified as AMS (see paragraph 2 (b) of Appendix 13 of Subpart B). iii. Applicants with great refractive error will wear contact lenses or glasses.

(2) Astigmatism.

i. In an initial applicant with a refraction error accompanied by an astigmatism component, astigmatism should not exceed 2.0 dioptrias.

ii. In recognition of revalidation or renewal, the applicant with sufficient experience to the satisfaction of the Authority and with a refraction error accompanied by an astigmatism component not exceeding 3.0 dioptrias may be qualified as suitable by the AMS (see paragraph 3 of Appendix 13 to Subpart B).

(3) The keratoconus is a reason for disqualification. The AMS may consider revalidation and renewal if the applicant meets the visual acuity requirements (see paragraph 3 of Appendix 13 of Subpart B).

(4) Anisometropy.

(i) In an initial applicant the difference in refractive error between the two eyes (anisometropy) should not exceed 2.0 dioptrias.

(ii) In recognition of revalidation or renewal, the applicant with sufficient experience to the satisfaction of the Authority and with a refractive error difference between both eyes (anisometropy) of up to 3.0 dioptrias can be assessed by the AMS. Contact lenses shall be used if the anisometropy exceeds 3.0 dioptrias (see paragraph 5 of Appendix 13 to Subpart B).

(5) The development of the presbycia should be followed in all the aero-medical examinations of renovation.

(6) The applicant must be able to read a letter N5 (or equivalent) to 30-50 cm and a N14 (or equivalent) to 100 cms, with correction if prescribed. [View JAR-FCL 3.220 (h)].

c) The applicant with significant defects in the binocular vision will be evaluated as unfit. (See paragraph 6 of Appendix 13 to Subpart B).

(d) The applicant with diplopia will be evaluated as unfit. (e) An applicant with an imbalance of the eye muscles (heteroforias) that exceeds (measured with the usual correction, if necessary) of:

2.0 hyperforia prismatic dioptrias at 6 meters,

10,0 esoforia prismatic dioptrias at 6 meters, 8.0 exoforia prismatic dioptrias at 6 meters; and 1.0 hyperforia prismatic dioptria at 33 cm, 6.0 esoforia prismatic dioptrias at 33 cm, 12.0 exoforia prismatic dioptrias at 33 cm,

will be evaluated as unfit. If the fusion capacity is sufficient to prevent asthenopia and diplopia, the AMS may consider an assessment of fit (see paragraph 6 of Appendix 13 Subpart B).

(f) The applicant with abnormal visual fields will be evaluated as unfit (see paragraph 4 of Appendix 13 Subpart B). (g)

(1) If a visual requirement is met only with the use of correction, the glasses or contact lenses shall provide an optimal visual function, well tolerated and suitable for the purposes of aviation. If contact lenses are used, they will be monofocal and for faraway vision. Orthokeratological crystals will not be used.

(2) The corrective lenses, when taken for use in aviation, shall allow the holder of the aircraft to meet the visual requirements at all distances. No more than one pair of glasses shall be used to meet this requirement. (3) Contact lenses, when used for aviation purposes, shall be monofocal and not tinted. (4) A pair of spare glasses of similar correction should be available when the privileges of the licence are exercised.

(h) Eye surgery.

(1) The history of refractive surgery leads to a lack of fitness. The rating of fit can be considered by the AMS (see paragraph 8 of Appendix 13 Subpart B).

(2) The history of cataract surgery, retinal surgery, and glaucoma surgery lead to lack of fitness. In revalidation/renewal it can be qualified by the AMS (see paragraph 9 of Appendix 13 Subpart B).

JAR-FCL 3.225. Perception of the colors.

(a) Normal color perception is defined as the ability to pass the Ishihara tables or the Nagel anomaloscope as normal tricromata (see Subpart B, Appendix 14, paragraph 1).

(b) The applicant must have a normal perception of the colours or distinguish them safely. In the initial examination the applicants will have to pass the Ishihara test. Those who do not pass the Ishihara test will be rated as distinguishing the colors safely if they exceed other tests performed with AMS-accepted methods (anomaloscope or colored lantern) (see Appendix 14 of Appendix 14). Subpart B). The revalidation or renewal shall only be verified by clinical means. (c) The applicant who does not exceed the colour perception tests shall be regarded as having an unsafe colour vision and shall be assessed as unfit.

JAR-FCL 3.230. Otorhinolaryngological requirements.

(a) The applicant or holder of a Class 1 medical certificate shall not have any anomaly in the functions of the ears, nose, sinuses or throat (including the oral cavity, teeth and larynx), or any condition active pathological, congenital or acquired, acute or chronic, or any follow-up of surgery and trauma that may interfere with the safe exercise of the privileges granted to them by the corresponding license (s).

(b) Full otorhinolaryngologic recognition will be required in the initial recognition, and thereafter when clinical required (extended recognition -see paragraph 1 and 2 of Subpart B Appendix 15) and include:

(1) medical history;

(2) clinical examination including otoscopy, rhinoscopy, and nose and throat examination; (3) timpanometry or equivalent; (4) clinical assessment of the vestibular system.

All cases of abnormality or doubt within an ENT zone will still be referred to as an aviation otorhinolaryngology specialist accepted by the AMS.

(c) An ordinary ear-nose-throat recognition shall be part of all revalidation and renewal recognition (see Appendix 15 of Subpart B). (d) The presence of any of the following conditions in the applicant shall result in an assessment of unfit.

(1) Pathologic, acute or chronic active process of the inner or middle ear.

(2) Uncured perforation, or dysfunction of the eardrum membranes (see paragraph 3 of Appendix 15 of Subpart B). (3) Alterations of the vestibular function (see paragraph 4 of Appendix 15 of Subpart B). (4) Significant ventilation restriction in either of the two nostrils, or any dysfunction of the sinuses. (5) Significant malformation or significant, acute or chronic infection in the oral cavity or upper respiratory tract. (6) Significant speech or speech disorder.

JAR-FCL 3.235. Hearing requirements.

(a) Hearing should be checked at all recognitions. The applicant shall understand correctly with each ear the conversation, when it is found to be at a distance of 2 metres and from the back to the AME.

(b) The hearing will be checked with tonal audiometry in the initial recognition and subsequent revalidation or renewal every five years until it reaches 40 years and every two years thereafter (see paragraph 1 of the Appendix 16 to Subpart B) (c) There should be no hearing loss in both ears, checking them separately, 35 dB (HL) at any of the 500, 1000, and 2000 Hz frequencies, or more than 50 dB (HL) at 3000 Hz. (d) In revalidation or renewal, applicants with hypoacusia may be qualified as eligible by the WHA if a satisfactory hearing ability is demonstrated in a verbal discrimination test (see paragraph 2 of Appendix 16 of Subpart B).

JAR-FCL 3.240. Psychological requirements.

(a) The applicant or holder of a Class 1 medical certificate shall not have any established psychological deficiencies (see Appendix 17, Subpart B, paragraph 1), which may interfere with the safe exercise of the the privileges granted to them by the corresponding licence (s). The AMS shall require a psychological assessment where it is indicated as part or complement of a psychiatric or neurological recognition (see Subpart B, Appendix 17, paragraph 2).

(b) THIS psychological evaluation will be performed by a psychologist accepted by the AMS. (c) Psychologists will issue a written report for the WHA detailing their opinion and recommendations.

JAR-FCL 3.245. Dermatological requirements.

(a) The applicant or holder of a Class 1 medical certificate shall not suffer any proven dermatological condition that may interfere with the safe exercise of the privileges granted to them by the license (s) (s).

(b) Particular attention should be paid to the following conditions (see Appendix 18 of Subpart B):

(1) Eczema (exogenous and endogenous).

(2) Severe Psoriasis. (3) bacterial infections. (4) Drug-induced Rashes. (5) Ampoule eruptions. (6) Tumor skin pathology. (7) Urbino.

The AMS should be consulted if there is any doubt about any other condition. JAR-FCL 3.246. Oncology.

(a) The applicant or holder of a Class 1 medical certificate shall not present any established, primary or secondary malignant disease which may interfere with the safe exercise of the privileges granted to them by the (s) corresponding licence (s).

(b) Following the treatment of a malignant disease, the applicant may be assessed as eligible as listed in Appendix 19 of Subpart B.

Subpart C. Medical Requirements Class 2

JAR-FCL 3,250. Cardiovascular System-Recognition.

(a) The applicant or holder of a Class 2 medical certificate shall not have any defect, congenital or acquired, in the cardiovascular system that may interfere with the safe exercise of the privileges granted to them by the the corresponding licence (s).

(b) A standard 12-track standard electrocardiogram (ECG) is required with a report in recognition for the initial medical certificate to be issued, in first recognition after the age of 40 years, and then in all aeronautical medical examinations. (c) ergometry (stress electrocardiography) is required only when clinically indicated in accordance with Subpart C. (d) Subpart 1, paragraph 1. The electrocardiogram and ergometry reports will be performed by the AME or other specialists accepted by the AMS. (e) If two or more major risk factors (smoking, hypertension, diabetes mellitus, obesity, etc.) are given in the applicant, an assessment of serum lipids and serum cholesterol is required in recognition for the issuance of the certificate. initial and first recognition after the age of 40 years and by clinical indication (see paragraph 2 of Appendix 1 to Subpart C).

JAR-FCL 3.255. Cardiovascular System-Blood pressure.

(a) Blood pressure shall be measured using the techniques provided in paragraph 3 of Appendix 1 of Subpart C for each medical examination.

(b) When the blood pressure effectively exceeds 160 mmHg of systolic and 95 mmHg of diastolic, with or without treatment, the applicant will be evaluated as unfit. (c) Treatment for blood pressure control shall be compatible with the safe exercise of the privileges granted by the corresponding licence (s) and comply with paragraph 4 of Appendix 1 to Subpart C). The initiation of a pharmacological treatment requires that a period of temporary suspension of the medical certificate be established to determine the absence of significant side effects. (d) Applicants with symptomatic hypotension will be assessed as unfit.

JAR-FCL 3.260. Cardiovascular System-Coronary Disease.

(a) The applicant with suspected cardiac ischemia will be investigated. Those suffering from a mild, asymptomatic coronary heart disease, which does not require treatment, may be considered eligible by the AMS if the investigations referred to in paragraph 5 of Appendix 1 of Subpart C are satisfactory.

(b) Applicants with symptomatic coronary heart disease or with medication-controlled heart symptoms, will be qualified as unfit. (c) After a cardiac ischemic event (defined as myocardial infarction, angina, significant arrhythmia or cardiac failure due to ischemia or any type of cardiac revascularization) certification for class 2 applicants may be considered by the AMS if the investigation referred to in paragraph 6 of Appendix 1 to Subpart B has been satisfactory.

JAR-FCL 3.265. Cardiovascular system-Arrhythmias/conduction alterations.

(a) Applicants with supraventricular rhythm disorders, including sinoatrial dysfunction, intermittent or established, will be qualified as unfit. The AMS may consider an aptitude assessment in accordance with paragraph 7 of Appendix 1 of Subpart C.

(b) Applicants with asymptomatic sinus bradycardia or sinus tachycardia may be qualified as fit in the absence of significant underlying pathology. (c) It is not necessary to describe as unfit applicants with supraventricular or ventricular complexes or uniform, isolated and asymptomatic ectopic headphones, but if the extrasystole is very frequent, or with complex forms, it will be required a complete cardiological assessment in accordance with paragraph 7 of Appendix 1 of Subpart C. (d) In the absence of another anomaly, applicants with incomplete branch block or a stable left-axis deviation may be qualified as fit. (e) Applicants with complete branch block, right, shall require a cardiological assessment in their first submission and thereafter, in accordance with the appropriate elements of paragraph 8 of Appendix 1 to Subpart C. (f) Applicants with complete left branch lock will be evaluated as unfit. It may be considered the fitness by the AMS, in accordance with paragraph 7 of Appendix 1 of Subpart B. (g) Applicants with first-degree A-V blocking and Mobitz type 1 can be assessed as fit in the absence of noticeable abnormality. Applicants with Mobitz type 2 or full A-V lock will be assessed as unfit. The AMS may consider fitness in accordance with paragraph 7 of Appendix 1 of Subpart B. (h) Applicants who present tachycardia with both wide and narrow complexes should be considered unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 7 of Appendix 1 of Subpart B. (i) Applicants with ventricular pre-excitation will be assessed as unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 7 of Appendix 1 of Subpart B. (j) Applicants requiring an endocardial pacemaker should be considered unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 8 of Appendix 1 of Subpart B. (k) Applicants who have received ablation therapy shall be assessed as unfit. An eligible rating by the AMS may be considered subject to compliance with paragraph 7 of Appendix 1 of Subpart B.

JAR-FCL 3.270. Cardiovascular System-General.

(a) Applicants with peripheral vascular disease will be qualified as unfit, before or after surgery. As long as it does not present significant functional alterations, the AMS may consider an assessment of fit, subject to being in accordance with paragraphs 5 and 6 of Appendix 1 of Subpart C.

(b) Applicants with aneurysm of the thoracic or abdominal aorta, before or after surgery, should be considered as unfit. Applicants with an infrared abdominal aortic aneurysm may be assessed as fit by the AME subject to comply with paragraph 8 of Appendix 1 of Subpart C. (c) Applicants with significant abnormalities in any of the valves They will be qualified as unfit.

(1) Applicants with minor abnormalities in the heart valves may be qualified as fit by the AMS subject to compliance with paragraph 9 (a) and (b) of Appendix 1 of Subpart C.

(2) Applicants who have undergone restorative or replacement valve surgery shall be qualified as unfit. An apt assessment may be considered by the AMS subject to compliance with paragraph 9 (c) of Appendix 1 of Subpart C.

(d) The systemic anticoagulant therapy is disqualifying. After a limited duration treatment, applicants may be considered for an AMS-grade rating in accordance with Subpart C. 1, Appendix 1, paragraph 10.

(e) Applicants with any failure of the pericardium, myocardium or endocardium not listed above will be qualified as unfit. The AMS may consider an assessment of fit after a complete resolution of the anomaly has occurred and following a satisfactory cardiology assessment in accordance with Subpart C. (f) Subpart 11, paragraph 11. Congenital heart defects, before or after corrective surgery, will be qualified as unfit. The AMS may consider an assessment of fit in accordance with paragraph 12 of Appendix 1 of Subpart C. (g) Transplantation of heart or heart/lung is a cause of lack of fitness. (h) Applicants with a history of repeated vasovagal syncope will be qualified as unfit. The AMS may consider the assessment of an applicant's fit with this background subject to compliance with paragraph 13 of Appendix 1 of Subpart C.

JAR-FCL 3.275. Respiratory-General System.

(a) The applicant or holder of a Class 2 medical certificate shall not have any anomaly in the respiratory system, congenital or acquired, which may interfere with the safe exercise of the privileges granted to them by the Licence (s).

(b) Only in cases where it is indicated for clinical or epidemiological reasons, a previous chest X-ray will be required. (c) A pulmonary function test is required (see Subpart C, Appendix 2, paragraph 1). Applicants with a significant impairment of lung function will be rated as unfit (see Appendix 2 of Appendix 2 of Subpart C).

JAR-FCL 3.280. Respiratory system-Alterations.

(a) Applicants with chronic obstructive airway disease will be qualified as unfit. Applicants with minor impairment of lung function may be qualified as fit.

(b) Applicants with asthma who require medication will be qualified in accordance with the criteria set out in Subpart C. (c) Subpart 2, Appendix 2. Applicants with Inflammatory System Active Diseases Respiratory will be qualified as temporarily unfit. (d) Applicants with active sarcoidosis shall be qualified as unfit (see paragraph 3 of Appendix 2 to Subpart C). (e) Applicants with spontaneous pneumothorax will be qualified as unfit, pending a full evaluation (see paragraph 4 Appendix 2 of Subpart C). (f) Applicants requiring a major surgical intervention affecting the breathing apparatus shall be qualified as unfit for a minimum period of three months after the operation and up to the time the effects of the operation are not may interfere with the safe exercise of the privileges granted to them by the corresponding licence (s) (see paragraph 5 of Appendix 2 to Subpart C). (g) Applicants with sleep apnea syndrome treated in an unsatisfactory manner should be considered as unfit.

JAR-FCL 3.285. Digestive-General System.

The applicant or holder of a Class 2 medical certificate shall not suffer from any functional or structural disease of the gastrointestinal tract or its attachments which may interfere with the safe exercise of the privileges conferred upon them. grant (s) the corresponding licence (s).

JAR-FCL 3.290. Digestive system-Alterations.

(a) Applicants with recurrent dyspeptic disorders requiring medication or pancreatitis will be qualified as unfit, pending evaluation in accordance with Subpart C. 1, Appendix 3, paragraph 1.

(b) Applicants with asymptomatic cholelithiasis discovered in an incidental manner shall be assessed as referred to in paragraph 2 of Appendix 3 of Subpart C. (c) The applicant who has an established medical history or a clinical diagnosis of inflammatory bowel disease, will be evaluated as unfit (see Appendix 3, paragraph 3 of Subpart C. (d) The applicant will not present any hernia that may increase the risk of disabling symptoms. (e) applicants with any disease or surgical intervention in any part of the digestive tract, or their annexes, which may cause intraining in flight, in particular any obstruction due to tightness or compression, will be assessed as unfit. (f) The applicant who has undergone a surgical operation in the digestive tract or its annexes, including full or partial resection or derivative techniques affecting any of these organs, shall be assessed as unfit for a period of time. a minimum of three months or up to the time the effects of such an operation are not likely to interfere with the safe exercise of the privileges granted to them by the corresponding licence (s) (see paragraph 4 Appendix 3 of Subpart C).

JAR-FCL 3.295. Metabolic, nutritional and endocrine diseases.

(a) The applicant or holder of a Class 2 medical certificate shall not suffer from any functional or structural metabolic, nutritional or endocrine condition which may interfere with the safe exercise of the privileges conferred upon them. grant the corresponding license (s).

(b) Applicants with metabolic, nutritional or endocrine dysfunctions may be qualified as fit in accordance with Subpart C. (c) Subpart 1 and 4 of Appendix 4. Applicants with diabetes mellitus may be qualified as fit only in accordance with paragraphs 2 and 3 of Appendix 4 of Subpart C. (d) Applicants with diabetes requiring insulin shall be qualified as unfit. (e) Applicants with a body mass index ≥ 35 may be considered eligible only if excess body weight may not interfere with the safe exercise of the corresponding licence (s) and provided that a satisfactory assessment of cardiovascular risk (see paragraph 1 Appendix 9 of Subpart B).

JAR-FCL 3,300. Haematology.

(a) The applicant or holder of a Class 2 medical certificate shall not suffer any haematological disease which may interfere with the safe exercise of the privileges granted to them by the appropriate licence (s).

(b) The haemoglobin must be checked for the initial medical certificate and when indicated for clinical reasons. Applicants with abnormal hemoglobin will be investigated. Applicants with a hematocrit of less than 32% shall be assessed as unfit (see Appendix 5, Subpart C, paragraph 1). (c) The applicant with sickle cell disease shall be assessed as unfit (see paragraph 1 of Appendix 5 to Subpart C). (d) The applicant with significant, localized and generalised enlargement of the lymph nodes or with blood diseases shall be assessed as unfit (see Appendix 5, Subpart C, paragraph 2). (e) The applicant with acute leukaemia shall be assessed as unfit. After an established referral, the AMS may qualify the applicant. Applicants with chronic leukemias will be qualified as unfit. After a period of demonstrated stability it can be positively assessed by the AMS (see paragraph 3 of Appendix 5 of Subpart C). (f) The applicant with a significant enlargement of the spleen will be assessed as unfit (see paragraph 4 Appendix 5 of Subpart C). (g) The applicant with significant polycythemia will be assessed as unfit in accordance with Subpart C (5) of Appendix 5 of Subpart C. (h) The applicant with a coagulation defect will be assessed as unfit (see Appendix 5 of Appendix 5). Subpart C).

JAR-FCL 3.305. Urinary system.

(a) The applicant or holder of a Class 2 medical certificate shall not suffer from any functional or structural disease of the urinary system or its attachments which may interfere with the safe exercise of the privileges conferred upon them. grant the corresponding license (s).

(b) The applicant who presents any sign of organic kidney disease will be evaluated as unfit. The urinalysis should be part of all medical examinations. The urine must not contain any abnormal elements which are considered to be significant pathologically. Particular attention should be paid to diseases affecting the urinary tract and the genital organs. (see paragraph 1 of Appendix 6 to Subpart C). (c) The applicant who presents reurethral calculations shall be assessed as unfit (see paragraph 2 of Appendix 6 to Subpart C). (d) The applicant with any disease or surgical procedure in the kidneys and in the urinary tract which may cause incapacitation, in particular any obstruction due to narrowing or compression, shall be assessed as not suitable. The applicant with compensated nephrectomy, without hypertension or uremia, may be considered as eligible by the AMS according to Subpart C. (e) Subpart 3, Appendix 6. The applicant has undergone significant kidney or kidney surgery. urinary tract, including full or partial resection, or a derivative technique of any of its organs, shall be evaluated as unfit for a minimum period of three months and until the time the effects of the operation are no longer likely to interfere with the safe exercise of the privileges granted to them by the licence (s) corresponding (see paragraphs 3 and 4 of Appendix 6 to Subpart C).

JAR-FCL 3.310. Sexually transmitted diseases and other infections.

(a) The applicant or holder of a Class 2 medical certificate shall not have an established medical history or a medical diagnosis of any sexually transmitted disease or other infection that may interfere with the exercise. insurance of the privileges granted to them by the corresponding licence (s).

(b) Particular attention shall be given, in accordance with Appendix 7 of Subpart C, to clinical records or indications indicating:

(1) HIV positive.

(2) Immunodeficiency. (3) Infectious hepatitis. (4) Syfilis.

JAR-FCL 3.315. Gynaecology and obstetrics.

(a) An applicant or holder of a Class 2 medical certificate shall not have any obstetric or gynaecological, functional or structural condition that may interfere with the safe exercise of the privileges granted to them by the (s) corresponding licence (s).

(b) An applicant with a history of severe menstrual disorders with little response to conventional treatment will be evaluated as unfit. (c) Pregnancy implies intraining. If the obstetric assessment indicates a completely normal pregnancy, the applicant may be assessed as fit until the end of week 26 of gestation, in accordance with paragraph 1 of Appendix 8 of Subpart C by the AMS, AMC or AME. The privileges of the license may be resumed once the complete recovery is confirmed after the birth or termination of the pregnancy. (d) An applicant who has undergone significant gynaecological surgery shall be assessed as unfit for a period of three months or until the time when the effects of the operation are unlikely to interfere with the exercise. insurance of the privileges granted to them by the license (s) (see paragraph 2 of Appendix 8 of Subpart C).

JAR-FCL 3.320. Muscle and skeletal requirements.

(a) The applicant or holder of a Class 2 medical certificate shall not have any abnormalities in the bones, joints, muscles and tendons, congenital or acquired which may interfere with the safe exercise of the privileges which give them the appropriate licence (s).

(b) The applicant shall have sufficient seated size, arm and leg size, and muscle mass for the safe exercise of the privileges granted to them by the applicable licence (see Appendix 9, Subpart C, paragraph 1). (c) The applicant shall have a functionally satisfactory musculoskeletal system. The applicant with any significant fallout from disease, accident or congenital failure of the bones, joints, muscles or tendons, with or without surgery, shall be evaluated in accordance with paragraphs 1, 2 and 3 of Appendix 9 of Subpart C.

JAR-FCL 3.325. Psychiatric requirements.

(a) The applicant or holder of a Class 1 medical certificate shall not have a history or established medical diagnosis of any disease or psychiatric disability or condition, acute or chronic, congenital or acquired, that may to interfere with the safe exercise of the privileges granted to them by the corresponding licence (s).

(b) Special attention should be paid to the following (see Appendix 10 of Subpart B):

(1) schizophrenia, schizotypic and delirium disorders;

(2) mood disorders; (3) neurotic disorders, related to stress and somatomorphs; (4) personality disorders; (5) organic mental disorders; (6) mental and behavioral disorders due to the alcohol;

JAR-FCL 3.330. Neurological requirements.

(a) The applicant or holder of a Class 2 medical certificate shall not have a history or established medical diagnosis of any neurological condition that may interfere with the safe exercise of the privileges conferred upon them. grant the corresponding license (s).

(b) Particular attention should be paid to the following (see Appendix 11 of Subpart C):

(1) progressive nervous system disease,

(2) epilepsy and other causes of consciousness disturbance, (3) diseases with high chances of being cured with brain dysfunctions, (4) head trauma, (5) spinal or peripheral nerve injuries.

JAR-FCL 3.335. Ophthalmological requirements.

(See Appendix 12 to Subpart C) (a) The applicant or holder of a Class 2 medical certificate shall not have any anomaly in the eye function or its attachments or any active, congenital or acquired pathological condition, acute or chronic, or any follow-up of eye surgery or trauma, that may interfere with the safe exercise of the privileges granted to them by the corresponding license (s).

(b) Ophthalmological recognition by an ophthalmologist or specialist in the care of the vision accepted by the AMS or at the discretion of the AMS for the AME is necessary (all abnormal or doubtful cases will still be referred to. ophthalmologist accepted by the AMS) in the initial assessment (see paragraph 1 (b) of Appendix 12 of Subpart C) and must include:

(1) Clinical history;

(2) Visual acuity, near and distant vision; uncorrected and with the best possible optical correction, if necessary; (3) Eye motility and binocular vision; (4) Vision of colors; (5) Visual fields; (6) Part evaluation of the eyes, its anatomy, the refractive means and the bottom of the eye. (c) Routine eye scan may be performed by an AME. It must be part of all revalidation and renewal acknowledgements (see paragraph 2 of Appendix 12 of Subpart C) and must include:

(1) Clinical history;

(2) Visual acuity, near and distant vision; uncorrected and with the best optical correction, if necessary; (3) Evaluation of the external part of the eyes, of its anatomy, of the refractive means and of the bottom of the eye; (4) more detailed examination as clinical indication (see Appendix 12, Subpart C, paragraph 2).

JAR-FCL 3.340. Visual requirements.

(a) Far visual acuity. The distant visual acuity, with or without correction, shall be 6/12 (0, 5) or higher in each eye, and visual acuity with both eyes shall be 6/6 (1, 0) or higher (see JAR-FCL 3.340 (f) below). No limitations apply to uncorrected visual acuity.

(b) Refraction errors. Refraction error is defined as the deviation from the metropy measure in dioptrias in the most ametropic meridian. Refraction will be measured by standard methods (see Appendix 13, Subpart C, paragraph 1). For refraction errors, applicants shall be considered eligible if they meet the following requirements:

(1) Refraction error i. In the initial recognition the refraction error should not be greater than + 5 or -8 dioptrias (see paragraph 2 (c) of Appendix 13 of Subpart C).

ii. In recognition of revalidation or renewal, the applicant with sufficient experience to the satisfaction of the Authority and with refraction error not exceeding up to + 5 dioptrias or a large myopic refraction error exceeding -8 dioptrias can be evaluated by the AMS (see paragraph 2 (c) of Appendix 13 of Subpart C). iii. Applicants with great refractive error will wear contact lenses or glasses.

(2) Astigmatism.

i. In an initial applicant with a refraction error accompanied by an astigmatism component, astigmatism should not exceed 3.0 dioptrias.

ii. In recognition of revalidation or renewal, the applicant with sufficient experience to the satisfaction of the Authority and with a refraction error accompanied by a component of astigmatism not exceeding 3.0 dioptrias may be assessed as suitable for the AMS.

(3) The keratoconus is a reason for disqualification. The AMS may consider the fitness assessment if the applicant meets the visual acuity requirements (see paragraph 3 of Appendix 13 of Subpart C).

(4) In the applicant with amblyopia, the visual acuity of the ambliope eye will be 6/18 (0, 3) or higher. The applicant can be assessed as fit as long as the visual acuity in the other eye is 6/6 (1, 0) or higher, (with or without correction) and no other significant pathology can be demonstrated. (5) Anisometropy.

i. In an initial applicant the difference in the refractive error between the two eyes (anisometropy) should not exceed 3.0 dioptrias.

ii. In recognition of revalidation or renewal, the applicant with sufficient experience to the satisfaction of the Authority and with a refractive error difference between the two eyes (anisometropy) of more than 3.0 dioptrias may be assessed by the AMS. Contact lenses should be used if anisometropy exceeds 3.0 dioptrias.

(6) The development of the presbycia should be followed in all the aero-medical examinations of renovation.

(7) The applicant must be able to read a letter N5 (or equivalent) to 30-50 cm and a N14 (or equivalent) to 100 cm, with correction if prescribed. (see JAR-FCL 3.340 (f) below).

(c) The applicant with significant defects in the binocular vision will be evaluated as unfit. (see paragraph 4 of Appendix 13 of Subpart C).

(d) The applicant with diplopia will be evaluated as unfit. (e) The applicant with abnormal visual fields shall be evaluated as unfit (see paragraph 4 of Appendix 13 Subpart C). (f)

(1) If a visual requirement is met only with the use of correction, the glasses or contact lenses shall provide a well-tolerated and appropriate visual function for the purposes of the aviation. If contact lenses are used, they will be monofocal and for faraway vision. Orthokeratological lenses shall not be used.

(2) The corrective lenses, when taken for use in aviation, shall allow the holder of the aircraft to meet the visual requirements at all distances. No more than one pair of glasses shall be used to meet this requirement. (3) Contact lenses, when used for aviation purposes, shall be monofocal and not tinted. (4) A pair of spare glasses of similar correction should be available when the privileges of the licence are exercised.

(g) Eye surgery.

(1) The history of refractive surgery leads to a lack of fitness. A positive assessment can be considered by the AMS (see Appendix 13 Subpart C, paragraph 6).

(2) The history of cataract surgery, retinal surgery, and glaucoma surgery lead to lack of fitness. A positive assessment can be considered by the AMS in revalidation or renewal (see paragraph 7 of Appendix 13 Subpart C).

JAR-FCL 3.345. Color perception.

(a) Normal color perception is defined as the ability to pass the Ishihara tables or the Nagel anomaloscope as a normal tricromata (see Subpart C, Appendix 14, paragraph 1).

(b) The applicant shall have a normal perception of the colours or distinguish them safely. In the initial recognition the applicant shall pass the Ishihara test. The applicant who does not exceed the Ishihara test shall be assessed as distinguishing the colours safely if it exceeds other tests with methods acceptable to the AMS (anomaloscope or colour lantern) (see paragraph 2 Appendix 14 of Subpart C). In revalidation or renewal it will only be necessary to verify the perception of colors for clinical reasons. (c) The applicant who does not exceed accepted tests for colour perception shall be considered as discromata and shall be assessed as unfit. (d) The applicant discromata may be assessed as being suitable for flying only by day.

JAR-FCL 3.350. Otorhinolaryngological requirements.

(a) The applicant or holder of a Class 2 medical certificate shall not have any anomaly in the functions of the ears, nose, sinuses or throat (including oral cavity, teeth and larynx), or any condition active pathological, congenital or acquired, acute or chronic, or any follow-up of surgery and trauma that may interfere with the safe exercise of the privileges granted to them by the corresponding license (s).

(b) An ordinary ear-nose-throat recognition will be part of all initial recognition, revalidation and renewal (see paragraph 2 of Appendix 15 of Subpart C). (c) The presence of any of the following conditions in the applicant shall result in an assessment of unfit.

(1) Pathologic, acute or chronic active process of the inner or middle ear.

(2) Uncured perforation or dysfunction of the eardrum membranes (see paragraph 3 of Appendix 15 of Subpart C). (3) Alterations of the vestibular function (see paragraph 4 of Appendix 15 of Subpart C). (4) Significant nasal ventilation in both sides, or any alteration in the function of the sinuses. (5) Significant malformation or infection of the oral or upper respiratory tract, significant, acute or chronic. (6) Significant speech or speech.

JAR-FCL 3.355. Hearing requirements.

(a) Hearing should be checked at all recognitions. The applicant will be able to correctly understand the ordinary conversation being at a distance of 2 meters and back to the AME.

(b) If an instrumental flight rating (s) is to be added to the applicable license (s), it is required that in the first recognition for the enablement a hearing test with pure tonal audiometry is performed (see paragraph 1 of Appendix 16 of Subpart C) to be repeated every five years until the end of 40 years and every two years thereafter.

(1) There should be no loss of hearing in both ears, when checked separately, of more than 35 dB (HL) at any of the 500, 1000 and 2000 Hz frequencies, or more than 50 dB (HL) at 3000 Hz.

(2) In recognition of revalidation or renewal applicants with hypoacusia may be considered eligible by the WHA if in a test of speech discrimination a satisfactory hearing capacity is demonstrated (see Paragraph 2 of Appendix 16 to Subpart C).

JAR-FCL 3.360. Psychological requirements.

(a) The applicant or holder of a Class 2 medical certificate shall have no established psychological deficiencies, particularly in operational skills or any relevant personality factor, that may interfere with the exercise of the privileges granted to them by the applicable licence (s).

The AMS will require a psychological evaluation (see Appendix 17 of Subpart C) when it is indicated as part or complement of a psychiatric or neurological recognition (see Appendix 17 of Appendix 17 of Subpart C). (b) This psychological assessment will be performed by a psychologist accepted by the AMS. (c) Psychologists must submit a written report to the AMS detailing their opinion and recommendations.

JAR-FCL 3.365. Dermatological requirements.

(a) The applicant or holder of a Class 2 medical certificate shall not suffer from any established dermatological condition that may interfere with the safe exercise of the privileges granted to them by the license (s) (s).

(b) Particular attention should be paid to the following conditions (see Appendix 18 of Subpart B).

(1) Eczema (exogenous and endogenous).

(2) Severe Psoriasis. (3) bacterial infections. (4) Drug-induced Rashes. (5) Ampoule eruptions. (6) Tumor skin pathology. (7) Urbino.

The AMS should be consulted if there is any doubt about any condition. JAR-FCL 3.370. Oncology.

(a) The applicant or holder of a Class 1 medical certificate shall not present any established, primary or secondary malignant disease which may interfere with the safe exercise of the privileges granted to them by the (s) corresponding licence (s).

(b) Following the treatment of a malignant disease, the applicant may be assessed as eligible as listed in Appendix 19 of Subpart C.

Stubs of sub-parts B and C

Appendix 1 of Subparts B and C

Cardiovascular system.

(View JAR-FCL 3.130 to 3,150 and 3,250 to 3,270).

1. An ergometry (stress electrocardiography) will be required: (a) when indicated by signs or symptoms suggestive of cardiovascular disease;

(b) to clarify an electrocardiogram at rest; (c) at the discretion of an aeronautical medicine specialist accepted by the AMS; (d) at the age of 65 and then every four years for the revalidation or renewal of Class 1.

2. (a) Significant abnormalities in the determination of plasma lipids should require review, investigation and monitoring by the AMC or AME in conjunction with the AMS.

(b) An accumulation of risk factors (smoking, family history, lipid abnormalities, hypertension, etc.) will require a cardiovascular assessment by the AMC or AME in conjunction with the AMS. 3. The diagnosis of hypertension will require a review of other possible vascular risk factors. The systolic pressure will be recorded with the appearance of the Korotkoff sounds (phase I) and the diastolic pressure with its disappearance (phase V). Blood pressure should be measured twice. If the blood pressure is high and/or the resting heart rate is high, subsequent observations should be made during the assessment. 4. Antihypertensive treatment must be agreed by the AMS. Drugs accepted by the AMS may include:

(a) diuretics, except those acting at the level of the handle;

(b) some beta-blockers, usually of the hydrophilic type; (c) angiotensin converting enzyme (ACE) inhibitors; (d) angiotensin II AT1 receptor antagonists (sartans); (e) the slow channels of calcium.

For Class 1, medication-treated hypertension may require a multipilot (OML Class 1) or Class 2, the limitation an OSL Class 2 safety pilot.

5. In the event of suspected asymptomatic coronary heart disease or peripheral arterial disease, ergometry will be required (in accordance with

(a) Effort ECG with limitation of symptoms to a Bruce stage IV, or equivalent, that shows no evidence of myocardial ischemia or rhythm disturbance;

(b) Ecocardiogram (or equivalent test accepted by the AMS) showing satisfactory left ventricular function with non-important abnormalities of the movement of the walls (e.g. dyskinesia or acinesia) a fraction Left ventricular ejection of 50% or more; (c) In cases of angioplasti/stent, a ganmagrafia, echo cardiography of effort (or equivalent test accepted by the AMS) showing that there is no evidence of reversible myocardial ischemia. If there is any doubt about myocardial irrigation in other cases (infarction or bypass grafting) a ganmagrafia will be required; (d) Other investigations, such as a 24-hour continuous outpatient electrocardiographic recording may be necessary for assess the risk of any changes in rhythm. Annual monitoring (or more often if necessary) will be done to ensure that the cardiological condition does not deteriorate. It will include a cardiology review by a cardiologist accepted by the WHA, including an effort ECG and a cardiologic risk assessment. Additional tests may be required by the AMS. After a venous bypass graft a ganmagrafia (or equivalent test accepted by the AMS) will be performed if there is any indication and, in any case, within 5 years of the procedure. In all cases, a coronary angiography, or equivalent test accepted by the AMS, should be considered if there are symptoms, signs or non-invasive tests that indicate cardiac ischemia.

AMS Evaluation.

Class 1 applicants who have successfully completed the 6 month review will be taken into consideration for a positive evaluation with multi-pilot limitation (OML Class 1).

Class 2 applicants who successfully meet paragraph 6 points may fly without the pilot safety limitation (OSL Class 2) but the AMS may require a flight period with safety pilot before being authorized for the flight only. Applicants for revalidation or renewal of class 2 may fly, at the discretion of the AMS, with limitation OSL Class 2 having exceeded only an ECG of effort with the standards of paragraph 6 (a).

7. Any significant rhythm or conduction condition requires evaluation by an AMS-accepted cardiologist and appropriate follow-up in the fitness case.

(a) This evaluation may include: (1) Bruce protocol effort ECG, or equivalent. The test would be limited to maximum effort or symptom). Bruce's Stadium 4 will be reached and will show that there is no evidence of significant abnormality of rhythm or conduction or myocardial ischemia. The suspension of cardioactive medication prior to the test shall be considered;

(2) electrocardiogram recorded for 24 hours on an outpatient basis in which no significant changes in conduction, nor rhythm disorders are demonstrated; (3) echo cardiography Doppler 2D which should show no significant hypertrophy or a structural or functional abnormality and a ventricular ejection fraction of at least 50%.

(b) Later evaluation may include:

(1) Repeat the 24-hour ECL record;

(2) electrophysiological study; (3) Gancagrafia or equivalent test; (4) cardiac MRI or equivalent test; (5) angiogram or equivalent test (see Appendix 1, paragraph 6).

(c) Class 1 Evaluation by the AMS:

(1) atrial fibrillation /shock; i. For Class 1, the positive assessment will be limited to applicants with a single episode of arrhythmia that considers the WHA that is not easy to resort to.

ii. Class 1 revalidation/renewal will be determined by the AMS.

(2) Full right branch lock:

i. For the initial Class 1 the positive assessment shall be considered by the AMS if the applicant is under 40 years of age. If you have more you will show a period of stability, usually 12 months.

ii. For class 1 revalidation/renewal, a positive evaluation without a multi-pilot limitation (OML Class 1) can be considered if the applicant is under the age of 40. If you are more than 40 years old you will be subject to a multi-pilot limitation (OML Class 1) for a period of 12 months.

(3) Full left branch lock.

In aspirants over 40 years of age, if necessary, study of the coronary arteries.

i. The aspirant to an initial Class 1 should demonstrate a period of 3 years of stability.

ii. For revalidation or renewal of class 1, a positive assessment can be considered without the multi-pilot limitation (OML Class 1) after a period of three years with such limitation.

(4) Ventricular Pre-excitation.

i. Aspirants to Class 1 with asymptomatic pre-excitation may be considered eligible for revalidation/renewal by the AMS with multipilot limitation (OML Class 1).

ii. Aspirants to Class 1 with asymptomatic pre-excitation can be considered eligible by the AMS, if an electrophysiological study, which includes adequate autonomic stimulation induced by drugs, reveals that an inducible tachycardia is excluded. of reentry and the existence of multiple paths.

(5) Marcasteps.

After the permanent implantation of a subendocardiac pacemaker, a health assessment will be required not before three months of implantation:

i. there are no other disqualifying conditions;

ii. a bipolar frontal system; iii. the applicant is not dependent on the pacemaker; iv. regular monitoring including the verification of the pacemaker; v. in the revalidation/renewal of class 1 the positive evaluation requires a limitation to multipilot (OML Class 1).

(6) Ablation. -For the positive evaluation of the class 1 aspirants who have successfully undergone an ablation, a limitation to multipilot (OML Class 1) is required for at least one year, unless a study Electrophysiological, performed within a minimum period of two months after ablation, shows satisfactory results. For those who cannot be assured of a long-term outcome by invasive or non-invasive testing, an additional period with limitation to multipilot may be required (OML Class 1). (d) Class 2 assessment by the AMS. -Class 2 evaluation by the AMS will follow the evaluation procedures of Class 1. A safety pilot limitation (OSL Class 2) or OPL (valid only without passengers) may be taken into account. 8. Aspirants with non-intervening infrared abdominal aortic aneurysms may be assessed as fit with multipilot limitation (OML Class 1) or for Class 2 with safety pilot (OSL Class 2) by the AMS. The AMS may require an investigation based on ultrasound, if necessary. Following the surgical treatment of the uncomplicated infrared abdominal aortic aneurysm, and after a cardiovascular assessment, class 1 applicants may be assessed as fit by the AMS with a multi-pilot limitation (OML Class 1). and a follow-up indicated by the AMS, the positive evaluation of Class 2 requires limitation with safety pilot (OSL Class 2).

9. (a) Aspirants with previously unrecognized cardiac murmurs of undetermined origin should require a review by a cardiologist accepted by the AMS and evaluation by the AMS. If considered significant, subsequent investigations should include at least one 2D Doppler cardiography echo. (b) Valvular alterations.

(1) Applicants with a bicuspid aortic valve may be assessed as fit without multipilot limitation (OML Class 1) or with safety pilot (Class 2 OSL) if no other cardiac or aortic abnormality is demonstrated, if The WHA may be determined to follow up with echo cardiography.

(2) Aspirants with aortic stenosis require revision by the AMS. The left ventricular function must be intact. A history of systematic embolism or systematic dilation of the thoracic aorta will be disqualifying. Those having a pressure gradient above 20 mm HG but not more than 40 can be assessed as fit for class 2 or for class 1 with multi-pilot limitation (OML Class 1). A pressure gradient above 50 mm of Hg. may be acceptable at the discretion of the AMS. The AMS can determine a follow-up with 2D cardiography with Doppler. (3) Aspirants with aortic insufficiency can be assessed without restriction only if it is very mild. There should be no demonstrable anomaly in the ascending aorta studied using 2D Doppler cardiography. The AMS can determine a follow-up, if necessary. (4) Aspirants with rheumatic mitral valvulopathy will be assessed as unfit. (5) mitral prolapse/mitral insufficiency. Applicants without symptoms with isolated mesosystolic snap may need no restriction. Class 1 applicants with mild uncomplicated insufficiency may require a multipilot limitation (OML Class 1) or with safety pilot (OSL Class 2). Applicants of class 1 uncomplicated regurgitation may require a multipilot limitation (OML Class 1), as determined by the AMS. The applicants with evidence of volume overload in the left ventricle assessed by the increase in the left ventricular diastolic diameter should be evaluated as unfit. A periodic review and evaluation by the AMS will be required if required.

(c) Valvular surgery.

(1) Applicants with mechanical valves must be assessed as unfit.

(2) Applicants without symptoms with biological valves in which, at least 6 months after surgery, studies demonstrating the structural and functional normality of the valves and the valves have been satisfactorily completed. The ventricles can be considered to qualify by the AMS for multipilot operation (OML):

i. an ECG of satisfactory effort, carried out with limitation for the symptoms and up to an IV of Bruce, or equivalent, in which a cardiologist accepted by the AMS interprets that there are no significant alterations. Myocardial gammagrafia/stress echocardiography will be required in cases where the ECG at rest is pathological and some alteration in the coronary arteries is demonstrated. See also paragraphs 5, 6 and 7 of Appendix 1 to Subparts B and C;

ii. A 2D Doppler echocardiography without significant and selective increase in the size of the cavities, with minimal structural alterations in the biological valve prosthesis and with a normal Doppler blood flow, without structural alterations or functional in the other valves. The left ventricular shortening fraction should be normal; iii. No evidence of coronary heart disease has been demonstrated unless a satisfactory revascularization has been achieved -see paragraph 7 above; iv. no cardioactive medication is required; v. the AMS will determine that a follow-up with ECG effort and 2D echocardiography, as needed.

An assessment of fit in Class 1 should be limited to multi-pilot (OML Class 1). A positive assessment of class 2 applicants may occur without limitation.

10. Applicants, after an anticoagulant therapy, should be screened by the AMS. Venous thrombosis and pulmonary embolism constitute a cause of disqualification while it is not possible to stop anticoagulant treatment. Pulmonary embolism requires a complete evaluation. Anticoagulant treatment for possible arterial thromboembolism is a cause of disqualification. 11. Applicants with abnormalities of epicardium/myocardium and endocardium, primary or secondary, should be assessed as unfit until a clinical resolution has taken place. A cardiovascular evaluation performed by the WHA may require a 2D Doppler echocardiography, an ergometry, a 24-hour Holter monitoring and myocardial gammagrafia/stress echocardiography. Coronariography may also be indicated. Frequent checks and the restriction of multi-pilot operation (OML Class 1) or the condition of carrying a safety pilot (OSL Class 2) may be required after certification. 12. Applicants with congenital heart defects, including surgically corrected ones, will normally be assessed as unfit unless the pathological process has little functional significance and no medication is required. A cardiological assessment will be required by the AMS. Investigations may include a 2D Doppler echocardiogram, ergometry and a 24-hour Holter. A regular cardiologic review will be required. The multipilot operation restriction (OML Class 1) and operation with safety pilot (OSL Class 2) may be required. 13. Applicants who have suffered recurrent syncope episodes should undergo the following tests:

(a) an effort ECG of 12 derivations with limitation for symptoms and up to a Bruce stage IV, or equivalent, in which a cardiologist accepted by the AMS interprets that there are no alterations. If the ECG at rest is pathological, myocardial gammagrafia/stress echocardiography is required.

(b) a 2D Doppler echocardiography showing the absence of increased selective and significant size of the cardiac cavities, as well as structural or functional alterations in the heart, valves, or myocardium. (c) a 24-hour outpatient ECG in which no changes in conduction are observed, nor are there any complex or sustained rhythm disorders, or evidence of myocardial ischemia. (d) and may include a basulation test carried out with a standard protocol in which the opinion of a cardiologist accepted by the AMS is that there is no evidence of vasomotor instability.

Applicants who meet these criteria can be considered fit, with restriction to multiple crew operations (OML Class 1) or operations with safety pilot (OSL Class 2) until at least 6 months of the index episode and provided that there have been no recurrences. The neurological review will normally be indicated. Unrestricted certification requires a five-year period of absence of episodes. Periods of major or minor consideration may be accepted by the AMS according to the individual circumstances of each case. Applicants who have presented episodes of loss of knowledge without significant alarm should be considered as unfit.

14. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding certification is provided and should be consulted along with the specific chapter of this system.

Appendix 2 of Subparts B and C

Respiratory system.

(See JAR-FCL 3.155, 3.160, 3.275, and 3.280).

1. Spirometric recognition is required in the initial Class 1 recognition. A FEVI/FVC ratio of less than 70% will require an assessment by a respiratory disease specialist.

2. Applicants who experience recurrent asthma attacks should be assessed as unfit.

(a) The AMS may consider Class 1 certification, if it is estimated to be stable with an acceptable lung function test and the medication is compatible with in-flight safety (absence of systemic steroids).

(b) The AME may consider Class 2 certification, with the advice of the AMS, if it is estimated to be stable with an acceptable lung function test, with medication compatible with flight safety (absence of steroids). (systemic), and a full report is sent to the AMS.

3. Applicants with active sarcoidosis will be unfit. The AMS may consider certification if the disease is:

(a) fully investigated with respect to the possibility of systemic involvement; and

(b) limited to inactive hyliar lymphadenopathy and if the applicant does not require medication.

4. Spontaneous pneumothorax.

(a) certification may be acceptable after the complete recovery of a spontaneous, single and no sequelae pneumothorax, one year after the event with a full respiratory assessment.

(b) the AMS may assess as eligible for revalidation or renewal for multi-pilot operations (OML Class 1) or with safety pilot (OSL Class 2), if the applicant is fully recovered from a single spontaneous pneumothorax after six weeks. The AMS can consider unrestricted fitness after a year, following a full respiratory assessment. (c) A recurrent spontaneous pneumothorax is disqualifying. The AMS may consider certification after a surgical intervention with a satisfactory recovery.

5. Pneumonectomy is disqualifying. The AMS may consider certification after minor thoracic surgery, after a satisfactory recovery and a full respiratory assessment. Multipilot (OML Class 1) or safety pilot (OSL Class 2) restrictions may be appropriate.

6. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 3 of Subparts B and C

digestive system.

(See JAR-FCL 3.165, 3.170, 3.285, and 3.290).

1. (a) Applicants with recurrent dyspepsia who require medication will be investigated.

(b) Pancreatitis is disqualifying. The AMS may consider certification if the cause or obstructive origin is eliminated (p. e.g., drugs, gallstones). (c) Alcohol may be a cause of dyspepsia and pancreatitis. If deemed appropriate, a full assessment of their use/abuse may be required. 2. After consideration by the AMS, applicants may be declared eligible for a single and large asymptomatic calculation in the gallbladder. The AMS may consider revalidation for multi-pilot operation (OML Class 1) or with safety pilot (OSL Class 2), to an individual with asymptomatic multiple cholelithiasis. 3. Chronic inflammatory bowel disease is acceptable as long as it has been established that it is in remission and stabilized no systematic steroids are required for its control. 4. Abdominal surgery is disqualifying for a minimum of three months. The AMS may consider further revalidation or renewal if the recovery is complete, the applicant is asymptomatic and the risk of secondary complications or recurrences is minimal. 5. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding certification is provided and should be consulted with the specific chapter to this system.

Appendix 4 of Subparts B and C

Nutritional, metabolic and endocrine disorders.

(See JAR-FCL 3.175 and 3.295).

1. A metabolic, nutritional, or endocrinological alteration is disqualifying. Revalidation can be considered by the AMS if the condition is asymptomatic, clinically compensated and stable with or without replacement therapy, and is regularly reviewed by an appropriate specialist.

2. Glucosuria and abnormal levels of blood glucose require research. The AMS may consider certification if a normal glucose tolerance (low kidney threshold) is checked or if decreased glucose tolerance, without secondary diabetes, is completely controlled on a diet and regularly reviewed. 3. The use of antidiabetic drugs is disqualifying. However, the use of biguanides or alpha glucosidase inhibitors in Class 1 cases with limitation for multipilot operation (OML Class 1) or unrestricted certification for Class 2 can be accepted. 4. Addison's disease is a cause of disqualification. Positive assessment for Class 2 or for the revalidation or renewal of Class 1 by the AMS may be considered as long as the applicant carries cortisone and has it available for use while exercising the privileges granted by the license. An OML or OSL limitation may be required. 5. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 5 of Subparts B and C

Hematology.

(View JAR-FCL 3.180 and 3,300).

1. Anemias demonstrated by a reduced level of hemoglobin require research. Anemia that does not respond to treatment is disqualifying. The AMS may consider certification in cases where the primary cause has been satisfactorily treated (p. (e.g., iron deficiencies or B12 deficiency) and hematocrit has stabilized by more than 32%, or when a minor thalassemia or hemoglobinopathies is diagnosed without a history of crisis and when full functional capacity is demonstrated.

2. The increase in the size of the components of the lymphatic system requires research. The AMS may consider certification in cases of acute infectious processes that are fully recovered, or Hodgkin's lymphoma and high-grade non-Hodgkin's lymphoma whose treatment has ended and is in complete remission. 3. The AMS may consider fitness in cases of chronic leukemia. 4. Splenomegaly requires research. The AMS may consider certification when the size increase is minimal, stable and no associated pathology is demonstrated (p. e.g., chronic treated malaria), or if growth is minimal and associated with another acceptable condition (p. e.g., Hodgkin lymphoma in remission). 5. Law enforcement requires investigation. The AMS may consider certification with multi-pilot limitation (OML Class 1) or with safety pilot (OSL Class 2) if the condition is stable and no associated pathology is demonstrated. 6. Significant defects in coagulation require research. The AMS may consider certification with multi-pilot limitation (OML Class 1) or with safety pilot (OSL Class 2) if there is no history of significant bleeding or episodes of thrombosis. 7. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding certification is provided and should be consulted with the specific chapter to this system.

Appendix 6 of Subparts B and C

Urinal system.

(View JAR-FCL 3.185 and 3.305).

1. Any abnormalities found in the urinalysis require research.

2. An asymptomatic calculation or history of nephritic colic requires research. While the assessment or treatment is expected, the AMS may consider revalidation with a multi-pilot operation restriction (OML Class 1) or safety pilot (OSL Class 2). The AMS may consider certification without restrictions after satisfactory treatment. For residual calculations, the AMS may consider revalidation with a multi-pilot operation restriction (OML Class 1), or safety pilot (OSL Class 2), or Class 2 revalidation without restriction. 3. Major urological surgery is disqualifying for a minimum period of three months. The AMS may consider certification if the applicant is fully asymptomatic and at least the risk of secondary complication or recurrence. 4. Renal transplantation or total cystectomy is not acceptable in the initial Class 1 examination. The revalidation may be considered by the AMS in case of:

(a) renal transplant that is completely compensated and tolerated only with minimal immunosuppressive therapy, after at least 12 months; and

(b) the total cystectomy that is functioning satisfactorily without any indication of infection or recurrence of the primary pathology.

In both cases the multipilot operation restriction (OML Class 1) or the safety pilot (OSL Class 2) may be considered necessary.

5. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 7 of Subparts B and C

sexually transmitted diseases and other infections.

(See JAR-FCL 3.190 and 3.310).

1. HIV positive is disqualifying.

2. The AMS may consider the revalidation or renewal of individuals with HIV positive with limitation multipilot operation (OML Class 1) or with safety pilot (OSL Class 2) subject to frequent reviews. The evolution to AIDS or AIDS-related complex is disqualifying. 3. Acute syphilis is disqualifying. The AMS may consider certification in the case of the treated and fully recovered from the primary and secondary stages. 4. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding certification is provided and should be consulted with the specific chapter to this system.

Appendix 8 of Subparts B and C

Gynecology and obstetrics.

(See JAR-FCL 3.195 and 3.315).

1. The AMS or the AMC or the AME in coordination with the AMS can assess how fit the pregnant crew during the first 26 weeks of gestation following a review of the obstetric assessment. The AMS or the AMC or AME shall provide written advice to both the applicant and his/her gynecologist regarding the potential significant complications of pregnancy (see Manual). Holders of a Class 1 certificate shall be restricted to multi-pilot operation (OML Class 1). In the case of pregnant women holding a Class 1 certificate, this limitation may be imposed and removed by the AME or SAMC informing the AMS, after delivery or termination of the pregnancy.

2. Major gynaecological surgery is disqualifying for a minimum of three months. The AMS may consider earlier revalidation if the holder is completely asymptomatic and there is only a minimal risk of secondary complication or recurrence. 3. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding certification is provided and should be consulted with the specific chapter to this system.

Appendix 9 of Subparts B and C

Musculoskeletal requirements.

(View JAR-FCL 3,200 and 3.320).

1. An abnormal physical, including obesity, or muscle weakness may require an in-flight medical test or flight simulator approved by the AMS. Particular attention should be paid to emergency and evacuation procedures. Restrictions may be required for specific type (s) (OAL), for multi-pilot operation (OML Class 1) or for safety pilot (OSL Class 2).

2. The AMS may consider certification for class 2 or revalidation for Class 1, in cases of member deficiency according to JAR-FCL 3.125, after a successful medical test in flight or in flight simulator. 3. The AMS may consider the certification of the applicant with inflammatory, infiltrative, traumatic or degenerative diseases of the musculoskeletal system. Considering that the disease is in remission, the applicant is not taking disqualifying medication and has successfully completed, where necessary, a medical test in flight or in flight simulator, the restriction may be required a specific class (s) (OAL), multi-pilot operation (Class 1 OML) or with safety pilot (OSL Class 2). 4. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 10 of Subparts B and C

Psychiatric requirements.

(See JAR-FCL 3.205 and 3.325).

1. An established picture of schizophrenia, schizotypic disorder or delirium disorder is disqualifying. Certification may only be considered if the AMS is convinced that the original diagnosis was inappropriate or inaccurate, or in the case of a single pathological episode of delirium, provided that the applicant does not present a permanent alteration.

2. An established mood disorder is disqualifying. The AMS may consider certification after detailed consideration of each case, depending on the characteristics and severity of the mood disorder and after all psychotropic medication has been interrupted for a period of time. appropriate time. 3. A single autolytic attempt or repetitive abnormal behaviors of deliberate self-harm are disqualifying. The AMS may consider certification after a complete assessment of a particular case and may require a psychological or psychiatric review. A neuropsychological assessment may be necessary. 4. Mental disorders of behavior due to alcohol or the use of other substances, with or without dependence, are a cause of disqualification. Certification by the AMS may be considered after a period of two years of documented abstinence or absence of substance use. Revalidation can be considered before, in which case a multiple crew limitation (OML Class 1) or a safety pilot limitation (OSL Class 2) may be appropriate. According to each individual case, and at the discretion of the AMS, treatment and review may include:

(a) a minimum of several weeks of treatment as a patient, followed by

(b) a review of a psychiatrist accepted by the AMS; and (c) continued review that includes blood tests and reports from colleagues that may be required indefinitely.

Appendix 11 of Subparts B and C

Neurological requirements.

(See JAR-FCL 3.210 and 3.330).

1. Any stabilized or progressive disease of the nervous system that has caused or may cause a significant disability is disqualifying. However, in cases of minor functional losses, associated with stationary diseases, the AMS may consider fitness, after a full assessment.

2. A story of one or more episodes of altered consciousness for unknown cause is disqualifying. In case of a singular episode that can be satisfactorily explained, it can be considered the fitness by the AMS, but the recurrence will be disqualifying. 3. Paroxysmal epileptic EEG abnormalities and focal slow waves are normally disqualifying. The AMS will carry out a more detailed assessment. 4. A diagnosis of epilepsy is disqualifying, unless it is unequivocal evidence of a benign childhood epilepsy syndrome with very little risk of recurrence and unless the applicant is free of recurrence and treatment since more than 10 years. One or more seizure episodes after 5 years is disqualifying. However, in the case of an acute symptomatic seizure which is considered to be very low risk of recurrence by a neurologist accepted by the AMS, it can be assessed by the AMS. 5. An applicant who has had a single afebrile epileptic seizure that has not been repeated after at least 10 years without treatment, and who does not present evidence of a continued predisposition to epilepsy, may receive a licence if considers that the risk of new seizures is within the limits acceptable to the AMS. As far as Class 1 certification is concerned, an "OML" limitation must be applied. 6. Any cranioencephalic trauma whose intensity has been sufficient to cause loss of consciousness, or has been associated with penetrating brain injury, should be evaluated by the WHA and should be observed by a consultant neurologist. accepted by the AMS. A full recovery must have occurred and there must be a low risk (within the acceptable limits of AMS) of epilepsy before revalidation is possible. 7. The consideration of applicants with a history of spinal cord injury or peripheral nerves should be considered in conjunction with musculoskeletal requirements, as listed in the Appendices and in the corresponding chapter of the Manual. 8. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system. All malignant brain tumors are a cause of disqualification.

Appendix 12 of Subparts B and C

Ophthalmological requirements.

(See JAR-FCL 3.215 and 3.335).

1. (a) In the initial assessment for the procurement of the Class 1 medical certificate, the ophthalmological assessment must be performed by an ophthalmologist accepted by the AMS, or by a vision specialist accepted by the AMS. All observed alterations and doubtful cases should be referred to an ophthalmologist accepted by the AMS.

(b) In the initial exploration for obtaining the medical certificate of Class 2, the examination must be carried out by an ophthalmologist accepted by the AMS or by a specialist of the vision accepted by the AMS, or, at the discretion of the the AMS, for an AME. Abnormal or doubtful cases will be referred to an ophthalmologist accepted by the AMS. Applicants who require visual correction to meet standards should submit a copy of the most recent prescription of their glasses. 2. In each renewal assessment or revalidation of aeronautical medicine it is necessary to determine the visual capacity of the holder of the license in both eyes, as well as to rule out any possible pathology. All observed alterations and doubtful cases should be referred to an ophthalmologist accepted by the AMS. 3. Due to the differences in the provision of optometry services in the different Member States of the JAA, as far as these requirements are concerned, each national AMS should determine whether the training and experience of its specialists in the field of optometry services. the vision is acceptable for these evaluations. 4. Disorders indicating the need for evaluation by an ophthalmology specialist are, among others, the substantial decrease in uncorrected visual acuity, any reduction of visual acuity with the best possible correction, or Existence of diseases, injuries or eye surgery. 5. The evaluation of the neoplasms in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 13 of Subparts B and C

Visual requirements.

(See JAR-FCL 3.215, 3.220, 3.335, and 3.340).

1. The error in refraction and functional performance shall constitute the main criterion for the valuation.

2. (a) Class 1. For those who achieve functional performance standards only with corrective lenses the AMS may consider fitness for Class 1 if the refraction error does not exceed + 5 to -6 dioptrias and yes:

(1) no significant pathology is checked;

(2) has been considered the optimal correction form; (3) a review has been conducted every 5 years by an ophthalmologist accepted by the AMS, if the refraction error is outside the range of +/-3 dioptrias.

(b) Class 1: The AMS may consider the positive assessment for revalidation or renewal if the myopic refraction is greater than -6 dioptrias if:

(1) no significant pathology can be checked;

(2) optimal correction has been considered; (3) a biannual review has been conducted by an ophthalmologist accepted by the AMS to those with a myopic refraction greater than -6 dioptrias.

(c) Class 2. If the refraction error is in the range of -5/-8 dioptrias in the initial examination or exceeding -8 dioptrias in the revalidation or renewal, the AMS may consider a Class 2 certification whenever:

(1) no significant pathology can be demonstrated;

(2) optimal correction has been considered.

3. Class 1 astigmatism. The AMS may consider certification in revalidation or renewal if the astigmatic component is greater than 3,0 dioptrias and:

(1) no significant pathology can be demonstrated;

(2) has been considered an optimal correction; (3) a biannual review is performed by an ophthalmologist accepted by the AMS.

4. Keratoconos. The AMS may consider revalidation after the diagnosis of a keratocone as long as:

(a) the visual requirements are met by the use of corrective lenses;

(b) a review is performed by an ophthalmologist accepted by the AMS. The frequency will be determined by the AMS.

5. Anisometropy.

Class 1. The AMS may consider certification in revalidation or renewal if anisometropy is greater than 3.0 dioptrias and: (1) no significant pathology can be demonstrated;

(2) has been considered an optimal correction; (3) a biannual review is performed by an ophthalmologist accepted by the AMS.

6. (a) Monocularity.

(1) Monocularity implies non-fitness for Class 1 certificates.

(2) In the case of an initial class 2 applicant that is functionally monocular, the AMS may consider certification if:

(a) the monocularity occurs before the age of 5 years of the applicant.

(b) at the time of the initial examination the best eye reaches:

(i) a distant visual acuity (no correction) of at least 6/6.

(ii) no refraction error. (iii) there is no history of refractive surgery. (iv) there is no significant pathology.

(c) an in-flight test performed by a qualified pilot accepted by the Authority, which is familiar with the potential difficulties associated with the monocularity, must be satisfactory.

(d) Operational limitations may be applied, as indicated by the aviation authority.

(3) The AMS may consider certification in the revalidation or renewal of Class 2 if the detected pathology is acceptable according to an assessment made by an ophthalmologist and subject to a satisfactory in-flight test. carried out by a qualified pilot accepted by the Authority who is familiar with the difficulties associated with the monocularity.

Operational limitations may be applied as indicated by the Authority. (b) Applicants with a central vision in one eye below the limits indicated in JAR-FCL 3.220 may be considered for Class 1 revalidation if the binocular field of vision is normal and the underlying pathology is acceptable according to the assessment by an ophthalmologist. A satisfactory result in the flight test and multi-pilot limitation (OML Class 1) is required. (c) In the case of reduced vision in one eye below the limits indicated in JAR-FCL 3.340, the revalidation of Class 2 may be considered if the underlying pathology and the visual capacity of the remaining eye are acceptable after evaluation. ophthalmology performed by an ophthalmologist accepted by the AMS. It is required in a satisfactory flight medical test, if indicated. (d) A defect applicant in the field of vision may be considered fit if the binocular visual field is normal and the main pathology is acceptable to the AMS.

7. Heteroforias. The applicant or holder of a certificate must be reviewed by an ophthalmologist accepted by the AMS. The merger reserve should be assessed by a method acceptable to the AMS (p. The Goldman red/green binocular fusion test).

8. After refraction surgery, Class 1 and Class 2 certification may be considered by the AMS as long as:

(a) refraction prior to intervention [defined by JAR-FCL 3.220 (b) and 3.340 (b)] not greater than + 5 0 -6 dioptrias for Class 1 not greater than + 5 or -8 dioptrias for Class 2;

(b) satisfactory stability of refraction (diurnal variation below 0.75 dioptrias) has been achieved; (c) examination of the eye shows the absence of postoperative complications; (d) sensitivity to glare is within normal limits; (e) the mesopic sensitivity is not altered; (f) a review is performed by an ophthalmologist accepted by the AMS at the discretion of the WHA.

9. (a) cataract surgery. Class 1 and Class 2 certification can be considered by the AMS at the end of 3 months.

(b) retinal surgery. Class 2 certification and for revalidation or renewal of Class 1on the part of the AMS can be considered normally at 6 months of the surgery with good results. Certification by the AMS for Class 1 and Class 2 after laser therapy on the retina can be accepted. If necessary, a follow up to be determined by the AMS. (c) glaucoma surgery. Certification by the AMS can be considered at 6 months of surgery with good results for Class 2 or the revalidation or renewal of Class 1. If necessary, a follow up to be determined by the AMS.

Appendix 14 of Subparts B and C

Perception of colors.

(See JAR-FCL 3.225 and 3.345).

1. The Ishihara test (version of 24 sheets) will be considered to be exceeded if the first 15 sheets are correctly identified without uncertainty or hesitation (less than 3 seconds per sheet). The foils should be presented at random. For the light conditions see the Civil Aviation Medicine Manual of the JAA.

2. Those who do not pass the Ishihara test should be examined for:

(a) Anomaly (Nagel or equivalent). This test is considered to be exceeded if the color recognition is tricromata and the identification range is 4 units of the scale or less, or by

(b) Test of the flashlight. This test is considered to be exceeded if the applicant passes without error a test with lanterns accepted by the AMS, such as those of Holmes Wright, Beynes, or Spectrolux.

Appendix 15 of Subparts B and C

Otorhinolaryngological Requirements.

(See JAR-FCL 3.230 and 3.350).

1. In the initial recognition, an exhaustive ORL recognition (see the Aeronautical Medicine Manual) must be carried out by, or under the guidance and supervision of an AMC or aviation otorhinolaryngology specialist accepted by the AMS.

2. In recognition of revalidation or renewal, all abnormal and doubtful cases within the ENT area must be referred to an aviation grant specialist accepted by the AMS. 3. A single dry tympanic perforation of non-infectious origin that does not interfere with the normal function of the ear can be considered acceptable for certification. 4. The presence of spontaneous or positional nystagmus should involve a complete vestibular assessment performed by a specialist accepted by the AMS. In these cases, no rotational vestibular response or abnormal response to caloric stimulus may be accepted. In recognition of revalidation or renewal the abnormal vestibular responses will be qualified in their clinical context by the AMS. 5. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 16 of Subparts B and C

Hearing requirements.

(See JAR-FCL 3.235 and 3.355).

1. The pure-tone audiometry shall cover the frequencies 500-3000 Hz. The frequency thresholds shall be determined as follows: 500 Hz.

1,000 Hz. 2,000 Hz 3,000 Hz.

2. (a) Cases of hypoacusia will be referred to the AMS for further assessment and evaluation.

(b) The AMS may consider revalidation if a satisfactory hearing can be checked in a noisy field equivalent to the usual cabin working conditions during all phases of the flight.

Appendix 17 of Subparts B and C

Psychological requirements.

(View JAR-FCL 3.240 and 3.360).

1. Indication. A psychological assessment shall be carried out as part of or in addition to a recognition by psychiatrists or neurologists when the Authority receives verifiable information from an identifiable source that raises questions about mental fitness or personality of a particular individual. The sources of this information may be accidents or incidents, problems in training or verifications of competence, crime or knowledge relevant to the safe exercise of the privileges granted to them by the license (s) (s).

2. Psychological criteria. The psychological evaluation may include the collection of biographical data, criteria on fitness as well as personality tests and a psychological interview.

Appendix 18 of Subparts B and C

Dermatological requirements.

(See JAR-FCL 3.245 and 3.365).

1. Any skin condition that causes pain, discomfort, irritation, or itching can distract the crew from their tasks and affect flight safety.

2. Any skin treatment, whether pharmacological or in the form of radiation therapy, may have systemic effects that should be considered prior to certification. A limitation may be required for multi-pilot (OML Class 1) or safety pilot (OSL Class 2) operations. 3. Malignant or premalignant skin conditions.

(a) malignant melanoma, squamous cell epithelioma, Bowen's disease, and Paget's are disqualifying. The AMS may consider certification if, where necessary, the injuries are completely eliminated and there is adequate monitoring.

(b) In the case of basalioma, keratoacanthoma and actinic keratosis, it is possible to consider certification by the AMS if, when necessary, the lesions have been completely removed and adequate monitoring is done.

4. In the case of other skin diseases:

(a) acute or chronic disseminated eczema

(b) skin reticulum, (c) secondary dermatologic problems in systemic disease, and similar problems require consideration of treatment and any other underlying conditions prior to evaluation by the AMS.

5. The evaluation of the malignant conditions in this system is also explained in the Oncology chapter of the Manual, where information regarding the certification is provided and should be consulted along with the specific chapter to this system.

Appendix 19 of Subparts B and C

Oncology requirements.

(View JAR-FCL 3.246 and 3.370).

1. Class 1 certification by the AMS and Class 2 certification by the AME may be considered according to the AMS, if: (a) There is no evidence of residual malignant disease after treatment;

(b) It has elapsed since the end of treatment the appropriate time period according to the type of tumor; (c) The risk of inability during the flight by recurrence or metastasis is within the limits acceptable by the AMS; (d) There is no evidence of short-term or long-term sequelae from treatment. Special attention will be given to applicants who have received anthracycline chemotherapy treatment; (e) The provisions regarding monitoring are acceptable to the AMS.

2. For revalidation, multipilot (OML Class 1) or security pilot (OSL Class 2) restrictions may be appropriate.