Draft CAR Section 7 Series C Part III - Empanelment of Medical Examiner for Conduct of Class I Medical Examination.

GOVERNMENT OF INDIA OFFICE OF DIRECTOR GENERAL OF CIVIL AVIATION TECHNICAL CENTRE, OPP SAFDARJANG AIRPORT, NEW DELHI CIVIL AVIATION REQUIREMENTS SECTION 7 – FLIGHT CREW STANDARDS TRAINING AND LICENSING SERIES C PART III ISSUE I, __ EFFECTIVE: FORTHWITH F. No. ______________ Subject: Empanelment of Medical Examiner for Conduct of Class I Medical Examination. 1. INTRODUCTION 1.1 Rule 39B of the Aircraft Rules, 1937 regarding Medical Standards of flight crew stipulates that no licence or rating required for any of the personnel of the aircraft shall be issued or renewed unless the applicant undergoes a medical examination with an approved medical authority and satisfies the medical standards as notified by the Director General. Further, CAR Section 7 Series C Part I specifies the approved medical authorities who can conduct the medical examinations. 1.2 This CAR deals with requirements for empanelment of medical examiners by DGCA for conducting Class I renewal medical examination. 1.3 This CAR is issued under the provisions of Rule 133A of the Aircraft Rules,1937. 2. REQUIREMENTS FOR MEDICAL EXAMINERS 2.1 The medical examiner shall meet the following qualfication requirements:- 1CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 2.1.1 Academic qualifications (i) A post-graduate degree in Aviation Medicine Or (ii) A post-graduate degree in Medicine with a minimum two months formal training in Aviation Medicine. 2.1.2 Experience (i) A one year tenure at IAM/ AFCME/ MEC(E) or DGCA approved Class I Medical Examination Centres/ DGCA Medical Assessor, Or (ii) Ten year experience in the medical department of a Scheduled operator with direct and continued responsibility of medical fitness of civil aircrew alongwith a one year experience of being a DGCA empanelled Class II Medical Examiner with an satisfactory record. Or (iii) Five year experience of being a DGCA empanelled Class II Medical Examiner with an satisfactory record. 2.1.2 Other Requirements (i) He shall be registered with Medical Council of India/ State Medical Council. (ii) He shall have the requisite infrastructure and facility to conduct the medical exam (location, place, timings, IT, medical eqpt). Certain reputed consultants in ENT, Ophthalmology, Cardiology, Psychiatry may be co-opted by the examiner. Similarly, diagnostic facilities may also be co-opted. In case of Labs, they must be NABL accredited. (iii) It will be the responsibility of the examiner to facilitate the medical exam in the least possible time and with minimum inconvenience to the aircrew. 3. SELECTION PROCESS 3.1 Information regarding empanelment shall be made available in the ‘Public Notices’ section of the DGCA website (http://dgca.nic.in). The notification would be published every year based on the requirement. 3.2 In response to the notification, persons desirous of being empanelled as Class I medical examiners by DGCA for conducting Class I renewal and Class II initial and renewal medical examination shall apply on plain paper to ‘Medical Cell, 2CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 DGCA HQs, Aurobindo Marg, New Delhi – 110 003’. 3.3 The envelope shall be superscribed ‘Application for Class I Examiner’. Application by Email/ Fax shall not be accepted. Applicants should ensure that all requirements mentioned in para 2 have been fulfilled. 4. PROFESSIONAL INTERVIEW 4.1 Applicants fulfilling qualifications and experience requirements specified in paragraph (2) above, shall be called for a professional interview for empanelment as Class I Medical Examiners by a DGCA Board consisting of a DGCA officer and two representatives of DGMS(Air) and DMS(CA). 4.2 Applicants shall be expected to have adequate awareness of provisions regulating the Class I & II renewal medicals including knowledge of relevant CARs, AIC including ICAO Standards and Recommended practices. 4.3 Applicants are expected to make their own travel arrangements for attending the interview. 4.4 Candidates recommended by the Board shall be required to make available their medical facility for inspection within two months of interview. 5. ASSESSMENT OF MEDICAL FACILITY 5.1 Class I Medical Examiner shall be permitted to operate from one medical facility only. 5.2 The facility shall have an office for the medical examiner having a telephone connection with Internet facility and Fax (for the purpose of according appointments/ interactions with aircrew/DGCA). 5.3 The facility shall have place for conduct of examination and filling up of necessary forms. 5.4 The medical facility may be either owned or taken on rent by medical examiner. Note: In case the medical examiner is using the medical facility of a renowned hospital then NOC from the hospital permitting to use of their facility for conduct of medical examination during the period of empanelment shall be submitted to DGCA. 3CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 5.5 Class I Examiner may choose to conduct the entire medical examination by him/herself or co-opt other specialists/ hospitals/ institutes for ENT/ Ophthalmology/ ECG/ laboratory tests. 5.6 The responsibility of all medicals shall be on the Class I examiner who is required to ensure that the medicals are done comprehensively and comply with ethical standards. Hence he/she should make these co-opted entities also aware of the significance of aviation medical examination and its implications. The co-opted entities shall have to be disclosed by the examiner. 5.7 The initial inspection of the facility shall be conducted as per Checklist (Annexure I) by DMS (CA) or Senior Medical Officer/ Aviation Medicine Specialist nominated by DGMS (Air). The inspection shall include inspection of co-opted facilities also. 6. APPROVAL 6.1 On compeletion of successful interview and inspection, Class I Medical Examiners are empanelled for a period of 3 years which may be extended for a further period of three years at a time, subject to re-assessment. 7. EXTENSION OF APPROVAL 7.1 Class 1 medical examiners may apply for extension to DGCA after completion of two and half years. 7.2 For extension, the Class 1 medical examiner should have attended atleast one workshop conducted by DGCA in the last 3 years and no case of proficiency related matter or professional misconduct. 7.3 Inspection of medical facility shall be be done prior to grant of extension of Class I Examiner status and as and when felt necessary by DMS (CA). 7.4 The application for extension shall be assessed by a Board consisting of representative from DGCA, PDMS(S) & DMS(CA) which shall be approved by DGCA based on the recommendations of DGMS (Air). 8. CONDUCT OF CLASS I MEDICAL EXAMINATION 8.1 Guidance material. The Class I examiner shall be provided with a copy of guidance and reference materials and CA-34/34A/ 35 from DGCA. 8.2 The following steps will be followed by the Class I medical examiners for conducting Class 1 renewal medical: 4CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 8.2.1 Accord of appointment. Based on the contact details of the examiner on the DGCA website, prospective aircrew shall contact the examiner by phone/ email. The examiner shall grant an appointment after verifying that the medical is not due at IAM/ AFCME/ MEC(E) either by virtue of the periodicity or by a specific annotation on CA-35/ Medical Assessment issued by DGCA. Medical renewals of aircrew with Foreign Aircew Temporary Authority (FATA) can also be conducted by the Class I Medical Examiner. 8.2.2 Pilot Medical Records (PMR) from DGCA. The PMR shall not be dispatched for medicals done by Class I Medical Examiners. The aircrew must carry a copy of the last medical assessment (issued by the DGCA) and CA-35. Once the digitization of medical records at DGCA is achieved, access to the archived medical records would be given to the Class I Medical Examiners also. 8.2.3 Documentation. The filling up of Form CA-34/34A/ 35 by the flight crew shall be in presence of the Class I examiner with a specific reference to history and consequences of withholding relevant information. The identity of the flight crew must be positively established at all points including during conduct of investigations. 8.2.4 Fees. The Class I medical examiner may collect reasonable charges for specialist consultation(s), administrative and postage/ handling charges. 8.2.5 Investigations. The mandatory investigations required for renewal of medical are already specified. Additional tests may be requested based on findings at clinical examination. Tests will be done at any NABL/ NABH accredited lab/ institution and at DGCA approved Air Force Class I centers. The lab/ centre will always establish the identity of the aircrew and endorse the same. The Class I Examiner shall give a request for investigation to the aircrew. The aircrew would get the investigations done at the lab/ centre after paying fee for the same to the lab/ centre. The reports would be sent to the Class I examiner which will be duly authenticated by him. 8.2.6 Eye & ENT check. The Class I examiner may conduct the examinations themselves or get it done by a co-opted referral service by a reputed specialist. 8.2.7 General Medical Examination & filling of necessary forms CA-34/34A/ 35.This has to be by the Class I Medical Examiner. A copy of CA-35 is to be handed over to the aircrew. 8.2.8 Dispatch of CA-34/34A/35 to DGCA. The completed CA-34/34A & 35 along with all investigation reports and opinions in original are to be dispatched to Medical Cell, DGCA by fastest means and records maintained. The envelope shall not be folded and shall be superscribed ‘Class I Renewal report’. A copy shall also be sent electronically . 8.2.9 Records. A copy of the CA-34/34A & 35 and investigation reports shall be maintained by the Class I Examiner in hard and/or soft copy for a period of five 5CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 years. 8.2.10 Reports and returns. A monthly summary of medicals conducted shall be forwarded to DMS (CA) in the format provided by the DGCA. 8.2.11 Unfit cases & and incomplete medicals. The CA-34/34A and 35 of cases who are declared unfit or where the medical is not completed are also to be forwarded to DGCA with recommendations. Cases of unfitness shall be intimated to/ discussed with Medical Cell at DGCA on priority. Review for fitness after recommended period of unfitness shall be done at AFCME/ IAM/ MEC (East)/DGCA only. 9. GENERAL 9.1 Class I Examiners shall affix the DGCA registration number on completed CA-34/34A/ 35. 9.2 Reference material for the conduct of medical are Civil Aviation Requirements (CAR) Section 7 Series C Part I, Aeronautical Information Circulars and ICAO Handbook (latest edition) of Civil Aviation Medicine. These are available on DGCA website (http://dgca.nic.in/medical). 9.3 Class 1 examiners may carry out tele-consultation on administrative/ professional aspects with DMS/ JDMS (CA) between 1100 and 1730h, at 011-24610629 at DGCA or on email doctor.dgca@nic.in. 9.4 DGCA may carry out audit of all examiners including record maintenance. 9.5 Professional disputes arising during the conduct of medicals by Class 1 medical examiners shall be resolved by DGMS (Air), who may take up the matter with DGCA. 9.6 A Class I Medical approval may be withdrawn from Class I Medical Examiners panel at the discretion of DGCA temporarily or permanently depending on nature of professional misconduct/proficiency related issues. Such decisions would be vetted at DGMS (Air) and DGCA. 9.7 Class I Medical Examiner who join Air Force, Army, Navy or any airlines will be removed from approved panel of Class 1 medical examiners. This CAR supercedes AIC No 2 of 2012. ANNEXURE I CHECKLIST FOR FACILITY INSPECTION OF 6CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 CLASS I MEDICAL EXAMINERS S No Item to be checked Findings/ Remarks 1. What is your plan to grant appointments for medicals and communicate with potential pilots? - Email - Cellphone - Landline - Personal interface - Facsimile - Other 2. How many medical examinations can you carry out in a day - Upto 5 - 5-10 - >10 3. Where do you propose to conduct the medical examination? - Home - Clinic - Hospital 4. Whether the place of medical examination is rented or owned? 5. If rented, have you taken NOC from Hospital/Owner? 6. Do you have adequate space in the place mentioned in 3 above to comfortably permit the aircrew to :- - Fill the forms - Await their appointment time - Undergo the medical 7 What time would you conduct the medical examinations? - Office hours on working days (please specify) - Any time 8. Do you have necessary IT infrastructure required for the conduct and transmission of Class I Medical Examination? - PC/ Laptop/ other device - Broadband connection - Scan and Fax - Trained manpower for these activities (self/ employee) 9. Do you have the necessary forms (CA-34/34AA and CA-35) for the conduct of the renewal medical examination? - Yes 7CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 - No, but shall print 10. Do you have the basic Medical Equipment to carry out the medical examination of an aircrew? - Stature recording - Weighing machine - Sphygmomanometer - Distance and near vision charts - Ishihara/ TMC plate test types - Stethoscope - Otoscope - Tongue depressor - Thudicum speculum - Light source for ENT examination - Ophthalmoscope - Knee hammer - Thermometer 11. Where do you intend to conduct the laboratory tests (pathology/ biochemistry/ ECG/ audiogram)? - Ask individual to get reports from NABH accredited hospitals. NABL accredited labs with identity proof. - Tie up with a NABH accredited hospital/ NABL accredited lab. 12. Do you plan to get into an arrangement with any of the following specialists to assist you in completing the renewal medical examination? - Ophthalmologist - Oto-rhino-laryngologist - Medical specialist - Psychiatrist/ Gynaecologist - Other specialists when indicated 13. Do you understand that the above specialists need to understand that aviation medical is special and needs to be given the utmost importance and performed meticulously? 14. Do you understand that while the specialists may give opinion and examine a particular case, the overall responsibility of the Class I Renewal Medical Examination is your only? 15. Do you have the facility for a chaperone for a lady pilot. 8CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 16. Are the laboratories/ specialists listed in S No 11 and 12 above conveniently located from the place of medical examination? Mention distance of the facilities. 17. What is the time-frame in which you intend to complete the medical examination (provided everything is normal and no special tests/ opinions are required)? - Same day - Two days - >2 days 18. How would you send the medical records (CA-34/34A and 35) to DGCA? - By courier - By speedpost 19. How do you intend to store medical examination records for a period of 5 years? - Duplicate (hard copy) of the CA-34/34A and CA-35 - Scanned copy - Other (please specify) 20. Are you open to conduct of a work audit on your work done by a DGCA team? 21. Are you aware that the term of appointment for Class I Medical Examiner is for three years and subject to extension after a re-inspection? 22. Are you aware that your empanelment may be disapproved for a professional misdemeanour at the discretion of DGCA? 23. Would you be able to submit a monthly summary of medicals conducted (number of appointments granted, number of medicals actually conducted, any cases granted unfitness or ‘unfit in absentia’)? 24. Are you aware that you would be conducting the Class I Renewal Medical Examination for and on behalf of the Govt. of India? 25. Do you understand that your role is to conduct a medical examination of the pilot who reports to you 9CIVIL AVIATION REQUIREMENTS SECTION 7 SERIES C PART III __ DECEMBER 2016 for the same and that you are not his/ her Authorised Medical Attendant (AMA)? 26. Do you understand that in exercising this privilege, in case you find a disability/ condition, you are not required/ expected/ bound to treat the pilot, but assess him unfit and advise him to seek medical care from AMA and report again (to IAM/ AFCME/ MEC(E)/ as directed by DGCA) when fitness is achieved? 27 Are you aware that the medical examinations need to be conducted (a) Utilising the highest ethical practices and with utmost honesty. (b) Using evidence based medical practice. (c) Complying to the DGCA CAR, AICs and ICAO Manual of Civil Aviation Medicine and instructions from DGCA issued from time to time. (d) To the best of your ability and care to ensure all columns are filled correctly and accurately. 28. Are you aware that false documentation/ unethical practice and not resorting to provisions listed above may lead to temporary/ permanent debarment from the Class I Examinership? 29. Are you aware that ‘medical confidentiality’ is of paramount importance and agree to maintain it. Other findings: ( ) ( ) Class I Medical Examiner DGCA representative 10