**Executive Summary**
This Civil Aviation Requirement (CAR) document, issued by the Director General of Civil Aviation (DGCA) on May 5, 2014, outlines the medical requirements and examination procedures for cabin crew in India. It details the required medical assessments, frequency of examinations, and processes for handling medical unfitness, including appeal procedures. The document also specifies the responsibilities of airlines and operators in maintaining medical records and ensuring cabin crew medical fitness, with Revision 3 dated August 2025.
**Key Points / Main Content**
* **Medical Examination Requirements:**
* Cabin crew must undergo initial and renewal medical examinations equivalent to a Class 2 Medical Examination.
* Medical examinations must include physical, mental, visual, color perception, and hearing assessments.
* Cabin crew must be free from abnormalities, disabilities, wounds, injuries, or side effects of medication that could interfere with their duties.
* **Frequency of Medical Examinations:**
* Initial examination upon induction.
* Renewal examinations:
* Every four years until age 40.
* Every two years until age 50.
* Yearly thereafter.
* Increased frequency may be required based on specific health conditions.
* **Medical Standards and Guidelines:**
* Standards for overweight/obese cabin crew are in line with AIC 09/2008.
* Class 2 Medical Examination provisions outlined in ICAO Annex 1 Chapter 6 and ICAO Document 8984 are to be followed.
* Medical AICs serve as guidelines.
* Functional assessment of overweight/ obese Cabin Crew shall be carried out to assess the handling of emergencies effectively.
* **Approved Medical Examiners:**
* Class 2 Medical Examinations can be conducted by:
* DGCA authorised Class 1 Medical Examiners.
* DGCA authorised Class 2 Medical Examiners.
* Doctors/Airline Medical Departments with aerospace medicine training.
* In contentious cases, DMS (CA) may authorise review by various medical centers.
* **Medical Examination Procedures:**
* Airlines and operators must maintain individual medical records for cabin crew.
* Airlines and operators must maintain a schedule for timely medical examinations.
* Medical reports indicating "Fit," "Temporary Unfit," or "Permanent Unfit" status are to be issued.
* Detailed processes are outlined for handling temporary and permanent unfitness cases.
* Contentious cases are handled first by the Airline Medical Department and then potentially referred to the Medical Assessor at DGCA.
* **Appeal Procedure:**
* Cabin crew declared unfit for over six months can appeal to the Medical Assessor at DGCA within 90 days.
* The appeal must include supporting medical documentation.
* **Maintenance of Records and Monitoring:**
* Medical records must be maintained by the airline/operators and are subject to DGCA inspection.
* Airlines are responsible for monitoring cabin crew medicals and data maintenance.
* **Investigation Requirements:**
* Details investigations required for initial medical examination and renewal medical examination, respectively.
* The lists outline haemogram, urine routine, ECGs, audiograms, blood sugar and other requirements
**Impact Analysis**
**Airlines/Operators**
* **Impact**
* Responsible for ensuring cabin crew undergo required medical examinations and meet medical fitness standards.
* Must maintain cabin crew medical records and schedules.
* Responsible for devising a methodology to monitor crew medicals and data maintenance.
* **Action Required**
* Establish a system for initial and periodic medical examinations.
* Document and implement the system.
**Cabin Crew**
* **Impact**
* Subject to the medical examination requirements outlined in the CAR.
* Must meet the medical fitness standards to be rostered for duty.
* May be declared "Fit," "Temporary Unfit," or "Permanent Unfit" based on medical examinations.
* **Action Required**
* Undergo initial and periodic medical examinations as required.
* Comply with any limitations or restrictions imposed on their medical fitness.
**DGCA**
* **Impact**
* Authority responsible for overseeing the implementation and enforcement of the CAR.
* Medical Assessor at DGCA handles appeals and contentious medical cases.
* **Action Required**
* Conduct inspections/audits to ensure compliance with the CAR.
* Process appeals for medical assessments.
Key Entities Referenced
Aircraft Rules, 1937: Deals with carriage of cabin crew; Rule 38B of the Aircraft Rules, 1937 is referenced in the document.
Director General of Civil Aviation (DGCA): The Office of the Director General of Civil Aviation issued this Civil Aviation Requirement (CAR) and is responsible for oversight and medical assessments.
Aircraft Act, 1937: This CAR is issued under the provisions of Rule 133A of the Aircraft Act, 1937.
Civil Aviation Requirements (CAR): The policy document laying down uniform requirements of medical fitness of cabin crew to be ensured by the operators.
Cabin Crew: The policy outlines the medical requirements for cabin crew.
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 II
ISSUE I, 5TH MAY 2014
EFFECTIVE: FORTHWITH
F. No. AV/22025/28/DMS/MED
SUBJECT: MEDICAL REQUIREMENTS AND EXAMINATION FOR CABIN CREW
1. INTRODUCTION
The Rule 38B of the Aircraft Rules, 1937 deals with carriage of cabin
crew. The sub-clause (d) of clause (3) of this rule provides that the
operator shall ensure that each cabin crew member remains medically
fit to discharge the duties specified in the Operations Manual. For this
purpose this CAR is issued to lay down uniform requirements of medical
fitness of cabin crew to be ensured by the operators. This CAR is issued
under the provisions of Rule 38B and Rule 133A of the Aircraft Act, 1937.
2. REQUIREMENTS FOR MEDICAL EXAMINATION
2.1 All cabin crew shall undergo initial and renewal medical examination of
equivalent to Class 2 Medical Examination.
2.2 All cabin crew shall undergo a medical examination based on the
following requirements:
(a) Physical and mental;
(b) Visual and colour perception; and
(c) Hearing.
2.3 Cabin crew shall be free from:
(a) Any abnormality, congenital or acquired; or
(b) Any active, latent, acute or chronic disability; or
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(c) Any wound, injury or sequelae from operation; or
(d) Any effect or side-effect of any prescribed or non-prescribed therapeutic,
diagnostic or preventive medication (including herbal/ alternative
medicine modalities) taken;
such as would entail a degree of functional incapacity which is likely to
interfere with the safe performance of their duties.
2.4 The medical examination shall take into account the medical history,
general and systemic clinical examination findings.
2.5. Frequency of Medical Examination. The Initial Medical Examination shall
be conducted upon induction. Subsequently, cabin crew shall undergo
renewal medical examination once every four years till the age of 40 yrs,
once every two years till the age of 50 yrs and yearly thereafter. The
frequency of medical examination may be increased in case of specific
cabin crew where a disease/condition has been detected and a more
frequent follow up is desirable.
2.6 All cabin crew shall undergo the investigations as per Appendix I (Note:
Standards for overweight/ obese for Cabin Crew shall be dealt in
conformity with AIC 09/2008 titled ‘Obesity & Commercial Aircrew’.
2.7 The provisions as applicable for Class 2 Medical Examinations as
brought out in ICAO Annex 1 Chapter 6 para 6.2.3, 6.2.4, 6.2.5, 6.4.1,
6.4.2, 6.4.3, 6.4.4 and 6.4.5 read in conjunction with ICAO document
8984 ‘Manual of Civil Aviation Medicine’ as amended from time to time
shall be followed. In addition, the provisions available in Medical AICs
(revised time to time) shall also serve as guidelines.
2.8 No cabin crew shall be accepted for rostering unless they have a valid
medical examination report.
2.9 Functional Assessment of overweight/ obese Cabin Crew shall be carried
out by the ‘Qualified Cabin Crew Instructor’/ ‘Safety and Emergency
Procedures Instructor’ at the time of making decision about fitness for duty
to assess whether she/he is able to carry out various activities towards
handling of aircraft emergencies and medical emergencies as effectively
as is expected.
3. APPROVED MEDICAL EXAMINERS/MEDICAL EXAMINATION CENTRES
3.1 The following authorities can carry out Class 2 Medical Examinations:
(a) All DGCA authorised Class 1 Medical Examiners.
(b) All DGCA authorised Class 2 Medical Examiners.
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(c) Doctors or Airline Medical Department who have undergone a minimum one
week training in Aerospace Medicine at the Institute of Aerospace Medicine,
Bangalore.
(d) In contentious cases, DMS (CA) may authorise a review/ special medical at
IAM Bangalore/AFCME New Delhi/ MEC(East) Jorhat or any other IAF
centre or DGCA empanelled medical center or Class 1 Empaneled Medical
Examiner. DGCA medical assessment will be mandatory in such cases.
The list of centres & examiners listed in para 3.1 (a) & (b) is available on
DGCA website (as amended from time to time). The choice of centre/
examiner shall be of the Airline Medical Department/ Operator.
3.2 The induction of Medical Examiners, their training requirements and
recurrent training is as per the CAR Section 7 Series ‘C’ Part I.
4. PROCEDURE AND GENERAL REQUIREMENTS FOR MEDICAL
EXAMINATION
4.1 Maintenance of Medical Records. The concerned department of scheduled
airlines and the Operator of non-scheduled airlines shall maintain the
individual medical records of all their cabin crew. A yearly summary of the
total number of induction and renewal medical examinations conducted and
their outcome may be forwarded to DGCA for scrutiny and retention.
4.2 Maintenance of schedule for Medical Examination. The concerned
department of scheduled airlines and the Operator of non-scheduled airlines
shall be responsible for maintaining a schedule to ensure timely conduct of
medical examinations of all their cabin crew.
4.3 Disposal of Cases. Cabin crew shall be handed over a medical report at the
end of the medical examination. The following disposals may be granted:
(a) Fit
(b) Temporary Unfit
(c) Permanent Unfit
4.4 Disposal of Temporary Unfit Cases. Cases may be declared Temporary
Unfit for a specified duration for a disease/ condition with specific annotation
regarding the next review and guidance on the investigations/ opinion/
treatment required before next review.
4.5 Disposal of Permanent Unfit Cases. Cases requiring to be placed
‘Permanently Unfit’ may be referred to Medical Assessor at DGCA with full
justification and supporting medical documents.
4.6 Disposal of contentious cases & arbitration. The first level of dealing with
such cases would be the Airline Medical Department itself. In cases where
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the matter is not resolved, the same may be referred to Medical Assessor
at DGCA. The Medical Assessor may advise for investigations/ opinions/
fresh medicals at IAF centres or DGCA empanelled private medical center
before finalizing the case. DGCA medical assessment will be mandatory in
such cases.
4.7 If the medical standards prescribed for Class 2 Medical Examination and
those laid down by DGCA are not met, the Medical Fitness shall not be
issued or renewed unless the following conditions are fulfilled:
(a) Accredited medical conclusion indicates that in special circumstances the
applicant’s failure to meet any requirement, whether numerical or otherwise,
is such that exercise of the duties is not likely to jeopardize flight safety;
(b) Relevant ability, skill and experience of the applicant and operational
conditions have been given due consideration; and
(c) The medical fitness is endorsed with any special limitation or limitations
when the safe performance of the cabin crew duties is dependent on
compliance with such limitation or limitations.
5 PROCEDURE FOR APPEAL MEDICAL EXAMINATION
5.1 In the event of a cabin crew being declared temporarily medically unfit for
more than six months at a stretch or in aggregate or permanently unfit, the
applicant may appeal to the Medical Assessor at DGCA for a review of the
medical assessment within a period of 90 days from the date of applicant
having been declared unfit.
5.2 The appeal shall be addressed to Director, Medical Services (Civil Aviation),
Director General of Civil Aviation, Technical Centre, Opposite Safdarjung
Airport, New Delhi-110003. The appeal shall be sent by registered post with
acknowledgement due or by Speed Post or through a reputed courier
company or may be delivered in person to the Receipt & Dispatch Section
in the O/o DGCA and obtain a receipt for the same. The appeal must be
accompanied by the following documents:
(a) All documents in original obtained by the applicant from reputed medical
institutions/ specialists clearly certifying that the applicant is fit for duties as
cabin crew, with specific reference to the cause of unfitness stated in the
medical assessment issued by the office of DGCA. The medical practitioner/
specialist certifying the fitness in such a case should give sound reasons
justifying their opinion.
(b) Reports of the medical examination and results of investigations, in original,
conducted by the medical practitioner/ specialist giving the aforesaid
certificate.
5.3 The appeal shall be considered by DGCA, and if found justified, it may be
referred to DGMS (Air). Medical records of the concerned cabin crew shall
be summoned by DGCA. If adequate medical evidence is provided for
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medical review, DGMS (Air) may recommend to DGCA an appeal/ review
medical examination at any place and may also ask for any such
investigation/ report or opinion of any specialist to determine the fitness of
the applicant. In case the appeal for medical review is not found justified,
DGMS (Air) will inform DGCA about the same giving the reasons and the
cabin crew shall be informed accordingly.
5.4 If the medical review is accepted, it shall be carried out at the centre
specified for the purpose. The fresh medical examination reports will be
considered to assess the medical fitness. The decision of the DGMS (Air)
on behalf of DGCA shall be final. The result thereof s hall be intimated by
the Medical Board to the O/o DGCA and the final assessment shall be
issued accordingly by DGCA.
6. MAINTENANCE OF RECORDS
The records of the medical examination of cabin crew shall be maintained
by the concerned department of scheduled airline/ operators. These would
be examined during the DGCA inspections.
7. Cabin crew medicals monitoring and documentation maintenance is the
responsibility of Airlines. Cabin crew medicals should be monitored by
medical department and airline supervisors. Airlines in consultation with
their medical department should device methodology for monitoring cabin
crew medicals and data maintenance. It will be inspected randomly by
DGCA authorities during inspections/ audits.
8. CONCLUSION
All operators are to ensure that a system for cabin crew initial (induction/
employment) and periodic medical examination based on guidelines above
is instituted, documented and implemented.
Director General of Civil Aviation
Revision 3 dated Aug 2025CIVIL AVIATION REQUIREMENTS SECTION 7
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Annexure I
LIST OF INVESTIGATIONS REQUIRED FOR MEDICAL EXAMINATION
OF CABIN CREWS
Sl Type of Medical Required investigations
No. Examination
1. Initial Medical Record of height, weight & Body Mass Index
Examination (BMI)
Blood Pressure
Complete Ophthalmic Examination (visual fields, distance and
near visual acuity with and without correction, colour vision on
Ishihara/Tokyo Medical
College (TMC) chart, ocular muscle balance)
Complete Ear Nose & Throat (ENT) Examination including Pure
Tone Audiogram
Haemogram (Complete Blood Counts)
Urine routine & microscopic examination
Blood Group & Rh Type
Electrocardiogram (ECG) - standard 12 lead with long lead II
Radiograph Chest PA view
Blood Sugar Fasting
Any other test deemed fit based on history/ clinical examination
2. Renewal Haemogram (Complete Blood
Medical Counts)
Examination Urine routine & microscopic
examination
Record of height, weight, BMI
Blood Pressure
Complete Ophthalmic Examination (visual fields, distance and
near visual acuity with and without correction, colour vision on
Ishihara/ TMC chart, ocular muscle balance)
Complete ENT Examination
ECG*
Pure Tone Audiogram*
Blood Sugar Fasting/PP
Lipid Profile (If overweight or Obese)
Any other test deemed fit based on history/clinical
examination/Disability.
* ECG & Audiogram are to be done only if clinically indicated in
renewal medical examinations till the age of 50. After 50, it is to
be done once every 5 years (that is during the medical that is due
after completing
the age of 50, 55, and so on)
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