Guidance for Civil Aviation Medical Examiners (CAMEs)

From: Transport Canada

As a Civil Aviation Medical Examiner (CAME) you play an important role in:

  • the health and safety of aviation personnel

  • preventing aircraft accidents due to medically related human factors, and

  • the safety of the general public

On this page

Procedures for initial medical exams

As a CAME you perform medical exams on applicants who want an aviation medical certificate. You’ll assess the applicants’ medical fitness, and make recommendations using an Electronic Medical Examination Report (eMER). Through the eMER, you’re informing us, in your expert opinion whether:

  • the applicant is considered medically fit

  • the applicant is considered medically unfit, or

  • more tests are needed

Even if a medical exam is incomplete, you must submit your findings through the eMER.

Detailed information on how to conduct a medical exam is found in the Handbook for Civil Aviation Medical Examiners.

Procedures for renewing a medical certificate

There are 2 ways an applicant can renew their medical certificate:

  • an in-person medical exam, or

  • a telemedicine appointment

In either scenario, the person who holds the medical certificate will contact you to schedule a medical exam. They must renew in-person if they:

  • are a new applicant

  • don’t have a valid medical certificate

  • has their last 2 renewals completed by telemedicine (this information can be found in eMER)

  • have had a medical certificate suspended as of March 17, 2020, or

  • have been asked by another CAME or Transport Canada to do an in-person exam

How to renew a certificate in-person

In this scenario, follow the same procedures you would for an initial medical certificate request.

If you believe a certificate holder is fit for renewal, stamp, sign and date their Aviation Document Booklet (ADB) or their paper medical certificate.

How to renew a certificate by telemedicine

Telemedicine renewals can be done by telephone, audio-conferencing or video-conferencing. Using video isn’t required, but it’s an option you can use.

To renew by telemedicine:

  1. Confirm the medical certificate holder’s identity (for example: date of birth, address, certificate number, combination of other personal details)
  2. Verify that the applicant’s is eligible for a telemedicine renewal. Applicants are not permitted to renew their medical certificate via telemedicine if their last two examinations were done via telemedicine, they must do an in-person evaluation
  3. Use the eMER to perform the exam and send Transport Canada the results
    • Routine tests, including electrocardiogram, urine testing, audiogram, and vision testing aren’t required as long as it’s clinically appropriate
    • If you or another CAME have previously indicated that special medical reports are required as a condition of the holder’s renewal, review these reports before granting a renewal and submit them via the eMER
    • Make sure the information submitted is complete and accurate

  4. If you assessed the holder fit for renewal, you must complete and send them a “Civil Aviation - Fit Certification (Form 26-0862A)”. The certificate holder must keep this certificate with their Aviation Document Booklet (ADB).

    • Stamping the medical certificate in the ADB is not required for telemedicine renewals

If you determine that an examination by telemedicine is insufficient due to present or past medical conditions, end the assessment and schedule an in-person exam. You must submit the results of the incomplete medical exam through eMER.

More detailed information on how to renew a medical certificate is found in the Handbook for Civil Aviation Medical Examiners.

Reporting a medical condition

Under the Aeronautics Act and the Canadian Aviation Regulations, physicians and optometrists are required to report if they believe that a patient (who is a pilot, flight engineer, or air traffic controller) has a medical condition that is likely to be a hazard to aviation safety.

The Aeronautics Act protects physicians and optometrists from legal or disciplinary proceedings that arise from sharing medical information with Transport Canada, if it’s done in good faith. The Aeronautics Act provides that the holders of Canadian aviation documents are deemed to agree to disclosing their information to Transport Canada by the physicians and optometrists making these reports.

A physician or optometrist is required to inform Transport Canada of the reasons for their opinion by the Electronic Medical Examination Report (eMER).

Guidelines for specific diseases and conditions

As a CAME, you must also know the current guidelines for specific diseases and conditions. We have set guidelines for:

Refer to the Civil Aviation Medicine – FAQs to learn more about specific medical conditions.

How to become a CAME

Licensed Physicians may apply directly to Transport Canada to be interviewed by a Regional Aviation Medical Officer. Fill out the Civil Aviation Medicine Credentialing Form (26-0852) and contact a Civil Aviation Medicine regional office to schedule an interview.

CAMEs are appointed on a need basis. If you’re accepted as a designated CAME, you’ll receive an official letter of appointment along with a full CAME authority package, a CAME numbered stamp and a wall certificate. You’ll also be granted access to the Electronic Medical Examination Report (eMER) system, an online tool used to perform medical examinations, submit reports and medical conditions and communicate with us.

Civil aviation medical examiner training

More information to come.

Contact information

If you have any questions, you can connect with us through the eMER. You can also give us a call at 1-800-305-2059.

Exemptions

Below is a list of exemptions that relate to aviation medical.

  • CAME-001-2023- Exemption from paragraphs 404.17 (a) and 404.18 (a) of the Canadian Aviation Regulations (CARs) and paragraph 424.17 (1) (a) and subsection 424.17 (4) of standard 424- medical requirements - Active
  • CAME-002-2023- Exemption from subsections 404.03 (2) (a) and (b) and 404.04 (1)(b) of the Canadian Aviation Regulations (CARs) - Active
  • CAME-001-2022- Exemption from paragraphs 404.17 (a) and 404.18 (a) of the Canadian Aviation Regulations (CARs) and paragraph 424.17 (1) (a) and subsection 424.17 (4) of standard 424- medical requirements – Replaced by active exemptions
  • CAME-002-2022- Exemption from subsections 404.03 (2) (a) and (b) and 404.04 (1)(b) of the Canadian Aviation Regulations (CARs)
  • CAME-001-2021- Exemption from paragraphs 404.17 (a) and 404.18 (a) of the Canadian Aviation Regulations (CARs) and paragraph 424.17 (1) (a) and subsection 424.17 (4) of standard 424- medical requirements
  • CAME-002-2021- Exemption from subsections 404.03 (2) (a) and (b) and 404.04 (1)(b) of the Canadian Aviation Regulations (CARs)
  • NCR-062-2020 - Exemption from paragraphs 404.03(2)(a) and (b) and 404.04(1)(b) of the Canadian Aviation Regulations
    Covers authorizations for CAMEs to renew by attestation and telemedicine consultations

See all Exemptions to the Canadian Aviation Regulations (CARs).

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