Procedures for civil aviation medical examinations and certificate renewals

Telemedicine remains an option for renewal of aviation Medical Certificates (MC). MC holders are reminded that the validity period for any certificate renewed by telemedicine has a maximum of 12 months. MC holders must undergo an in-person examination to renew their MC if their last two (2) renewals were done by telemedicine. Any renewals by attestation of fitness do not count towards this change, eg: if an applicant renewed their MC by attestation followed by a telemedicine renewal, they may renew their MC once more via telemedicine before requiring an in-person examination.

Medical certificates expire on the first day of the month. Validity periods are calculated from the first day of the month following the date of the medical examination.

We encourage all applicants to apply as early as possible. Certification for complex files may take longer than 40 business days. To help applicants undergoing flight training, Transport Canada (TC) issued exemption CAME-002-2023. This allows for applicants pursuing commercial pilot training who hold a Category 3 and 4 medical certificate to take written examinations for commercial training, while awaiting issuance of a Category 1 medical, if it has been 3 or more months after their medical examination with a Civil Aviation Medical Examiner (CAME). Applicants should refer to CAME-002-2023 to confirm their eligibility for the exemption.

Should you have any questions, please submit an enquiry to Civil Aviation Medicine (CAM). CAM is also available at 1-800-305-2059, however queries with complete information are preferred.


All aviation Medical Certificate (MC) holders shall continue to comply with the Canadian Aviation Regulations (CARs) in all respects. The CARs continue to apply in all respects other than those noted in CAME-001-2023 and CAME-002-2023. Aviation MC holders are reminded that they shall not exercise their privileges if they cease to hold a valid MC by meeting any of the circumstances set out in section 404.06 of the CARs.

See the ‘How this applies’ section to understand your options for renewal.

See also a list of frequently asked questions below.

How this applies

How this certification process applies depends on your current status.

  • New applicants (Category 1,2,3)
  • New application and MCs expired before March 17, 2020 (Category 4)
  • MCs expired before March 17, 2020 (Category 1, 2, 3)
  • MCs expiring between March 17, 2020 and March 3, 2025 (Category 1, 2, 3, 4)
  • MCs expiring after March 3, 2025 (all categories)

Frequently Asked Questions

1. Who is not eligible for a telemedicine consultation?
  • Applicants that fall into the following groups are not eligible for a telemedicine consultation:

    • All ab initio (new) applicants
    • All applicants whose previous two (2) renewals were by telemedicine
    • All applicants with an MC that expired earlier than March 17, 2020. Note: Cat 1 MC holders may include the expiry date of their private pilot licence (PPL) privileges for the purposes of determining eligibility for telemedicine.
    • All applicants with MCs that were suspended as of March 17, 2020 or more recently; and
    • Any applicant who is deemed ineligible at the discretion of a CAME and is requested to do an in-person examination
2. What happens to MCs that were renewed by Attestation under the previous set of exemptions?
  • Attestations for MC’s that expired between March 17, 2020 and March 1, 2021 (inclusive) remain valid for the length originally specified, provided they were signed prior to the MC expiry date.
  • At the end of their validity period, MC holders may renew by either Telemedicine consultation or an in-person examination.
3. Do CAMEs need applicant signatures on Medical Examination Reports (MERs) for renewal by telemedicine?
  • No. However, CAMEs must adequately confirm the identity of the applicant (e.g. date of birth, address, certificate number, combination of other personal details).
  • Explanation: The renewal by telemedicine is a risk management measure in place of a blanket extension of MCs. Only existing holders of Canadian aviation documents are eligible for telemedicine, and are therefore already subject to CARs.
4. How do CAMEs validate the telemedicine renewal of the MC or Aviation Document Booklet if they cannot stamp them?
  • A stamp is not required on the MC or Aviation Document Booklet (ADB).
  • If deemed fit for renewal, CAMEs must provide the renewal applicant with a completed “Civil Aviation- Fit Certification” form (26-082A). The applicant must keep this document with their MC or ADB.
5. How can CAMEs provide a telemedicine certificate to someone with “Not valid for Civil Aviation Medical Examiner (CAME) renewal” on their current MC.
  • This affects only a small number (about 200) of pilots and air traffic controllers (ATC) with specific medical diagnoses. In such cases, CAMEs should not complete the fit certification form. CAMEs are required to send the telemedicine report to CAM HQ where it will be processed and assessed. These applicants must submit the required annual reports relating to their medical diagnosis (sent either by the CAME or separately). Documentation of a physical examination by their personal physician may be acceptable in lieu of the normal CAME physical examination. Alternatively either the applicant or CAME may decide to complete a full MER with physical examination by the CAME (as usual).
6. The CAME I normally see for examination is not offering Telemedicine, what do I do?
  • CAMEs are not required to offer Telemedicine

  • A benefit of renewal by Telemedicine is that it does not geographically limit MC holders when seeking a CAME for renewal

  • For convenience, a list of CAMEs offering Telemedicine has been posted here.

7. Will I keep my original expiry date if I renew by Telemedicine?
  • Validity periods for MCs renewed by telemedicine are calculated from the first day of the month following the date of the telemedicine examination. This decision is compliant with the International Civil Aviation Organization’s (ICAO) guidance for allowing Telemedicine consultations for MC renewal.

  • CAR 404.04 (8) (a), which allows for an MC holder to keep their existing expiry date if the medical examination is done within 90 days of the expiry date, does not apply to the calculation of validity periods with Telemedicine consults as this provision is not included in CAME-001-2023 or CAME-002-2023.

8. As a CAME, what should I know about conducting telemedicine consults?
  • Telemedicine is an accepted practice by Provincial and Territorial health authorities, and CAMEs should consult the policies on telemedicine practice in their jurisdiction. For example, see this link to the College of Physicians and Surgeons of Ontario for the CPSO policy on telemedicine.
  • Telemedicine is an accepted practice by the International Civil Aviation Organization the context of continuing aviation medical certification activities during the COVID-19 pandemic. See this link for the ICAO Quick Reference Guide.
  • The intent of providing CAMEs with the discretion to conduct telemedicine renewals is to reduce the requirement for aviators to have contact with healthcare settings which could serve as vectors for community transmission of COVID-19.
  • This measure is in the interest of public health while maintaining an acceptable level of aviation safety.
  • According to Exemption CAME-001-2022 Condition 6, the Telemedicine Medical Examination Report (MER) 26-0010AE (2006-03) must be sent to TCCA Medicine (CAM) when a telemedicine consultation is deemed sufficient.
  • Note that as with any examination for aviation licensing, the form must be sent to CAM whether or not fit certification is provided or a physical examination is carried out (in accordance with CAR 424.17- Responsibilities of Medical Examiner)
  • CAMEs unable to provide telemedicine consultation are welcome to refer applicants requesting this service to other CAMEs who are able.
9. Scenarios
  1. Cat 1 pilot over 40 but under 60. Normally, their Cat 1 MCs are valid for 1 year for two-pilot operations, but only valid for 6 months for single pilot operations with passengers, under CARs 404.04 (6.2). The associated private pilot privileges are normally valid for 2 years.
    • Applicants may renew by telemedicine provided their medical certificate was valid on or after March 17th, 2020. To meet this criteria, the most recent in-person aviation medical examination must have been in March 2018 or more recently.
    • If the pilot in this scenario proceeds with a telemedicine renewal and assessed fit, the validity period will be (calculated from the first day of the month following the telemedicine examination):
      • 6 months for single pilot commercial operations with passengers; and
      • 12 months for other commercial flying operations,
      • 12 months for private pilot privileges
    • If the most recent in-person aviation examination was prior to March 2018, applicants will need to get a full medical.
  2. Pilot seeking category upgrade (eg. Cat 3 to Cat 1)
    • An upgrade may be sought via telemedicine provided that:
      • The applicant was eligible for a telemedicine renewal based on their previous medical certificate; and,
      • All required tests are completed (e.g. ECG, audiogram).
    • TC CAM review of the telemedicine report is required prior to issuance of an upgraded medical certificate. An in-person examination may be required at the discretion of the CAME or TC CAM.

Related exemptions

  • 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
  • CAME-002-2023- Exemption from subsections 404.03 (2) (a) and (b) and 404.04 (1)(b) of the Canadian Aviation Regulations (CARs)
  • 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
  • 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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