Use of General Directions (GDs)

Primary Legislation:	Civil Aviation Act 2023, Sch 2, Cl 25(1)
Secondary Legislation:	CAR Part 67.57, 67.67, 67.103, 67.105 and 67.107
Form:	Not applicable
Use by:	Medical Examiner conducting examination and Medical Examiner conducting the assessment.

Role of General Directions

The Act states that the Director may issue General Directions in relation to:

• Conducting examinations of applicants and licence holders and reporting the results of those examinations to the Director; and
• Providing exceptions for temporary medical conditions to the reporting requirements set in Schedule 2, clause 8, refer to Change in medical condition / suspension process; and
• Specifying the requirements of examinations or other clinical matters, which must be reasonable, including but not limited to:
  • The medical content of examinations;
  • The interpretation and analysis of results of examinations;
  • The significance of results of examinations for the purpose of determining whether or not an applicant is eligible for a medical certificate under Schedule 2, clauses 2, 3 and 5.

General Directions (GDs) are items of legislation and as such must be adhered to. A brief description of some of the GDs is offered below:

Timetable for routine examinations

General Directions for Timing of Routine Examinations [PDF 500 KB]

This GD prescribes the timing of routine examinations. An important feature of this GD is the series of tables that detail the examination requirements needed to issue a certificate and includes examples. Here are some examples.

Example 1

A 43 year old applicant applies for the first time for a Class 2 certificate.

The requirements are those for an initial general medical examination as demonstrated in the first line of the table 'Class 2 medical certificate'.

Thus the applicant will need to undergo, as per the first medical examination requirements: 

12 lead ECG, Cardio-vascular risk estimation - only if note 1 applies, blood lipids estimation and blood sugar estimation, a chest X-ray - only if note 2 applies, Spirometry, Audiometry - refer to note 3, and Colour vision testing.

Part 2 - Class 2 medical certificate

Timing of routine examination Class 2 certificate	12-lead ECG	Cardiovascular risk estimation	Blood lipids & blood sugar estimation	Audiometry for IFR priveleges	Ishihara	Spirometry	Chest X-ray
First general medical examination		if note 1 applies				If note 3 applies	If note 2 applies

Notes

1. Cardiovascular risk estimation: This examination is required if the Class 2 applicant is 40 years of age or older.
2. Chest X ray: This examination is required only if the applicant’s history indicates a high likelihood of asymptomatic pulmonary disease. An example of such a history is if the applicant had a prolonged stay in an area where infective pulmonary disease is endemic.
3. Spirometry: This routine examination is required only if the applicant have smoked tobacco in the past 5 years.
4. Audiometry for IFR Privileges: Audiometry is only required for class 2 applicants who undertake flights under Instrument Flight Rules (IFR). If audiometry is not undertaken as specified in the schedule then any medical certificate that is issued must be endorsed 'Not valid for IFR flight'.

Example 2

The same applicant presents again at age 45 for a subsequent examination for re-issue of his Class 2 medical certificate.

One needs to look at the relevant age. 

Part 2 - Class 2 medical certificate

Timing of routine examination Class 2 certificate	12-lead ECG	Cardiovascular risk estimation	Blood lipids & blood sugar estimation	Audiometry	Special vision examination	Spirometry	Chest X-ray
Age 43
Age 44
Age 45
Age 46

Thus the applicant needs no routine investigations.

Example 3

An applicant aged 65 presents for a subsequent Class 1 examination. His last examination was at age 64. The examinations required under the GD 'timetable for routine examinations” are:

Part 1 - Class 1 medical certificate

Timing of routine examination Class 2 certificate	12-lead ECG	Cardiovascular risk estimation	Blood lipids & blood sugar estimation	Audiometry	Special vision examination	Spirometry	Chest X-ray
Age 63
Age 64
Age 65
Age 66

The examinations required under the current age of 65: Audiometry and Special vision examination.

Please check that the routine examinations required at age 64 have been completed. If they were not done, these examinations would need to be completed.

Note: The previous Medical Assessment Report (MAR) should indicate the date of the last routine examination undertaken. The ME should check this previous MAR to ensure that the compulsory investigations had been carried out when due.

Examination procedures

General Directions for Examination Procedures [PDF 1.6 MB]

This GD prescribes how to conduct, interpret and report a number of examinations as well as their validity periods. MEs should become familiar with this GD, which is by and large self-explanatory.

Clinical GD(s)

These GDs prescribe which examination(s) or investigation(s) are to be conducted in relation to certain medical conditions and give directions in regard to the assessment of these conditions.

There are currently no clinical GDs.

Conditions that do not need reporting GD (temporary medical conditions):

General Directions Exceptions for Temporary Medical Conditions [PDF 325 KB]

This GD describes changes in medical condition that do not need reporting to the Director – refer to Change in medical condition / suspension process for explanation on 'change in medical condition' reporting obligations.

Key points

The GDs prescribe:

• The timing of routine examinations;
• The content of examinations;
• The interpretation of examination results;
• The reporting of examinations;
• What temporary medical conditions do not need to be reported.

The Medical Examiner (ME):

• Must refer to the applicable GD(s) relating to the assessment being performed.