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CFI Practical Test Standards: Technical Subject Areas


Aeronautical Information Manual

Chapter 8. Medical Facts for Pilots

Section 1. Fitness for Flight

8-1-1. Fitness For Flight
8-1-2. Effects of Altitude
8-1-3. Hyperventilation in Flight
8-1-4. Carbon Monoxide Poisoning in Flight
8-1-5. Illusions in Flight
8-1-6. Vision in Flight
8-1-7. Aerobatic Flight
8-1-8. Judgment Aspects of Collision Avoidance

Read the online version at FAA.gov.


14 CFR 61.23 Medical certificates

Medical certificates: Requirement and duration

Read the whole thing at ecfr.gov.


FAA Pilot Portal: Medical Certification

The FAA's Pilot Portal includes information on Medical Certification.


Human Factors

This task blends topics covered in the PHAK — Chapter 2, "Aeronautical Decision-Making" and Chapter 17, "Aeromedical Factors." Some topics may appear medical at first, by they are relevant to ADM, including the "IMSAFE" checklist.

Aeromedical Risks

Student pilots need to know the real risks of hypoxia, hyperventilation, ear/sinus issues, and other risk areas. They need to understand that they can be misled by motion sickness and illusions during flight. A faulty airplane can cause C02 poisoning, which requires a specific type of monitor. Fatigue, stress, and dehydration are other risks that student pilots mitigate through their own pre-flight behaviors.

And of course, flying doesn't mix with alcohol or drugs. Scuba diving carries specific risks and mitigation strategies.

Try discussing this section as a type of spiral curriculum — has your student ever felt adverse effects in other settings, such as when at work or driving a car? Can they recall a time when they were fatigued, or drank more than they intended to? Does your student understand that intoxication is simply one kind of hypoxia? (Toxic hypoxia.) Have they experienced motion sickness? Do they have any diving experience, or do they have friends or relatives who dive?

Risk Management

The "Risk Management" area of this task includes aeromedical and non-medical topics:

  • Aeromedical and physiological issues
  • Hazardous attitudes
  • Distractions, task prioritization, loss of situational awareness, or disorientation.
  • Confirmation and expectation bias

Noting that most airplane accidents are caused by pilot errors and not mechanical mishaps is a good way to start discussing IMSAFE and hazardous attitudes. Operational pitfalls include more pilot-introduced risks. The PAVE checklist is an antidote to confirmation bias.

Medical Certificates

The Practical Test Standards: Flight Instructor (Airplane) (2012) document included two topics in the "Aeromedical Factors" task were not included in the 2023 Airmen Certification Standards under the revised "Human Factors":

  • How to obtain an appropriate medical certificate.
  • How to obtain a medical certificate in the event of a possible medical deficiency.

While candidates are not required to cover this information as part of this task, it might come up. CFIs also may need to counsel student pilots on how to proceed if they suspect they have a disqualifying condition.

During the oral exam, point to the Medical Certification page on the FAA's pilot portal as a primary resource for student pilots.

Student Pilots can find an Aviation Medical Examiner (AME) on the FAA's website: Find an Aviation Medical Examiner (AME).

While it's not referenced in the PTS task, 14 CFR 67 is the regulatory document for all FAA Medical Certification topics. This spells out qualifying and disqualifying criteria for the three certificate classes.

Statement of Demonstrated Ability (SODA)

CFR § 67.401 Special issuance of medical certificates covers the Statement of Demonstrated Ability (SODA) The key language here is:

"…if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of medical certificate applied for can be performed without endangering public safety.

"At the discretion of the Federal Air Surgeon, a Statement of Demonstrated Ability (SODA) may be granted, instead of an Authorization, to a person whose disqualifying condition is static or nonprogressive and who has been found capable of performing airman duties without endangering public safety."


Airmen Certification Standards: Flight Instructor (Airplane)

Areas of Operation II. Technical Subject Areas
Task A: Human Factors

References

  1. Aeronautical Information Manual (AIM): Chapter 8: Medical Facts for Pilots
  2. Airplane Flying Handbook (FAA-H-8083-3)
  3. Commercial Pilot: Airplane Practical Test Standards (FAA-S-8081-12) (cancelled)
  4. Commercial Pilot: Airplane Airman Certification Standards (FAA-S-ACS-7A)
  5. Private Pilot Airman Certification Standards (FAA-S-ACS-6)

Objective: To determine the applicant understands personal health, flight physiology, aeromedical and human factors, can apply that knowledge, manage associated risks, demonstrate appropriate skills, and provide effective instruction.

Knowledge: The applicant demonstrates instructional knowledge by describing and explaining:

  1. Symptoms, recognition, causes, effects, and corrective actions associated with aeromedical and physiological issues, including:
    1. Hypoxia
    2. Hyperventilation
    3. Middle ear and sinus problems
    4. Spatial disorientation
    5. Motion sickness
    6. Carbon monoxide poisoning
    7. Stress
    8. Fatigue
    9. Dehydration and nutrition
    10. Hypothermia
    11. Optical illusions
    12. Dissolved nitrogen in the bloodstream after scuba dives
  2. Regulations regarding use of alcohol and drugs.
  3. Effects of alcohol, drugs, and over-the-counter medications.
  4. Aeronautical Decision-Making (ADM) to include using Crew Resource Management (CRM) or Single- Pilot Resource Management (SRM), as appropriate

Risk Management: The applicant explains and teaches how to identify and manage risk associated with:

  1. Aeromedical and physiological issues.
  2. Hazardous attitudes.
  3. Distractions, task prioritization, loss of situational awareness, or disorientation.
  4. Confirmation and expectation bias

Skills: The applicant demonstrates and simultaneously explains how to

  1. Associate the symptoms and effects for at least three of the conditions listed in K1a through K1l with the cause(s) and corrective action(s).
  2. Perform self-assessment, including fitness for flight and personal minimums, for actual flight or a scenario given by the evaluator.

Flight Instructor Test Questions

Hypoxia

Hypoxia is the result of decreasing amounts of oxygen as your altitude increases.

During a climb to 18,000 feet, the percentage of oxygen in the atmosphere remains the same.

Which statement regarding hypoxia is true? Belligerence or a false sense of security may be symptoms of hypoxia.

How can smoking affect a pilot? Reduces the oxygen-carrying capability of the blood.
— Smoking also reduces night vision by approximately 20%. (A distractor puts this at 50%. Another distractor suggests smoking increases carbon dioxide gasses, rather than carbon monoxide. Both distractors are a bit sneaky, since all three answers look plausible.)

Anemic hypoxia has the same result as hypoxic hypoxia, but it is most of the result of a leaking exhaust manifold.
— Anemic hypoxia is also known as hypemic hypoxia, and is caused by contaminated blood. CO poisoning would cause anemic/hypemic hypoxia.

Which statement is true regarding alcohol in the human system? Alcohol renders a pilot more susceptible to hypoxia.

What physical change would most likely occur to occupants of an unpressurized aircraft flying above 15,000 feet without supplemental oxygen? A blue coloration of the lips and fingernails develop along with tunnel vision.
— Blue discoloration of the lips and fingernails is cynanosis.

The advantage of experiencing hypoxia in an altitude chamber is it helps pilots learn to recognize their own symptoms in a controlled environment.

Hyperventilation

Hyperventilation results in a lack of carbon dioxide in the body.

A person should be able to overcome the symptoms of hyperventilation by slowing the breathing rate and increasing the amount of carbon dioxide in the body.

Which is a common symptom of hyperventilation? Tingling sensations.

Motion Sickness

What suggestion could you make to students who are experiencing motion sickness? Tell the students to avoid unnecessary head movement and to keep their eyes on a point outside the aircraft.

Motion sickness is caused by continued stimulation of the tiny portion of the inner ear which controls sense of balance..

Alcohol

No person may act as a crewmember of a civil aircraft with a minimum blood alcohol level of 0.04 percent or greater. (91.17)

Scuba Diving

If an individual has gone scuba diving which has not required a controlled ascent and will be flying to cabin pressure altitudes of 8,000 feet or less, the recommended waiting time is at least 12 hours.

If an individual has gone scuba diving which has required a controlled ascent and will be flying to cabin pressure altitudes of 8,000 feet or less, the recommended waiting time is at least 24 hours.

Oral Exam Questions

  1. How can a student pilot obtain a Medical Certificate?
  2. How long is a Medical Certificate valid?
  3. What are some examples of disqualifying conditions?
  4. Where can a student pilot research disqualifying medical conditions?
  5. Can a student pilot be issued a medical certificate if they have a disqualifying condition?
  6. What are the four types of hypoxia? Under what circumstances would each type occur?
  7. What causes hyperventilation? What is the appropriate treatment?

Robert Wederquist   CP-ASEL - AGI - IGI
Commercial Pilot • Instrument Pilot
Advanced Ground Instructor • Instrument Ground Instructor


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