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Such applicants for the revalidation of a class 1 medical certificate shall be referred to the medical assessor of the licensing authority. Such applicants for a class 1 medical certificate shall be referred to the medical assessor of the licensing authority. Such applicants for a class 2 medical certificate shall be assessed in consultation with the medical assessor of the licensing authority. An exercise ECG when required as part of a cardiovascular assessment should be symptom limited and completed to a minimum of Bruce Stage IV or equivalent. If there is no significant functional impairment, a fit assessment may be considered provided:. Further tests may be required which should show no evidence of myocardial ischaemia or significant coronary artery stenosis. Follow-up by ultra-sound scans or other imaging techniques, as necessary, should be determined by the medical assessor of the licensing authority. Regular evaluations by a cardiologist should be carried out. If considered significant, further investigation should include at least 2D Doppler echocardiography or equivalent imaging. Applicants with significant abnormality of any of the heart valves should be assessed as unfit. Follow-up with echocardiography, as necessary, should be determined by the medical assessor of the licensing authority. Applicants with an aortic valve orifice with indexation on the body surface of more than 0. Follow-up with 2D Doppler echocardiography, as necessary, should be determined by the medical assessor of the licensing authority in all cases. Alternative measurement techniques with equivalent ranges may be used. Regular evaluation by a cardiologist should be considered. Applicants with a history of systemic embolism or significant dilatation of the thoracic aorta should be assessed as unfit. A greater degree of aortic regurgitation should require an OML. There should be no demonstrable abnormality of the ascending aorta on 2D Doppler echocardiography. Follow-up, as necessary, should be determined by the medical assessor of the licensing authority. Periodic cardiological review should be determined by the medical assessor of the licensing authority. Periodic cardiological review should be required, as determined by the medical assessor of the licensing authority. Applicants who have undergone cardiac valve replacement or repair should be assessed as unfit. A fit assessment may be considered in the following cases:. Investigations which demonstrate normal valvular and ventricular configuration and function should have been completed as demonstrated by:. Left ventricular fractional shortening should be normal. Follow-up with exercise ECG and 2D echocardiography, as necessary, should be determined by the medical assessor of the licensing authority. Anticoagulation should be considered stable if, within the last 6 months, at least 5 international normalised ratio INR values are documented, of which at least 4 are within the INR target range. The INR target range should be determined by the type of surgery performed. Applicants with arterial or venous thrombosis or pulmonary embolism should be assessed as unfit. A fit assessment with an OML may be considered after a period of stable anticoagulation as prophylaxis, after review by the medical assessor of the licensing authority. Anticoagulation should be considered stable if, within the last 6 months, at least 5 INR values are documented, of which at least 4 are within the INR target range and the haemorrhagic risk is acceptable. In cases of anticoagulation medication not requiring INR monitoring, a fit assessment with an OML may be considered after review by the medical assessor of the licensing authority after a stabilisation period of 3 months. Applicants with pulmonary embolism should also be evaluated by a cardiologist. Following cessation of anticoagulant therapy, for any indication, applicants should undergo a re-assessment by the medical assessor of the licensing authority. Coronary angiography may be indicated. Frequent review and an OML may be required after fit assessment. Applicants following surgical correction or with minor abnormalities that are functionally unimportant may be assessed as fit following cardiological evaluation. No cardioactive medication is acceptable. The potential hazard of any medication should be considered as part of the assessment. Particular attention should be paid to the potential for the medication to mask the effects of the congenital abnormality before or after surgery. Regular cardiological evaluations should be carried out. A fit assessment may be considered after a 6-month period without recurrence, provided cardiological evaluation is satisfactory. Such evaluation should include:. The medical assessor of the licensing authority may determine a shorter or longer period of OML according to the individual circumstances of the case. Acceptable medication may include:. Applicants with angina pectoris should be assessed as unfit, whether or not it is alleviated by medication. Further tests may be required, which should show no evidence of myocardial ischaemia or significant coronary artery stenosis. Medication, when used to control cardiac symptoms, is not acceptable. All applicants should be on appropriate secondary prevention treatment. A an exercise ECG showing neither evidence of myocardial ischaemia nor rhythm or conduction disturbance;. If there is any doubt about myocardial perfusion in other cases infarction or bypass grafting a perfusion scan, or equivalent test, should also be carried out;. D further investigations, such as a hour ECG, may be necessary to assess the risk of any significant rhythm disturbance. It should include a review by a cardiologist, exercise ECG and cardiovascular risk assessment. Additional investigations may be required by the medical assessor of the licensing authority. A After coronary artery bypass grafting, a myocardial perfusion scan, or equivalent test, should be performed if there is any indication, and in all cases within 5 years from the procedure. B In all cases, coronary angiography should be considered at any time if symptoms, signs or non-invasive tests indicate myocardial ischaemia. Appropriate follow-up should be carried out at regular intervals. Bruce stage 4 should be achieved and no significant abnormality of rhythm or conduction, or evidence of myocardial ischaemia should be demonstrated. Withdrawal of cardioactive medication prior to the test should normally be required;. Further evaluation may include equivalent tests may be substituted :. Anticoagulation should be considered stable if, within the last 6 months, at least 5 INR values are documented, of which at least 4 are within the INR target range. Applicants who have undergone ablation therapy should be assessed as unfit. A fit assessment may be considered following successful catheter ablation and should require an OML for at least one year, unless an electrophysiological study, undertaken at a minimum of 2 months after the ablation, demonstrates satisfactory results. Applicants with significant disturbance of supraventricular rhythm, including sinoatrial dysfunction, whether intermittent or established, should be assessed as unfit. A fit assessment may be considered if cardiological evaluation is satisfactory. A For initial applicants, a fit assessment should be limited to those with a single episode of arrhythmia which is considered by the medical assessor of the licensing authority to be unlikely to recur. B For revalidation, applicants may be assessed as fit if cardiological evaluation is satisfactory and the stroke risk is sufficiently low. Applicants with Mobitz type 2 AV block should require full cardiological evaluation and may be assessed as fit in the absence of distal conducting tissue disease. A fit assessment may be considered if there is no underlying pathology. The OML may be considered for removal if an electrophysiological study demonstrates no infra-Hissian block, or a 3-year period of satisfactory surveillance has been completed. Limitations may not be necessary if an electrophysiological study, including adequate drug-induced autonomic stimulation, reveals no inducible re-entry tachycardia and the existence of multiple accessory pathways is excluded. Applicants with a subendocardial pacemaker should be assessed as unfit. A fit assessment with an OML may be considered at revalidation no sooner than 3 months after insertion provided:. Applicants with asymptomatic QT prolongation may be assessed as fit with an OML subject to satisfactory cardiological evaluation. Applicants with a Brugada pattern Type 1 should be assessed as unfit. Applicants with Type 2 or Type 3 may be assessed as fit, with limitations as appropriate, subject to satisfactory cardiological evaluation. An exercise ECG when required as part of a cardiovascular assessment should be symptom-limited and completed to a minimum of Bruce Stage IV or equivalent. Applicants with an accumulation of risk factors smoking, family history, lipid abnormalities, hypertension, etc. Reporting of resting and exercise electrocardiograms should be by the AME or an accredited specialist. A fit assessment may be considered for an applicant with peripheral arterial disease, or after surgery for peripheral arterial disease, provided there is no significant functional impairment, any vascular risk factors have been reduced to an appropriate level, the applicant is receiving acceptable secondary prevention treatment, and there is no evidence of myocardial ischaemia. Regular follow-up should be carried out. Follow-up with echocardiography, as necessary, should be determined in consultation with the medical assessor of the licensing authority. Applicants with an aortic valve orifice of more than 1 cm 2 and a mean pressure gradient above 20 mmHg, but not greater than 50 mmHg, may be assessed as fit with an ORL or OSL. Follow-up with 2D Doppler echocardiography, as necessary, should be determined in consultation with the medical assessor of the licensing authority in all cases. Regular cardiological evaluation should be considered. Applicants with a greater degree of aortic regurgitation may be assessed as fit with an OSL. Follow-up, as necessary, should be determined in consultation with the medical assessor of the licensing authority. Periodic cardiological review should be determined in consultation with the medical assessor of the licensing authority. The review should show that the anticoagulation is stable. The INR results should be recorded and the results should be reviewed at each aero-medical assessment. Applicants taking anticoagulation medication not requiring INR monitoring, may be assessed as fit without the above-mentioned limitation in consultation with the medical assessor of the licensing authority after a stabilisation period of 3 months. A fit assessment with an ORL or OSL may be considered after a period of stable anticoagulation as prophylaxis in consultation with the medical assessor of the licensing authority. Applicants with pulmonary embolism should also undergo a cardiological evaluation. Following cessation of anticoagulant therapy for any indication, applicants should undergo a re-assessment in consultation with the medical assessor of the licensing authority. Cardiological follow-up may be necessary and should be determined in consultation with the medical assessor of the licensing authority. A fit assessment may be considered after a 6-month period without recurrence, providing cardiological evaluation is satisfactory. Neurological review may be indicated. Medication, when used to control angina pectoris, is not acceptable. A an exercise ECG showing neither evidence of myocardial ischaemia nor rhythm disturbance;. If there is doubt about revascularisation in myocardial infarction or bypass grafting, a perfusion scan, or equivalent test, should also be carried out;. A After coronary artery bypass grafting, a myocardial perfusion scan or equivalent test should be performed if there is any indication, and in all cases within five years from the procedure for a fit assessment without an OSL, OPL or ORL. A fit assessment may be considered following successful catheter ablation subject to satisfactory cardiological review undertaken at a minimum of 2 months after the ablation. Where anticoagulation is needed, a fit assessment with an ORL or OSL may be considered after a period of stable anticoagulation as prophylaxis, in consultation with the medical assessor of the licensing authority. Applicants with complete right bundle branch block may be assessed as fit with appropriate limitations, such as an ORL, and subject to satisfactory cardiological evaluation. Applicants with complete left bundle branch block may be assessed as fit with appropriate limitations, such as an ORL, and subject to satisfactory cardiological evaluation. Asymptomatic applicants with ventricular pre-excitation may be assessed as fit with limitation s as appropriate, subject to satisfactory cardiological evaluation. Limitations may not be necessary if an electrophysiological study is conducted and the results are satisfactory. A fit assessment may be considered no sooner than 3 months after insertion, providing:. Applicants with Type 2 or Type 3 may be assessed as fit, with limitation s as appropriate, subject to satisfactory cardiological evaluation. GM1 MED. GM2 MED. Asymptomatic applicants with pre-excitation may be assessed as fit if they meet the following criteria, which may also indicate a satisfactory electrophysiological evaluation:. GM3 MED. The INR result should be recorded and the results should be reviewed at each aero-medical assessment. GM4 MED. GM5 MED. Asymptomatic applicants with pre-excitation may be assessed as fit if they meet the following criteria:. However, they may be assessed as fit once pulmonary function has recovered and is satisfactory. Before further consideration is given to their application, applicants with an established diagnosis of any of the medical conditions specified in points 3 and 5 shall undergo satisfactory cardiological evaluation. A spirometric examination is required for initial examination and on clinical indication. Applicants with chronic obstructive pulmonary disease should be assessed as unfit. Applicants with only minor impairment of pulmonary function may be assessed as fit. Applicants with asthma requiring medication or experiencing recurrent attacks of asthma may be assessed as fit if the asthma is considered stable with satisfactory pulmonary function tests and medication is compatible with flight safety. Applicants requiring systemic steroids should be assessed as unfit. For applicants with active inflammatory disease of the respiratory system a fit assessment may be considered when the condition has resolved without sequelae and no medication is required. Investigation should be undertaken with respect to the possibility of systemic, particularly cardiac, involvement. A fit assessment may be considered if no medication is required, and the disease is investigated and shown to be limited to hilar lymphadenopathy and inactive. A fit assessment may be considered if respiratory evaluation is satisfactory:. Applicants with unsatisfactorily treated sleep apnoea syndrome should be assessed as unfit. Applicants with asthma may be assessed as fit if the asthma is considered stable with satisfactory pulmonary function tests and medication is compatible with flight safety. Applicants with active inflammatory disease of the respiratory system should be assessed as unfit pending resolution of the condition. Investigation should be undertaken with respect to the possibility of systemic involvement. A fit assessment may be considered once the disease is inactive. Applicants requiring major thoracic surgery should be assessed as unfit until recovery is complete, the applicant is asymptomatic, and the risk of secondary complication is minimal. Applicants with oesophageal varices should be assessed as unfit. Applicants with pancreatitis should be assessed as unfit pending assessment. A fit assessment may be considered if the cause is removed. Applicants with an established diagnosis or history of chronic inflammatory bowel disease should be assessed as fit if the inflammatory bowel disease is in established remission and stable and if systemic steroids are not required for its control. Applicants with peptic ulceration should be assessed as unfit pending full recovery and demonstrated healing. Applicants who have undergone a surgical operation for medical conditions of the digestive tract or its adnexa, including a total or partial excision or a diversion of any of these organs or herniae should be assessed as unfit. A fit assessment may be considered if recovery is complete, the applicant is asymptomatic, and there is only a minimal risk of secondary complication or recurrence. Applicants with morphological or functional liver disease, or after surgery, including liver transplantation, may be assessed as fit subject to satisfactory gastroenterological evaluation. Applicants with pancreatitis should be assessed as unfit pending satisfactory recovery. A fit assessment may be considered following gallstone removal. Applicants with an established diagnosis or history of chronic inflammatory bowel disease may be assessed as fit provided that the disease is stable and not likely to interfere with the safe exercise of the privileges of the applicable licence s. Applicants with peptic ulceration should be assessed as unfit pending full recovery. Applicants with metabolic, nutritional or endocrine dysfunction may be assessed as fit if the condition is asymptomatic, clinically compensated and stable with or without replacement therapy, and regularly reviewed by an appropriate specialist. A fit assessment with an OML may be considered, provided that cortisone is carried and available for use whilst exercising the privileges of the applicable licence s. Applicants with acute gout should be assessed as unfit. A fit assessment may be considered once asymptomatic, after cessation of treatment or the condition is stabilised on anti-hyperuricaemic therapy. Applicants with hyperthyroidism or hypothyroidism should be assessed as unfit. A fit assessment may be considered when a stable euthyroid state is attained. Glycosuria and abnormal blood glucose levels require investigation. A fit assessment may be considered if normal glucose tolerance is demonstrated low renal threshold or impaired glucose tolerance without diabetic pathology is fully controlled by diet and regularly reviewed. Subject to good control of blood sugar with no hypoglycaemic episodes:. Applicants with metabolic, nutritional or endocrine dysfunction should be assessed as unfit. A fit assessment may be considered if the condition is asymptomatic, clinically compensated and stable. Applicants with acute gout should be assessed as unfit until asymptomatic. Applicants with thyroid disease may be assessed as fit once a stable euthyroid state is attained. A fit assessment may be considered if normal glucose tolerance is demonstrated low renal threshold or impaired glucose tolerance is fully controlled by diet and regularly reviewed. Applicants with diabetes mellitus may be assessed as fit. The use of antidiabetic medications that are not likely to cause hypoglycaemia may be acceptable. Applicants with abnormal haemoglobin should be investigated. A fit assessment may be considered in cases where the primary cause, such as iron or B12 deficiency, has been treated and the haemoglobin or haematocrit has stabilised at a satisfactory level. Applicants with erythrocytosis should be assessed as unfit. A fit assessment with an OML may be considered if investigation establishes that the condition is stable and no associated pathology is demonstrated. A fit assessment may be considered where minor thalassaemia or other haemoglobinopathy is diagnosed without a history of crises and where full functional capability is demonstrated. The haemoglobin level should be satisfactory. A fit assessment may be considered if there is no history of significant bleeding episodes. Applicants with a haemorrhagic disorder require investigation. A fit assessment with an OML may be considered if there is no history of significant bleeding. A fit assessment may be considered when the applicant is asymptomatic and there is only minimal risk of secondary complication or recurrence. A fit assessment may be considered once recovery is complete, the applicant is asymptomatic, and there is only minimal risk of secondary complication or recurrence. Applicants with significant localised and generalised enlargement of the lymphatic glands or haematological disease should be assessed as unfit and require investigation. Once in established remission, applicants may be assessed as fit. After a period of demonstrated stability a fit assessment may be considered. Haemoglobin and platelet levels should be satisfactory. Regular follow-up is required. Applicants with splenomegaly should be assessed as unfit and require investigation. A fit assessment may be considered when the enlargement is minimal, stable and no associated pathology is demonstrated, or if the enlargement is minimal and associated with another acceptable condition. Haemoglobin should be tested when clinically indicated. Applicants with anaemia demonstrated by a reduced haemoglobin level or low haematocrit may be assessed as fit once the primary cause has been treated and the haemoglobin or haematocrit has stabilised at a satisfactory level. Applicants with erythrocytosis may be assessed as fit if the condition is stable and no associated pathology is demonstrated. Applicants with a haemoglobinopathy may be assessed as fit if minor thalassaemia or other haemoglobinopathy is diagnosed without a history of crises and where full functional capability is demonstrated. Applicants with a coagulation or haemorrhagic disorder may be assessed as fit if there is no likelihood of significant bleeding. Applicants with a thrombotic disorder may be assessed as fit if there is minimal likelihood of significant clotting episodes. Applicants with significant enlargement of the lymphatic glands or haematological disease may be assessed as fit if the condition is unlikely to interfere with the safe exercise of the privileges of the applicable licence s. Applicants may be assessed as fit in cases of acute infectious process which is fully recovered or Hodgkin's lymphoma or other lymphoid malignancy which has been treated and is in full remission. Applicants with splenomegaly may be assessed as fit if the enlargement is minimal, stable and no associated pathology is demonstrated, or if the enlargement is minimal and associated with another acceptable condition. Applicants shall be assessed as unfit where their urine contains abnormal elements considered to be of pathological significance that could entail a degree of functional incapacity which is likely to jeopardise the safe exercise of the privileges of the license or could render the applicant likely to become suddenly unable to exercise those privileges. However, after full recovery, they may be assessed as fit. Investigation is required if there is any abnormal finding on urinalysis. A fit assessment may be considered if blood pressure is satisfactory and renal function is acceptable. Applicants presenting with renal disease may be assessed as fit if blood pressure is satisfactory and renal function is acceptable. Applicants requiring dialysis should be assessed as unfit. In cases of infectious disease, consideration should be given to a history of, or clinical signs indicating, underlying impairment of the immune system. A fit assessment may be considered following completion of therapy. Specialist evaluation should consider the extent of the disease, the treatment required and possible side effects of medication. Applicants with acute syphilis should be assessed as unfit. A fit assessment may be considered in the case of those fully treated and recovered from the primary and secondary stages. Frequent review of the immunological status and neurological evaluation by an appropriate specialist should be carried out. A cardiological evaluation may also be required, depending on the medication. Applicants with infectious hepatitis should be assessed as unfit. A fit assessment may be considered once the applicant has become asymptomatic. Regular review of the liver function should be carried out. A cardiological evaluation may be required, depending on the medication. However, they may be assessed as fit after full recovery. Notwithstanding point MED. Applicants who have undergone a major gynaecological operation should be assessed as unfit. A fit assessment may be considered if recovery is complete, the applicant is asymptomatic, and the risk of. Applicants who have undergone a major gynaecological operation should be assessed as unfit until recovery is complete, the applicant is asymptomatic, and the risk of secondary complication or recurrence is minimal. However, where their sitting height, arm and leg length and muscular strength is sufficient for the safe exercise of the privileges in respect of a certain aircraft type, which can be demonstrated where necessary through a medical flight or a simulator flight test, the applicant may be assessed as fit and their privileges shall be limited accordingly. However, where their functional use of the musculoskeletal system is satisfactory for the safe exercise the privileges in respect of a certain aircraft type, which may be demonstrated where necessary through a medical flight or a simulator flight test, the applicant may be assessed as fit and their privileges shall be limited accordingly. Appropriate limitation s apply. Appropriate limitation s may apply. However, they may be assessed as fit after satisfactory psychiatric evaluation. Sources for this information can be accidents or incidents, problems in training or proficiency checks, behaviour or knowledge relevant to the safe exercise of the privileges of the applicable licence s. Assessment of holders of a class 1 medical certificate referenced in MED. A SIC limitation should be imposed in case of a fit assessment. Follow-up and removal of SIC limitation, as necessary, should be determined by the medical assessor of the licensing authority. Following a risk assessment performed by the competent authority on the target population, screening tests may include additional drugs. If random psychoactive substance screening test is considered, it should be performed and reported in accordance with the procedures developed by the competent authority. Applicants with a history, or the occurrence, of a functional psychotic disorder should be assessed as unfit. A fit assessment may be considered if a cause can be unequivocally identified as one which is transient, has ceased and the risk of recurrence is minimal. Applicants with an organic mental disorder should be assessed as unfit. Once the cause has been treated, an applicant may be assessed as fit following satisfactory psychiatric evaluation. Applicants who use psychoactive medication likely to affect flight safety should be assessed as unfit. If stability on maintenance psychoactive medication is confirmed, a fit assessment with an OML may be considered. If the dosage or type of medication is changed, a further period of unfit assessment should be required until stability is confirmed. Applicants with an established history or clinical diagnosis of schizophrenia, schizotypal or delusional disorder may only be considered for a fit assessment if the medical assessor of the licensing authority concludes that the original diagnosis was inappropriate or inaccurate as confirmed by psychiatric evaluation, or, in the case of a single episode of delirium of which the cause was clear, provided that the applicant has suffered no permanent mental impairment. Applicants with an established mood disorder should be assessed as unfit. After full recovery and after full consideration of the individual case, a fit assessment may be considered, depending on the characteristics and severity of the mood disorder. Where there are signs or is established evidence that an applicant may have a neurotic, stress-related or somatoform disorder, the applicant should be referred for psychiatric or psychological opinion and advice. Where there are signs or is established evidence that an applicant may have a personality or behavioural disorder, the applicant should be referred for psychiatric or psychological opinion and advice. At revalidation or renewal, a fit assessment may be considered earlier with an OML. Depending on the individual case, treatment and evaluation may include in-patient treatment of some weeks and inclusion into a support programme followed by ongoing checks, including drug and alcohol testing and reports resulting from the support programme, which may be required indefinitely. Applicants who have carried out a single self-destructive action or repeated acts of deliberate self-harm or suicide attempt should be assessed as unfit. A fit assessment may be considered after full consideration of an individual case and may require psychiatric or psychological evaluation. Neuropsychological evaluation may also be required. The assessment should take into consideration if the indication for the treatment, side effects and addiction risks of such treatment and the characteristics of the psychiatric disorder are compatible with flight safety. Assessment of holders of a class 2 medical certificate referenced in MED. Applicants with an established history or clinical diagnosis of schizophrenia, schizotypal or delusional disorder may only be considered for a fit assessment in consultation with the medical assessor of the licensing authority if the original diagnosis was inappropriate or inaccurate as confirmed by psychiatric evaluation, or, in the case of a single episode of delirium of which the cause was clear, provided that the applicant has suffered no permanent mental impairment. Where there are signs or is established evidence that an applicant may have a neurotic, stress-related or somatoform disorder, the applicant should be referred for psychiatric opinion and advice. Where there are signs or is established evidence that an applicant may have a personality or behavioural disorder, the applicant should be referred for psychiatric opinion and advice. If stability on maintenance psychoactive medication is confirmed, a fit assessment with an OSL or OPL may be considered. A In the case of a positive drug or alcohol result, confirmation should be required in accordance with national procedures for drugs and alcohol testing. B In case of a positive confirmation test, a psychiatric evaluation should be undertaken before a fit assessment may be considered. Applicants for a class 1 medical certificate shall be referred to the medical assessor of the licensing authority. The fitness of applicants for a class 2 medical certificate shall be assessed in consultation with the medical assessor of the licensing authority. One or more convulsive episode after the age of 5 should lead to unfitness. In the case of an acute symptomatic seizure, which is considered to have a very low risk of recurrence, a fit assessment may be considered after neurological evaluation. Applicants with any disease of the nervous system which is likely to cause a hazard to flight safety should be assessed as unfit. However, in certain cases, including cases of minor functional losses associated withstable disease, a fit assessment may be considered after full evaluation which should include a medical flight test which may be conducted in a flight simulation training device. Applicants with an established diagnosis of migraine or other severe periodic headaches likely to cause a hazard to flight safety should be assessed as unfit. A fit assessment may be considered after full evaluation. The evaluation should take into account at least the following: auras, visual field loss, frequency, severity, therapy. In the case of a single episode of disturbance of consciousness, which can be satisfactorily explained, a fit assessment may be considered, but applicants experiencing a recurrence should be assessed as unfit. Applicants with a head injury which was severe enough to cause loss of consciousness or is associated with penetrating brain injury should be evaluated by a neurologist. A fit assessment may be considered if there has been a full recovery and the risk of epilepsy is sufficiently low. Applicants with a history or diagnosis of spinal or peripheral nerve injury or a disorder of the nervous system due to a traumatic injury should be assessed as unfit. Applicants with a disorder of the nervous system due to vascular deficiencies including haemorrhagic and ischaemic events should be assessed as unfit. A cardiological evaluation and medical flight test should be undertaken for applicants with residual deficiencies. However, in certain cases, including cases of functional loss associated with stable disease, a fit assessment may be considered after full evaluation which should include a medical flight test which may be conducted in a flight simulation training device. The evaluation should take into account at least the following: auras, visual field loss, frequency, severity, and therapy. Applicants with a head injury which was severe enough to cause loss of consciousness or is associated with penetrating brain injury may be assessed as fit if there has been a full recovery and the risk of epilepsy is sufficiently low. An evaluation by a neurologist may be required depending on the staging of the original injury. Applicants for a class 1 medical certificate shall be assessed as unfit, where they do not have normal fields of vision and that medical condition is likely to jeopardise the safe exercise of the privileges of the license, taking account of any appropriate corrective measures where relevant. Applicants who have undergone eye surgery shall be assessed as unfit. However, they may be assessed as fit after full recovery of their visual function and subject to satisfactory ophthalmological evaluation. A comprehensive eye examination by an eye specialist is required at the initial examination. All abnormal and doubtful cases should be referred to an ophthalmologist. The examination should include:. A routine eye examination may be performed by an AME and should include:. Applicants with a visual field defect, who do not have reduced central vision or acquired loss of vision in one eye, may be assessed as fit if the binocular visual field is normal. Applicants with keratoconus may be assessed as fit if the visual requirements are met with the use of corrective lenses and periodic evaluation is undertaken by an ophthalmologist. Applicants with heterophoria imbalance of the ocular muscles exceeding:. A fit assessment may be considered if an orthoptic evaluation demonstrates that the fusional reserves are sufficient to prevent asthenopia and diplopia. The assessment after eye surgery should include an ophthalmological examination. Intraocular lenses should be monofocal and should not impair colour vision and night vision. A fit assessment may be considered 6 months after surgery, or earlier if recovery is complete. A fit assessment may also be considered earlier after retinal laser therapy. Regular follow-up by an ophthalmologist should be carried out. A fit assessment may be considered 6 months after surgery or earlier if recovery is complete. Correcting lenses should permit the licence holder to meet the visual requirements at all distances. Reduced vision in one eye or monocularity: Applicants with reduced vision or loss of vision in one eye may be assessed as fit if:. Reduced stereopsis, abnormal convergence not interfering with near vision and ocular misalignment where the fusional reserves are sufficient to prevent asthenopia and diplopia may be acceptable. Applicants who pass that test may be assessed as fit. This test is considered passed if the colour match is trichromatic and the matching range is 4 scale units or less, or if the anomalous quotient is acceptable; or by. This test is considered passed if the applicant passes without error a test with accepted lanterns. This test is considered passed if the threshold is less than 6 standard normal SN units for deutan deficiency, or less than 12 SN units for protan deficiency. A threshold greater than 2 SN units for tritan deficiency indicates an acquired cause which should be investigated. Applicants for revalidation or renewal with greater hearing loss shall demonstrate satisfactory functional hearing ability. A vestibular function test may be appropriate. A fit assessment may be considered once the condition has stabilised or there has been a full recovery. An applicant with a single dry perforation of non-infectious origin and which does not interfere with the normal function of the ear may be considered for a fit assessment. Applicants with disturbance of vestibular function should be assessed as unfit. A fit assessment may be considered after full recovery. The presence of spontaneous or positional nystagmus requires complete vestibular evaluation by specialist. Applicants with significant abnormal caloric or rotational vestibular responses should be assessed as unfit. Abnormal vestibular responses should be assessed in their clinical context. Applicants with any dysfunction of the sinuses should be assessed as unfit until there has been full recovery. Applicants with a significant infection of the oral cavity or upper respiratory tract should be assessed as unfit. Applicants with a significant disorder of speech or voice should be assessed as unfit. Applicants with significant restriction of the nasal air passage on either side, or significant malformation of the oral cavity or upper respiratory tract may be assessed as fit if ENT evaluation is satisfactory. Applicants with permanent dysfunction of the Eustachian tube s may be assessed as fit if ENT evaluation is satisfactory. Applicants with sequelae of surgery of the internal or middle ear should be assessed as unfit until recovery is complete, the applicant is asymptomatic, and the risk of secondary complication is minimal. The aircraft should be equipped with appropriate alternative warning devices in lieu of sound warnings. An ENT examination should form part of all initial, revalidation and renewal examinations. An applicant with a single dry perforation of non-infectious origin which does not interfere with the normal function of the ear may be considered for a fit assessment. Applicants with disturbance of vestibular function should be assessed as unfit pending full recovery. Applicants with any dysfunction of the sinuses should be assessed as unfit pending full recovery. The pure tone audiogram may also cover the 4 Hz frequency for early detection of decrease in hearing. Applicants shall be assessed as unfit, where they have an established dermatological condition which is likely to jeopardise the safe exercise of the privileges of the licence. In cases where a dermatological condition is associated with a systemic illness, full consideration should be given to the underlying illness before a fit assessment may be considered. Special attention should be paid to applicants who have received anthracycline chemotherapy;. Last updated date. More info and download PDF. A fit assessment may be considered in the following cases: 1 Mitral leaflet repair for prolapse is compatible with a fit assessment, provided post-operative investigations reveal satisfactory left ventricular function without systolic or diastolic dilation and no more than minor mitral regurgitation. Investigations which demonstrate normal valvular and ventricular configuration and function should have been completed as demonstrated by: i a satisfactory symptom limited exercise ECG. Acceptable medication may include: i non-loop diuretic agents; ii ACE inhibitors; iii angiotensin II receptor blocking agents sartans ; iv channel calcium blocking agents; v certain generally hydrophilic beta-blocking agents. If there is any doubt about myocardial perfusion in other cases infarction or bypass grafting a perfusion scan, or equivalent test, should also be carried out; D further investigations, such as a hour ECG, may be necessary to assess the risk of any significant rhythm disturbance. Such evaluation should include: i exercise ECG to the Bruce protocol or equivalent. Further evaluation may include equivalent tests may be substituted : iv hour ECG recording repeated as necessary; v electrophysiological study; vi myocardial perfusion imaging; vii cardiac magnetic resonance imaging MRI ; viii coronary angiogram. A fit assessment with an OML may be considered at revalidation no sooner than 3 months after insertion provided: i there is no other disqualifying condition; ii a bipolar lead system, programmed in bipolar mode without automatic mode change has been used; iii the applicant is not pacemaker dependent; and iv the applicant has a follow-up at least every 12 months, including a pacemaker check. If there is doubt about revascularisation in myocardial infarction or bypass grafting, a perfusion scan, or equivalent test, should also be carried out; D further investigations, such as a hour ECG, may be necessary to assess the risk of any significant rhythm disturbance. A fit assessment may be considered no sooner than 3 months after insertion, providing: i there is no other disqualifying condition; ii a bipolar lead system, programmed in bipolar mode without automatic mode change, has been used; iii the applicant is not pacemaker dependent; and iv the applicant has a follow-up at least every 12 months, including a pacemaker check. A fit assessment may be considered if respiratory evaluation is satisfactory: i 1 year following full recovery from a single spontaneous pneumothorax; ii at revalidation, 6 weeks following full recovery from a single spontaneous pneumothorax, with an OML for at least a year after full recovery; iii following surgical intervention in the case of a recurrent pneumothorax provided there is satisfactory recovery. A fit assessment may be considered if respiratory evaluation is satisfactory: i six weeks following full recovery from a single spontaneous pneumothorax; ii following surgical intervention in the case of a recurrent pneumothorax, provided there is satisfactory recovery. A fit assessment may be considered if recovery is complete, the applicant is asymptomatic, and the risk of b Pregnancy 1 A pregnant licence holder may be assessed as fit with an OML during the first 26 weeks of gestation following review of the obstetric evaluation by the AeMC or AME who should inform the medical assessor of the licensing authority. This test is considered passed if the colour match is trichromatic and the matching range is 4 scale units or less, or if the anomalous quotient is acceptable; or by 2 lantern testing with a Spectrolux, Beynes or Holmes-Wright lantern. Special attention should be paid to applicants who have received anthracycline chemotherapy; 5 satisfactory oncology follow-up reports are provided to the medical assessor of the licensing authority. Previous Next.

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University of equal opportunities. I wish you all the best. Alojzy Z. European meeting at the University of Warsaw. Over guests, eight European universities, dozens of parallel sessions, workshops and meetings. On 26th September, Prof. Elio Franzini, the Rector of the University of Milan. Hall of Residence No. Nowak, the UW Rector, said. For the next four years, the University will be governed by Rector Prof. Nowak and Vice-Rectors: Prof. Sambor Grucza, Prof. Ewa Krogulec, Prof. Zygmunt Lalak, Prof. Adam Niewiadomski and Prof. European meeting at the University of Warsaw Over guests, eight European universities, dozens of parallel sessions, workshops and meetings. Events for international employees A guided city walk, library training, and introduction to the USOS system are among the events open to new international employees of the University of Warsaw. They are organised or co-organised by the Welcome Point of the UW at the end of October and the beginning of November. Dan W. Thanks to it, mentoring or expert visits by outstanding academics from foreign-renowned universities and research institutions take place at the University of Warsaw. On 6th November, the UW will host a mentoring visit of Prof. Puchniak from Singapore Management University. Welcome meeting for new international UW employees Welcome Point is organising a meeting for new international employees of the University of Warsaw that will be held on 24th October at noon in the Old Library building. The participants will be introduced to the structure and functioning of the University as well as the most important formalities related to living in Warsaw. On 25th September, Prof. The initiative was prepared by UW students and the Academic Ombudsman. The building meets the standards of modern residential construction with numerous environmentally friendly and energy-saving solutions, such as a ventilation heat pump, heat recovery from exhaust air and photovoltaic modules. The hall of residence is very popular with students and doctoral candidates. UW scholarships for students from Palestine The University of Warsaw will make it possible for people from Palestine to pursue their studies. Nowak, the UW Rector. Joint activities will include the promotion and publication of research results and university-led cooperation with industry. Honorary Doctorate for Prof. Agnieszka Nogal Prof. Now all courses, exams and trainings will be easily accessible in one place online. More news. Download the application for Android Download the application for iOS. Study in Warsaw Poland - the right choice Visit our campus. Welcome Point. HR Excellence in Research. Academic units. Polish language courses. Maps, brochures and presentations.

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