Regulation (EU) 2019/27
(a) The privileges of holders of an aero-medical examiner (AME) certificate are to issue, revalidate and renew class 2 medical certificates and LAPL medical certificates and to conduct the relevant medical examinations and assessments.
(b) Holders of an AME certificate may apply for an extension of their privileges to include medical examinations for the revalidation and renewal of class 1 medical certificates, if they comply with the requirements set out in point MED.D.015.
(c) The privileges of a holder of an AME certificate referred to in points (a) and (b) shall include the privileges to conduct cabin crew members’ aero-medical examinations and assessments and to provide the related cabin crew members’ medical reports, as applicable, in accordance with this Annex (Part-MED).
(d) The scope of the privileges of the holder of an AME certificate, and any condition thereof, shall be specified in that certificate.
(e) A holder of an AME certificate shall not at any time hold more than one AME certificate issued in accordance with this Regulation.
(f) Holders of an AME certificate shall not undertake aero-medical examinations and assessments in a Member State other than the Member State that issued their AME certificate, unless they have completed all the following steps:
(1) they have been granted access by the other Member State concerned to exercise their professional activities as a specialised doctor;
(2) they have informed the competent authority of that other Member State of their intention to conduct aero-medical examinations and assessments and to issue medical certificates within the scope of their privileges as AME;
(3) they have received a briefing from the competent authority of that other Member State.
Regulation (EU) 2019/27
(a) An application for an AME certificate or for an extension of the privileges of an AME certificate shall be made in a form and manner specified by the competent authority.
(b) Applicants for an AME certificate shall provide the competent authority with:
(1) their personal details and professional address;
(2) documentation demonstrating that they comply with the requirements of point MED.D.010, including evidence of successful completion of the training course in aviation medicine appropriate to the privileges they apply for;
(3) a written declaration that, once the AME certificate has been issued, the AME will issue medical certificates on the basis of the requirements of this Regulation.
(c) When AMEs undertake aero-medical examinations in more than one location, they shall provide the competent authority with relevant information regarding all practice locations and practice facilities.
MED.D.010 Requirements for the issue of an AME certificate
Regulation (EU) 2019/27
Applicants shall be issued an AME certificate, where they meet all of the following conditions:
(a) they are fully qualified and licensed for the practice of medicine and have evidence of completion of specialist medical training;
(b) they have successfully completed a basic training course in aviation medicine, including practical training in the examination methods and aero-medical assessments;
(c) they have demonstrated to the competent authority that they:
(1) have adequate facilities, procedures, documentation and functioning equipment suitable for aero-medical examinations;
(2) have in place the necessary procedures and conditions to ensure medical confidentiality.
MED.D.011 Privileges of an AME certificate holder
Regulation (EU) 2019/27
Through the issuance of an AME certificate, the holder shall be granted the privileges to initially issue, revalidate and renew all of the following:
(a) class 2 medical certificates;
(b) LAPL medical certificates;
(c) cabin crew members’ medical reports.
MED.D.015 Requirements for the extension of privileges
Regulation (EU) 2019/27
Applicants shall be issued an AME certificate extending their privileges to the revalidation and renewal of class 1 medical certificates where they meet all of the following conditions:
(a) they hold a valid AME certificate;
(b) they conducted at least 30 examinations for the issue, revalidation or renewal of class 2 medical certificates or equivalent over a period of no more than 3 years preceding the application;
(c) they successfully completed an advanced training course in aviation medicine, including practical training in the examination methods and aero-medical assessments;
(d) they have successfully completed practical training of a duration of at least 2 days, either at an AeMC or under the supervision of the competent authority.
MED.D.020 Training courses in aviation medicine
Regulation (EU) 2019/27
(a) Training courses in aviation medicine refered to in MED.D.010(b) and MED.D.015(c) shall only be provided after the prior approval of the course by the competent authority of the Member State where the training organisation has its principal place of business. In order to obtain such approval, the training organisation shall demonstrate that the course syllabus contains the learning objectives to acquire the necessary competencies and that the persons in charge of providing the training have adequate knowledge and experience.
(b) Except in the case of refresher training, the courses shall be concluded by a written examination on the subjects included in the course content.
(c) The training organisation shall issue a certificate of successful completion to participants when they have obtained a pass in the examination.
AMC1 MED.D.020 Training courses in aviation medicine
ED Decision 2019/002/R
(a) Basic training course for AMEs
The basic training course for AMEs should consist of 60 hours of theoretical and practical training, including specific examination techniques.
(b) The learning objectives to acquire the necessary competencies should include theoretical knowledge, risk management, and decision-making principles in the following subjects. Demonstrations and practical skills should also be included, where appropriate.
(1) Introduction to aviation medicine;
(2) Basic aeronautical knowledge;
(3) Aviation physiology;
(4) Cardiovascular system;
(5) Respiratory system;
(6) Digestive system;
(7) Metabolic and endocrine systems;
(8) Haematology;
(9) Genitourinary system;
(10) Obstetrics and gynaecology;
(11) Musculoskeletal system;
(12) Psychiatry;
(13) Psychology;
(14) Neurology;
(15) Visual system and colour vision;
(16) Otorhinolaryngology;
(17) Oncology;
(18) Incidents and accidents escape and survival;
(19) Medication and flying;
(20) Legislation, rules and regulations;
(21) Cabin crew working environment;
(22) In-flight environment; and
(23) Space medicine.
AMC2 MED.D.020 Training courses in aviation medicine
ED Decision 2019/002/R
(a) Advanced training course for AMEs
The advanced training course for AMEs should consist of 66 hours of theoretical and practical training, including specific examination techniques.
(b) The learning objectives to acquire the necessary competencies should include theoretical knowledge, risk management, and decision-making principles in the following subjects. Demonstrations and practical skills should also be included, where appropriate.
(1) Pilot working environment;
(2) Aerospace physiology;
(3) Clinical medicine;
(4) Cardiovascular system;
(5) Neurology;
(6) Psychiatry/psychology;
(7) Visual system and colour vision;
(8) Otorhinolaryngology;
(9) Dentistry;
(10) Human factors in aviation;
(11) Incidents and accidents, escape and survival; and
(12) Tropical medicine.
(c) Practical training in an AeMC should be under the guidance and supervision of the head of the AeMC.
(d) After the successful completion of the practical training, a report of demonstrated competency should be issued.
GM1 MED.D.020 Training courses in aviation medicine
ED Decision 2019/002/R
(a) Basic training course in aviation medicine 60 hours
(1) Introduction to aviation medicine 2 hours
(i) History of aviation medicine
(ii) Specific aspects of civil aviation medicine
(iii) Different types of recreational flying
(iv) AME and pilots relationship
(v) Responsibility of the AME in aviation safety
(vi) Communication and interview techniques
(2) Basic aeronautical knowledge 2 hours
(i) Flight mechanisms
(ii) Man-machine interface, informational processing
(iii) Propulsion
(iv) Conventional instruments, ‘glass cockpit’
(v) Recreational flying
(vi) Simulator/aircraft experience
(3) Aviation physiology 9 hours
(i) Atmosphere
(A) Functional limits for humans in flight
(B) Divisions of the atmosphere
(C) Gas laws — physiological significance
(D) Physiological effects of decompression
(ii) Respiration
(A) Blood gas exchange
(B) Oxygen saturation
(iii) Hypoxia signs and symptoms
(A) Average time of useful consciousness (TUC)
(B) Hyperventilation signs and symptoms
(C) Barotrauma
(D) Decompression sickness
(iv) Acceleration
(A) G-Vector orientation
(B) Effects and limits of G-load
(C) Methods to increase Gz-tolerance
(D) Positive/negative acceleration
(E) Acceleration and the vestibular system
(v) Visual disorientation
(A) Sloping cloud deck
(B) Ground lights and stars confusion
(C) Visual autokinesis
(vi) Vestibular disorientation
(A) Anatomy of the inner ear
(B) Function of the semicircular canals
(C) Function of the otolith organs
(D) The oculogyral and coriolis illusion
(E) ‘Leans’
(F) Forward acceleration illusion of ‘nose up’
(G) Deceleration illusion of ‘nose down’
(H) Motion sickness — causes and management
(vii) Noise and vibration
(A) Preventive measures
(4) Cardiovascular system 3 hours
(i) Relation to aviation; risk of incapacitation
(ii) Examination procedures: ECG, laboratory testing and other special examinations
(iii) Cardiovascular diseases:
(A) Hypertension, treatment and assessment
(B) Ischaemic heart disease
(C) ECG findings
(D) Assessment of satisfactory recovery from myocardial infarction, interventional procedures and surgery
(E) Cardiomyopathies; pericarditis; rheumatic heart disease; valvular diseases
(F) Rhythm and conduction disturbances, treatment and assessment
(G) Congenital heart disease: surgical treatment, assessment
(H) Cardiovascular syncope: single and repeated episodes
Topics (5) to (11) inclusive, and (17) 10 hours
(5) Respiratory system
(i) Relation to aviation, risk of incapacitation
(ii) Examination procedures: spirometry, peak flow, x-ray, other examinations
(iii) Pulmonary diseases: asthma, chronic obstructive pulmonary diseases
(iv) Infections, tuberculosis
(v) Bullae, pneumothorax
(vi) Obstructive sleep apnoea
(vii) Treatment and assessment
(6) Digestive system
(i) Relation to aviation, risk of incapacitation
(ii) Examination of the system
(iii) Gastro-intestinal disorders: gastritis, ulcer disease
(iv) Biliary tract disorders
(v) Hepatitis and pancreatitis
(vi) Inflammatory bowel disease, irritable colon/irritable bowel disease
(vii) Herniae
(viii) Treatment and assessment including post-abdominal surgery
(7) Metabolic and endocrine systems
(i) Relation to aviation, risk of incapacitation
(ii) Endocrine disorders
(iii) Diabetes mellitus Type 1 & 2
(A) Diagnostic tests and criteria
(B) Anti-diabetic therapy
(C) Operational aspects in aviation
(D) Satisfactory control criteria for aviation
(iv) Hyper/hypothyroidism
(v) Pituitary and adrenal glands disorders
(vi) Treatment and assessment
(8) Haematology
(i) Relation to aviation, risk of incapacitation
(ii) Blood donation aspects
(iii) Erythrocytosis; anaemia; leukaemia; lymphoma
(iv) Sickle cell disorders
(v) Platelet disorders
(vi) Haemoglobinopathies; geographical distribution; classification
(vii) Treatment and assessment
(9) Genitourinary system
(i) Relation to aviation, risk of incapacitation
(ii) Action to be taken after discovery of abnormalities in routine dipstick urinalysis, e.g. haematuria; albuminuria
(iii) Urinary system disorders:
(A) Nephritis; pyelonephritis; obstructive uropathies
(B) Tuberculosis
(C) Lithiasis: single episode; recurrence
(D) Nephrectomy, transplantation, other treatment and assessment
(10) Obstetrics and gynaecology
(i) Relation to aviation, risk of incapacitation
(ii) Pregnancy and aviation
(iii) Disorders, treatment and assessment
(11) Musculoskeletal system
(i) Vertebral column diseases
(ii) Arthropathies and arthroprosthesis
(iii) Pilots with a physical impairment
(iv) Treatment of musculoskeletal system, assessment for flying
(12) Psychiatry 2 hours
(i) Relation to aviation, risk of incapacitation
(ii) Psychiatric examination
(iii) Psychiatric disorders: neurosis; personality disorders; psychosis; organic mental illness
(iv) Alcohol and other psychoactive substance(s) use
(v) Treatment, rehabilitation and assessment
(13) Psychology 2 hours
(i) Introduction to psychology in aviation as a supplement to psychiatric assessment
(ii) Methods of psychological examination
(iii) Behaviour and personality
(iv) Workload management and situational awareness
(v) Flight motivation and suitability
(vi) Group social factors
(vii) Psychological stress, stress coping, fatigue
(viii) Psychomotor functions and age
(ix) Mental fitness and training
(14) Neurology 3 hours
(i) Relation to aviation, risk of incapacitation
(ii) Examination procedures
(iii) Neurological disorders
(A) Seizures — assessment of single episode
(B) Epilepsy
(C) Multiple sclerosis
(D) Head trauma
(E) Post-traumatic states
(F) Vascular diseases
(G) Tumours
(H) Disturbance of consciousness — assessment of single and repeated episodes
(iv) Degenerative diseases
(v) Sleep disorders
(vi) Treatment and assessment
(15) Visual system and colour vision 4 hours
(i) Anatomy of the eye
(ii) Relation to aviation duties
(iii) Examination techniques
(A) Visual acuity assessment
(B) Visual aids
(C) Visual fields — acceptable limits for certification
(D) Ocular muscle balance
(E) Assessment of pathological eye conditions
(F) Glaucoma
(iv) Monocularity and medical flight tests
(v) Colour vision
(vi) Methods of testing: pseudoisochromatic plates, lantern tests, anomaloscopy
(vii) Importance of standardisation of tests and of test protocols
(viii) Assessment after eye surgery
(16) Otorhinolaryngology 3 hours
(i) Anatomy of the systems
(ii) Clinical examination in ORL
(iii) Functional hearing tests
(iv) Vestibular system; vertigo, examination techniques
(v) Assessment after ENT surgery
(vi) Barotrauma ears and sinuses
(vii) Aeronautical ENT pathology
(viii) ENT requirements
(17) Oncology
(i) Relation to aviation, risk of metastasis and incapacitation
(ii) Risk management
(iii) Different methods of treatment and assessment
(18) Incidents and accidents, escape and survival 1 hour
(i) Accident statistics
(ii) Injuries
(iii) Aviation pathology, post-mortem examination, identification
(iv) Aircraft evacuation
(A) Fire
(B) Ditching
(C) By parachute
(19) Medication and flying 2 hours
(i) Hazards of medications
(ii) Common side effects; prescription medications; over-the-counter medications; herbal medications; ‘alternative’ therapies
(iii) Medication for sleep disturbance
(20) Legislation, rules and regulations 4 hours
(i) ICAO Standards and Recommended Practices, European provisions (e.g. Implementing Rules, AMC and GM)
(ii) Incapacitation: acceptable aero-medical risk of incapacitation; types of incapacitation; operational aspects
(iii) Basic principles in assessment of fitness for aviation
(iv) Operational and environmental conditions
(v) Use of medical literature in assessing medical fitness; differences between scientific study populations and licensed populations
(vi) Flexibility
(vii) Annex 1 to the Chicago Convention, paragraph 1.2.4.9
(viii) Accredited Medical Conclusion; consideration of knowledge, skill and experience
(ix) Trained versus untrained crews; incapacitation training
(x) Medical flight tests
(21) Cabin crew working environment 1 hour
(i) Cabin environment, workload, duty and rest time, fatigue risk management
(ii) Cabin crew safety duties and associated training
(iii) Types of aircraft and types of operations
(iv) Single-cabin crew and multi-cabin crew operations
(22) In-flight environment 1 hour
(i) Hygiene aboard aircraft: water supply, oxygen supply, disposal of waste, cleaning, disinfection and disinsection
(ii) Catering
(iii) Crew nutrition
(iv) Aircraft and transmission of diseases
(23) Space medicine 1 hour
(i) Microgravity and metabolism, life sciences
(24) Practical demonstrations of basic aeronautical knowledge 8 hours
(25) Concluding items 2 hours
(i) Final examination
(ii) De-briefing and critique
GM2 MED.D.020 Training courses in aviation medicine
ED Decision 2019/002/R
(a) Advanced training course in aviation medicine 66 hours
(1) Pilot working environment 6 hours
(i) Commercial aircraft flight crew compartment
(ii) Business jets, commuter flights, cargo flights
(iii) Professional airline operations
(iv) Fixed wing and helicopter, specialised operations including aerial work
(v) Air traffic control
(vi) Single-pilot/multi-pilot
(vii) Exposure to radiation and other harmful agents
(2) Aerospace physiology 4 hours
(i) Brief review of basics in physiology (hypoxia, rapid/slow decompression, hyperventilation, acceleration, ejection, spatial disorientation)
(ii) Simulator sickness
(3) Clinical medicine 5 hours
(i) Complete physical examination
(ii) Review of basics with relationship to commercial flight operations
(iii) Class 1 requirements
(iv) Clinical cases
(v) Communication and interview techniques
(4) Cardiovascular system 4 hours
(i) Cardiovascular examination and review of basics
(ii) Class 1 requirements
(iii) Diagnostic steps in cardiovascular system
(iv) Clinical cases
(5) Neurology 3 hours
(i) Brief review of basics (neurological and psychiatric examination)
(ii) Alcohol and other psychoactive substance(s) use
(iii) Class 1 requirements
(iv) Clinical cases
(6) Psychiatry/psychology 5 hours
(i) Brief review of basics (psychiatric/psychological evaluation techniques)
(ii) Alcohol and other psychoactive substance(s) use
(iii) Class 1 requirements
(iv) Clinical cases
(7) Visual system and colour vision 5 hours
(i) Brief review of basics (visual acuity, refraction, colour vision, visual fields, night vision, stereopsis, monocularity)
(ii) Class 1 visual requirements
(iii) Implications of refractive and other eye surgery
(iv) Clinical cases
(8) Otorhinolaryngology 4 hours
(i) Brief review of basics (barotrauma — ears and sinuses, functional hearing tests)
(ii) Noise and its prevention
(iii) Vibration, kinetosis
(iv) Class 1 hearing requirements
(v) Clinical cases
(9) Dentistry 2 hours
(i) Oral examination including dental formula
(ii) Oral cavity, dental disorders and treatment, including implants, fillings, prosthesis, etc.
(iii) Barodontalgia
(iv) Clinical cases
(10) Human factors in aviation, including 8 hours demonstration and practical experience 22 hours
(i) Long-haul flight operations
(A) Flight time limitations
(B) Sleep disturbance
(C) Extended/expanded crew
(D) Jet lag/time zones
(ii) Human information processing and system design
(A) Flight Management System (FMS), Primary Flight Display (PFD), datalink, fly by wire
(B) Adaptation to the glass cockpit
(C) Crew Coordination Concept (CCC), Crew Resource Management (CRM), Line Oriented Flight Training (LOFT) etc.
(D) Practical simulator training
(E) Ergonomics
(iii) Crew commonality
(A) Flying under the same type rating, e.g. A-318, A-319, A-320, A-321
(iv) Human factors in aircraft incidents and accidents
(v) Flight safety strategies in commercial aviation
(vi) Fear and refusal of flying
(vii) Psychological selection criteria
(viii) Operational requirements (flight time limitation, fatigue risk management, etc.)
(11) Incidents and accidents, escape and survival 2 hours
(i) Accident statistics
(ii) Types of injuries
(iii) Aviation pathology, post-mortem examination related to aircraft accidents, identification
(iv) Rescue and emergency evacuation
(12) Tropical medicine 2 hours
(i) Endemicity of tropical disease
(ii) Infectious diseases (communicable diseases, sexually transmitted diseases, HIV etc.)
(iii) Vaccination of flight crew and passengers
(iv) Diseases transmitted by vectors
(v) Food and water-borne diseases
(vi) Parasitic diseases
(vii) International health regulations
(viii) Personal hygiene of aviation personnel
(13) Concluding items 2 hours
(i) Final examination
(ii) De-briefing and critique
GM3 MED.D.020 Training courses in aviation medicine
ED Decision 2019/002/R
(a) Principles of training:
To acquire knowledge and skills for the aero-medical examination and assessment, the training should be:
(1) based on regulations;
(2) based on general clinical skills and knowledge necessary to conduct relevant examinations for the different medical certificates;
(3) based on knowledge of the different risk assessments required for various types of medical certification;
(4) based on an understanding of the limits of the decision-making competences of an AME in assessing safety-critical medical conditions for when to defer and when to deny;
(5) based on knowledge of the aviation environment; and
(6) exemplified by clinical cases and practical demonstrations.
(b) Training outcomes:
The trainee should demonstrate a thorough understanding of:
(1) the aero-medical examination and assessment process:
(i) principles, requirements and methods;
(ii) ability to investigate all clinical aspects that present aero-medical risks, the reasonable use of additional investigations;
(iii) the role in the assessment of the ability of the pilot or cabin crew member to safely perform their duties in special cases, such as the medical flight test;
(iv) aero-medical decision-making based on risk management;
(v) medical confidentiality; and
(vi) correct use of appropriate forms, and the reporting and storing of information;
(2) the conditions under which the pilots and cabin crew carry out their duties; and
(3) principles of preventive medicine, including aero-medical advice in order to help prevent future limitations.
(c) The principles and training outcomes stated at (a) and (b) should also be taken into consideration for refresher training programmes
MED.D.025 Changes to the AME certificate
Regulation (EU) 2019/27
(a) Holders of an AME certificate shall, without undue delay, notify the competent authority of the following circumstances which could affect their AME certificate:
(1) the AME is subject to disciplinary proceedings or investigation by a medical regulatory body;
(2) there are changes to the conditions under which the certificate was granted, including the content of the statements provided with the application;
(3) the requirements for the issuance of the AME certificate are no longer met;
(4) there is a change to the aero-medical examiner’s practice location(s) or correspondence address.
(b) Failure to notify the competent authority in accordance with point (a) shall result in the suspension or revocation of the AME certificate in accordance with point ARA.MED.250 of Annex II (Part-ARA).
MED.D.030 Validity of AME certificates
Regulation (EU) 2019/27
An AME certificate shall be valid for a period of 3 years, unless the competent authority decides to reduce that period for duly justified reasons related to the individual case.
Upon application by the holder, the certificate shall be:
(a) revalidated, provided that the holder:
(1) continues to fulfil the general conditions required for medical practice and maintains his or her licence for the practice of medicine;
(2) has undertaken refresher training in aviation medicine within the last 3 years;
(3) has performed at least 10 aero-medical examinations or equivalent every year;
(4) remains in compliance with the terms of the certificate;
(5) exercises the privileges in accordance with the requirements of this Annex (Part-MED);
(6) has demonstrated that he or she maintains his or her aero-medical competency in accordance with the procedure established by the competent authority.
(b) renewed, provided that the holder complies with either the requirements for revalidation set out in point (a) or with all of the following requirements:
(1) continues to fulfil the general conditions required for medical practice and maintains his or her licence for the practice of medicine;
(2) has undertaken refresher training in aviation medicine within the previous year;
(3) has successfully completed practical training within the previous year, either at an AeMC or under the supervision of the competent authority;
(4) remains in compliance with the requirements of point MED.D.010;
(5) has demonstrated that he or she maintains his or her aero-medical competency in accordance with the procedure established by the competent authority.
AMC1 MED.D.030 Validity of AME certificates
ED Decision 2019/002/R
(a) It is the responsibility of the AME to continuously maintain and improve their competencies.
(b) During the period of validity of the AME certificate, an AME should attend a minimum of 20 hours of refresher training.
(c) An AME exercising class 1 privileges should attend at least 10 hours of refresher training per year.
(d) A proportionate number of refresher training hours should be provided by, or conducted under the direct supervision of, the competent authority or the medical assessor.
(e) The curricula of refresher training hours referred to in (c) should be decided by the competent authority following a risk-based assessment.
(f) Attendance at scientific meetings and congresses, and flight deck experience may be credited by the competent authority for a specified number of hours against the training obligations of the AME, provided the competent authority has assessed it in advance as being relevant for crediting purposes.
(g) In case of renewal of an AME certificate, the practical training should include at least 10 aero-medical assessments, in accordance with the type of the requested AME certificate.
GM1 MED.D.030 Validity of AME certificates
ED Decision 2019/002/R
(a) The curricula for the refresher training hours that should be provided by, or conducted under the direct supervision of, the competent authority or the medical assessor may include but are not limited to subjects such as:
(1) Psychiatry
(i) Relation to aviation, risk of incapacitation;
(ii) Psychiatric examination;
(iii) Psychiatric disorders: neurosis, personality disorders, psychosis, organic mental illness;
(iv) Alcohol and other psychoactive substance(s) use; and
(v) Treatment, rehabilitation and assessment.
(2) Psychology
(i) Introduction to psychology in aviation as a supplement to psychiatric assessment;
(ii) Methods of psychological examination;
(iii) Behaviour and personality;
(iv) Workload management and situational awareness;
(v) Flight motivation and suitability;
(vi) Group social factors;
(vii) Psychological stress, stress coping, fatigue;
(viii) Psychomotor functions and age; and
(ix) Mental fitness and training.
(3) Communication and interview techniques
(b) Scientific meetings, congresses or flight deck experience that may be credited by the competent authority:
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International Academy of Aviation and Space Medicine Annual Congresses (ICASM) |
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Aerospace Medical Association Annual Scientific Meetings (AsMA) |
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Flight crew compartment experience (a maximum of 5 hours credit per 3 years):
(i) Jump seat 5 sectors — 1 hour credit
(ii) Simulator 4 hours — 1 hour credit
(iii) Aircraft piloting 4 hours — 1 hour credit
(c) An AME exercising class 1 revalidation/renewal privileges should attend international aviation medicine scientific meetings or congresses at regular intervals.
(d) Aero-medical examinations of military pilots may be considered as equivalent in accordance with MED.D.030(a)(3), subject to approval by the medical assessor of the competent authority.
GM2 MED.D.030 Validity of AME certificates
ED Decision 2019/002/R
(a) The competent authority should promote better performance of AMEs by supporting the establishment of AME peer support groups that could provide both professional support and educational enhancement.
(b) Attendance to AME peer support group meetings may be credited by the competent authority as refresher training. The competent authority should determine a maximum of hours that can be credited as refresher training during the period of authorisation.
(c) AME peer support groups may be established as part of, or complementary to, national associations of aerospace medicine.