Pilot in person medicals have been required for decades, at least annually, if not semi-annually for those older or health compromised. This was always done for pilot, passenger and operational safety. Much of that is outlined in Transport Canada's Civil Aviation Medical Examiner (CAME) Handbook, the intro stating to CAMEs bluntly: "It is your responsibility to interview and perform a complete examination on all applicants for aviation medical certification."
With COVID unleashed, medical attestations were permitted in 2020 (NCR 062-2020) with telemedical exemptions following, allowing a pilot to go as long as 36 months without an in-person medical (or ECG).
This continued long after society re-opened right into 2023. Through much of that, pilots could, however, hop on a jammed subway, or head to a hockey game with thousands, for hours. Meanwhile, Transport Canada (TC) continued the charade of allowing 36 months without an ECG because of 'COVID' and 'social distancing'. This was senseless, a decoupling from common sense, and more importantly, safety.
CAME-001-2021, CAME-002-2021, CAME-001-2022, CAME-002-2022 were then followed, bizarrely, March 1st 2023 with CAME-001-2023 which now allows Canadian airlines pilots to do telemedicals as an option, into 2025. In doing so TC changed the justification from social distancing to "flexibility".
Almost concurrently, March 14th, 2023, the Transportation Safety Board (TSB) released an accident report on an ATPL (Airline Transport Pilot Licence) pilot pointing to lack of proper medical screening. The pilot (who perished in the private aircraft) had 'attested' to his health months prior, because TC allowed it. The TSB recommended TC provide "review and improvement to the Civil Aviation Medical Examiners’ guidelines".
Flexibility and convenience must never trump safety in aviation. We are upending the most basic tenets of Safety Management Systems (SMS), risking serious in-flight medical incidents for our crews and passengers. We are the only nation I know of, globally, allowing this, in an era post COVID vaccine mandate when I've heard from scores of pilots suffering adverse effects from the same. By allowing telemedicals, we are accepting unprecedented levels of risk, compromising pilot health and safety, and likely in violation of basic ICAO medical provisions.
How does any of this fit within an SMS environment that Transport Canada and Canadian airlines pretend to ascribe to? Health is not subjective, about how we "feel". Scores of pilots have shown up for a medical "feeling" fine and then had cancer, cardiovascular or other serious issues detected. We are not permitted to subjectively 'attest' to competence for simulator events - both licensing and medical fitness need to be objectively assessed.
I've heard from CAMES and others well-placed that shortages and 'expediency' are at the root of this mess. God forbid we see an incident or accident like TSB's A21W0089 with passengers on board (not all flights are multi-crew). Serious questions of liability and accountability will need to be answered.
I have yet to hear any good answers from the airlines, CAMEs or anyone at Transport Canada.
Canadian airlines and unions are sadly embracing this telemedical approach and have even rejected formally raised concerns from pilots.
When Transport Canada continues to allow or encourage dangerous nonsense (like untested medical procedures), airlines and unions need not partake.
Director, Free to Fly Canada