AME Head

Managing decrease in fitness

Any loss of fitness is a worrying time for pilots and cabin crew because it can quite quickly lead to a suspension of licence privileges. If you are concerned about your medical status, your first point of contact is now your AME –  the CAA will no longer answer medical enquiries from license holders. Our focus will be to work with you, and to co-ordinate with specialists and the CAA in order to keep you flying, or return you to flying status as efficiently as possible.

The legal requirements governing decrease in fitness are summarised below:


Licence holders shall not exercise the privileges of their licence and related ratings or
certificates at any time when they:

  1. are aware of any decrease in their medical fitness that might render them unable to safely
    exercise those privileges;
  2. take or use prescribed or non-prescribed medication that is likely to interfere with the safe
    exercise of the privileges of the applicable licence; or
  3. receive any medical, surgical or other treatment that is likely to interfere with flight safety

In addition, licence holders shall, without undue delay, seek aeromedical advice when they:

  1. have undergone a surgical operation or invasive procedure;
  2. have commenced the regular use of any medication;
  3. have suffered any significant personal injury involving incapacity to function as a member of the flight crew;
  4. have been suffering from any significant illness involving incapacity to function as a member of the flight crew;
  5. are pregnant;
  6. have been admitted to hospital or medical clinic;
  7. first require correcting lenses.

Licence holders shall seek the advice of their AME (LAPL holder may also seek advice of the GP who signed their medical certificate). They will assess the medical fitness of the licence holder and decide whether they are fit to resume the exercise of their privileges.

Cabin crew members shall not perform duties on an aircraft and, where applicable, shall not exercise the privileges of their cabin crew attestation when they are aware of any decrease in their medical fitness, to the extent that this condition might render them unable to discharge their safety duties and responsibilities.

In addition, cabin crew members shall, without undue delay, seek aero-medical advice when they:

  1. have undergone a surgical operation or invasive procedure;
  2. have commenced the regular use of any medication;
  3. have suffered any significant personal injury involving incapacity to function as a member of the cabin crew;
  4. have been suffering from any significant illness involving incapacity to function as a member of the cabin crew;
  5. are pregnant;
  6. have been admitted to hospital or medical clinic;
  7. first require correcting lenses.

Cabin crew members shall, without undue delay, seek the advice of an Aeromedical Examiner (AME), Aeromedical Centre (AeMC), or Occupational Health Medical Practitioner (OHMP) as applicable. The AME, AeMC or OHMP shall assess the medical fitness of the cabin crew members and decide whether they are fit to resume their safety duties.

Following the CAA’s decision to devolve management of pilots’ fit/unfit status to AMEs, the CAA will no longer discuss fitness status directly with pilots, and requires them to contact the AME who carried out their most recent medical. This has resulted in a considerable increase in workload in managing fitness issues and issuing fit/unfit letters.

However, we continue to offer routine fit/unfit casework free of charge where it requires less than 30 minutes administration time/instance.

For more complex cases, we charge a fee of £90/hr to cover the cost of the associated casework, subject to a £45 minimum charge.

All charges from third parties, including from specialists providing reports/opinions, remain the responsibility of the applicant.