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Medical Manual
Part 3: Clinical aviation medicine and clinical guidelines
Central nervous system

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Licensing and certification

Pilots

Flight training

Flight Instructor Guide

Instructional theory introduction Learning theory Human behaviour Effective communication The teaching process Teaching methods Evaluation Instructional aids Role modelling References for instructional theory Briefings introduction Taxiing Effects of controls Straight and level Climbing and descending Medium, climbing and descending turns Slow flight Basic stalling Circuit introduction Circuit considerations Engine failure after take-off Flapless landings Crosswind circuit Glide approach Vacating and joining at aerodromes Radio failure Forced landing without power – pattern Forced landing without power – considerations Steep turns Advanced stalling Maximum rate turns Wing-drop stalling Short field take-off and landing Low flying introduction Low flying consolidation Precautionary landing Terrain and weather awareness Basic mountain flying Compass use Instrument flying introduction Limited panel Unusual attitudes Night flying 1 Dead-reckoning navigation 2 Landing away 3 Weather avoidance and diversion 4 Inadvertent IMC and lost procedure Supervision of solo cross-country Appendix I Ground course Appendix 2 Sign-out checklist Flight Instructor Guide downloads

Pilot syllabus assistance Flight test standards guides Type ratings Approved instructional techniques courses Approved examiner theory course Fixed-wing flight training safety strategy

Standard overhead join

Helicopter flight instructor manual How to be a chief flying instructor

Pilot licensing

Licence application PPL privileges by DL9 medical certificate Using privileges of a New Zealand pilot licence on a validation from a foreign NAA Recognising foreign pilot licences Trans-Tasman Mutual Recognition Act (TTMRA) NVIS rating

Pilot logbook

Engineering

Inspection Authorisation (IA) certificate Maintenance engineer licensing

Part 66 AME licence syllabuses Recognising foreign AME licences Trans-Tasman Mutual Recognition Act (TTMRA)

Type ratings

Medical certification

For medical examiners

Medical Manual

Part 1: Introduction Part 2: The medical certification system

Legislation Application for a medical certificate Examination by the Medical Examiner Use of General Directions Assessment by Medical Examiner Applicant meets the medical standards Applicant does not meet the medical standards Accredited Medical Conclusion Extension of medical certificate Issue of medical certificate Communication Review of assessment by CAA Change in medical condition Review of Director’s decision by the Convener Replacement certificate Medical Examiner absence

Part 3: Clinical aviation medicine and clinical guidelines

Cardiovascular system

General considerations 12-lead ECG interpretation Atrial and ventricular premature beats Atrial fibrillation (AF) and atrial flutter Aortic aneurysm Aortic valve disease Atrio-ventricular block Brugada syndrome Cardiomyopathy Cardiovascular risk assessment Congenital heart disease Coronary heart disease Hypertension Implantable devices - Pacemaker Left anterior and left posterior hemi-block Left Bundle Branch Block Marfan’s syndrome Mitral valve disease Oral anticoagulants Pericarditis Peripheral vascular disease QT prolongation Right Bundle Branch Block Sinus node arrest and sinoatrial block Tricuspid and pulmonary valve disease Valve replacement or repair Ventricular pre-excitation

Central nervous system

Cerebrovascular diseases / accidents Demyelinating disease Loss of consciousness (non-traumatic) Meningitis / encephalitis Migraines and headaches Neurocognitive impairment Parkinson’s disease Seizure disorders Transient global amnesia Traumatic brain injuries

Haematology

Haemochromatosis HIV - Post-Exposure Prophylaxis (PEP) HIV - Pre-Exposure Prophylaxis (PrEP)

Medication

HIV - Post-Exposure Prophylaxis (PEP) HIV - Pre-Exposure Prophylaxis (PrEP) Oral anticoagulants Weight loss - GLP-1 medication

Mental health

ADHD Alcohol and other drugs Mental health problems

Metabolism, nutritional and endocrine system

Adrenal Gland Disorder – Addison Disease Diabetes type I Diabetes type II Pituitary gland disorders Thyroid Gland Disorders Weight loss - GLP-1 medication

Ophthalmology

Introduction Anisometropia Astigmatism Cataract Colour vision Demyelinating disease & optic neuritis Diabetes Duane syndrome Eye muscle balance (phoria) Functional and true monocularity Glaucoma and ocular hypertension Hypermetropia Implantable collamer lenses Keratoconus Macular disease Myopia Presbyopia Refractive eye surgery Retinal detachment Secondary glaucoma Severe myopia Strabismus (tropia) Substandard vision in one eye Uveitis Visual aids Other conditions

Otorhinolaryngology (ENT)

Introduction Allergic rhinitis External ear disease Hearing impairment Impaired speech Inner ear disease and vestibulo-cochlear nerve Malignancies Nasal and sinus disease Nasal polyps Recurrent tonsillitis, tonsillectomy Sinusitis Tympanic membrane and middle ear disease

Respiratory system

Asthma Chronic Obstructive Pulmonary Disease Non-Spontaneous Pneumothorax Obstructive Sleep Apnoea Sarcoidosis Spontaneous Pneumothorax Traumatic Pneumothorax Tuberculosis

Part 4: General Directions Part 5: Annexes

General Directions

Timetable for routine examinations Examination procedures Temporary medical conditions Colour vision deficiency

How to become a medical examiner How to maintain your medical examiner designation Medical examiner resources

CME Medical information sheets Forms

For pilots and air traffic controllers

Obtaining your first medical certificate Renewing your medical certificate How to replace a medical certificate Private pilots who are flying on a DL9P driver licence medical certificate Accredited medical conclusion How to review a medical decision How to report a change in medical condition If I have concerns about a pilot or air traffic controller Regulatory information sheets Clinical guidelines for pilots and air traffic controllers

After a heart attack, or coronary artery stents Alcohol consumption and medical aviation safety Asthma ADHD Cardiovascular risk assessment Cataract Colour vision Depression Diabetes Glaucoma and ocular hypertension Haemochromatosis HIV - Post-Exposure Prophylaxis (PEP) HIV - Pre-Exposure Prophylaxis (PrEP) Hypertension Keratoconus Kidney stones Laser and refractive eye surgery Medical incapacitation Oral anticoagulants Obstructive sleep apnoea Parkinson’s disease Pregnancy Pregnant professional pilots report Recreational drugs Strokes and Transient Ischaemic Attacks Transient global amnesia (TGA) Weight loss

Forms NZ medical examiners Overseas medical examiners

Operators

Activity statistics Adventure aviation

List of Part 115 certificated organisations How to apply for an adventure aviation operator certificate

Agricultural operations

Agricultural operations safety checklist How to apply for, renew, or amend an agricultural aircraft operator certificate

Issue Renew Amend

List of Part 137 agricultural aircraft operators

Air cargo

How to become a certificated regulated air cargo agent RACA security check application List of Part 109 regulated air cargo agents

Air operations

Airlines (Part 121 and 125)

Cabin safety for airlines

Foreign air operators

Guidance for foreign operators

Air operations with helicopters and small aeroplanes How to apply for, renew, or amend an air operator certificate

List of certificated organisations

Emerging Technologies Programme

Latest news Emerging Aviation Technologies Forum Reduced and Zero Emissions Project Contact us

Research and development organisation certification Aviation security

Security rules

Air traffic services

ATS syllabus assistance List of Part 172 air traffic service organisations

Sport and recreation

List of Part 149 Certificated Organisations Amateur-built aircraft Vector magazine and Part 149 pilot/parachutist certificate holders

Fit and proper person process How to be a senior person Drug and alcohol management Address for service Airshows

Central nervous system

Last updated: February 2026

ICAO Annex 1	Chapter 6
CAR Part 67	67.103 b & c, 67.105 b & c, 67.107 b & c
General Directions	Nil
ICAO Medical Manual	Chapter 10

In this section:

* Developed in collaboration with CASA Medical.

Cerebrovascular diseases / accidents

Demyelinating disease

Loss of consciousness (non-traumatic)

Meningitis / encephalitis

Migraines and headaches

Neurocognitive impairment

Parkinson’s disease *

Seizure disorders

Transient global amnesia *

Traumatic brain injuries