Last updated: June 2022

About this Manual

This Medical Manual aims, in conjunction with the relevant legislation, to provide information and guidance on administrative processes and policies and requirements relating to medical certification under the Civil Aviation Act 1990.

The Medical Manual Part 3, provides guidelines to Medical Examiners (MEs) in relation to a number of medical conditions that may be of Aeromedical significance. This manual must be used in conjunction with any applicable legislation: Civil Aviation Act, Civil Aviation Rule Part 67 and General Directions.

Where any doubt or contradiction exists, the legislation provisions, inclusive of the General Directions, take precedence. Guidelines should be applied using judgement. Departure from them is acceptable when medical evidence justifies. Such justification should be fully explained in the documentation provided to the Central Medical Unit.

This Part 3 of the document is not intended to be a textbook in Aviation Medicine but is intended to be a living document. MEs wishing to print this manual should check regularly on the Civil Aviation Authority (CAA) website that they are using a current version. Suggestions for improvements are welcome.

The CAA website provides a number of links. Medical Examiners need to be aware however that local legislation and CAA policies and opinions, may be different from those of overseas jurisdictions.

This document is to be used in conjunction with:

  • The Civil Aviation Act 1990;

  • The Civil Aviation Rules Part 67;

  • The General Directions and Emergency Directives issued by the Director of Civil Aviation;

  • Civil Aviation Authority medical certification forms;

  • Medical Information Sheet, posted on the CAA website;

  • Advice from the CAA Aviation Medicine Team given on an ad hoc basis or via emails or regular newsletters.

Who will use this Manual

This Medical Manual is published primarily for Medical Examiners (MEs) to assist them in discharging their civil aviation regulatory responsibilities. In particular it gives guidance in regard to the applicable decision pathways, such as provided for under section 27B(1) and 27B(2) of the Civil Aviation Act.

It may also provide a useful resource to participants who hold or are applying for New Zealand medical certificates.

Structure of this Manual

This Medical Manual is divided into 5 parts:

Part 1: Introduction

Part 2: The medical certification system

Part 3: Clinical aviation medicine

Part 4: General Directions and emergency directives

Part 5: Annexes

In addition each part may contain annexed supporting documents.

Copies of this Medical Manual

This Medical Manual is intended to be accessed via the CAA website. No printed copies are provided by the CAA. Users who refer to printed copies of this Medical Manual must ensure that they are using the most up-to-date version.

Medical Examiners will be advised, by e-mail, when updated versions of this Medical Manual are available on the CAA website.


Terms used in the civil aviation regulatory environment can be found at Section 2 of the Civil Aviation Act 1990, at other parts and sections of the Act (e.g. the start of Part 2A – Medical Certification), in Civil Aviation Rules Part 1 and Part 67.3, and in the General Directions.


Throughout this document:

The Act means the Civil Aviation Act 1990;

The Director means the Director of Civil Aviation;

The Delegate means a Medical Examiner with delegation to act on behalf of the Director, but only in accordance with the terms of the delegated authority;

Medical standards mean the medical standards contained within Civil Aviation Rule Part 67;

Part 67 means Civil Aviation Rule Part 67;

The Rules mean the Civil Aviation Rules.


Throughout this document the abbreviations mean as follows:

AMC: Accredited Medical Conclusion

CAA: Civil Aviation Authority

CAR: Civil Aviation Rule

GD: General Direction

ME: Medical Examiner

ME1: Medical Examiner 1

ME2: Medical Examiner 2

SME: Special Medical Examiner

SMO: CAA Senior Medical Officer

PMO: CAA Principal Medical Officer

Address for correspondence

Aviation Medicine
Civil Aviation Authority
P. O. Box 3555
Wellington 6140

Telephone: +64 (0)4 560 9466

Facsimile: +64 (0)4 560 9470


Aviation medicine links

ICAO Medical Manual – Manual of Civil Aviation Medicine(external link)
CASA Medical Manual – Designated Medical Examiners’ Handbook(external link)

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