Private pilots and their associations have been unanimous for years: the aeromedical system in its current form is outdated. It is still based on basic assumptions that originate from military aviation medicine in the early 20th century and were later adopted by the ICAO. These guidelines make sense for professional pilots in many respects, but are too strict for private pilots and not adapted to the actual, very low medical risk.
Depending on their age, private pilots have to undergo a medical examination every five, two or even every year. Older pilots in particular often experience these appointments with considerable stress, as the consequences can be serious: Months of waiting or even the loss of their medical, even if they feel healthy in everyday life and can drive without any problems.
Outdated principles - and a lack of adaptation to modern knowledge
The current system often ignores modern medical findings on the risk of individual illnesses in flight operations. International studies have shown for years that medical causes of accidents in general aviation are extremely rare. Nevertheless, the European system remains highly formalistic and leaves doctors little room for manoeuvre in their decision-making. This development means that individual medical assessments are losing importance in favour of rigid guidelines.
International developments - Great Britain and the USA are modernising their systems
While Europe remains stagnant, many countries have recognised the signs of the times.
Great Britain: Medical Self-Declaration
The „Pilot Medical Declaration“ exists there for national licences. Pilots can use an online platform to independently declare their fitness to fly without having to visit a flight physician. A medical is still only required for international flights or specific illnesses. The system is considered efficient, safe and greatly reduces bureaucracy.
USA: BasicMed as a model for success
With „BasicMed“, the FAA has created a widely recognised model. It is based on personal responsibility and an examination by a normal family doctor. The medical is valid for aircraft up to 5,700 kg and up to six occupants - including IFR. Over 80,000 pilots are already using the system, without safety having suffered as a result. The USA shows: Less bureaucracy does not mean less safety.
Germany: A system at the limit
While international models are simpler, the procedure in Germany is becoming increasingly complex.
A massive decline in flight medics
A few years ago there were still around 500 aviation physicians in Germany, today there are fewer than 300:
- Increased documentation requirements
- Less freedom to make decisions
- Intensive inspections by the LBA
- High administrative effort
Many doctors give up in frustration, which leads to regional gaps in care - a problem that hardly any other EASA country has.
Structural problems at the LBA
The Federal Aviation Office is at the centre of many complaints. Pilots report about:
- Months of processing time
- incorrect medical assessments
- Unclear decision-making processes
- Overload and lack of expertise
- Strongly fluctuating quality between individual clerks
Several pilots see no other option than to take legal action before the Braunschweig Administrative Court - a process that now seems almost systemic.
Why does the BAF work - but not the LBA?
A look at the Federal Supervisory Authority for Air Traffic Control shows that efficient processes are possible. The BAF is responsible for the medical fitness of air traffic controllers and works:
- fast
- professional
- stable
- service-orientated
In contrast to the LBA, neither overloading nor systemic errors are known there. This raises the legitimate question as to why a similar organisational model is not adopted for private aviation.
Migration abroad - a symptom of system failure
The problems in the German system have consequences: Every month, around 50 German private pilots have their licences transferred abroad. Austro Control in Austria, which is regarded as efficient and service-orientated, is particularly popular. Associations now openly speak of a considerable disadvantage for the location.
Movement at European level
EASA is now taking the issue seriously. While the ICAO is not currently aiming for a timely reform, the EASA is actively collecting proposals from the industry. Discussions include
- A stronger role for personal responsibility
- Simplified medical procedures
- Modernised risk assessment specifically for private pilots
- Digitalised processes
- Orientation towards international models
Concrete steps have yet to be taken, but the will to reform is growing.
Conclusion
The aeromedical system for private pilots in Germany is in a deep crisis. Outdated regulations, overburdened authorities and a lack of room for manoeuvre for doctors are leading to unnecessary stress and growing frustration. International examples show what a modern, risk-appropriate and more efficient system could look like. Europe - and Germany in particular - now have a responsibility to finally implement this modernisation push.
Source references:
AOPA
