A system at the limit: the situation in Germany
Medicals are probably the most sensitive topic among German private pilots at the moment. Even those whose own medical certificates are not currently affected are experiencing in their immediate environment how colleagues are losing their medicals or waiting months for decisions. What is particularly problematic here is not so much the medical assessment itself, but rather the administrative processing by the aviation medical department of the Federal Aviation Office.
In practice, those affected report extremely long processing times even for simple procedures, such as extensions or clearly defined medical issues. The impression of two-tier treatment has been reinforced: Applications from commercial pilots are prioritised, while private pilots regularly have to wait significantly longer. What might be understandable for a short transitional period has become established over the years and is increasingly perceived as a structural problem.
What's more, these failures are not a recent phenomenon. Opportunities to modernise processes, increase staff or clarify responsibilities have been missed over the years, both at the level of the authority management and in political supervision. The result is a system that no longer meets the needs of general aviation.
The USA: personal responsibility as a guiding principle
While there are complaints of a standstill in Germany, a remarkable development has taken place in the USA in recent years. An alternative system was introduced there back in 2017 with the so-called BasicMed programme. Since then, private pilots no longer have to visit an aviation doctor, but can be examined by a normal family doctor. This confirms basic fitness to fly on the basis of a clearly defined health check.
The system is strongly based on personal responsibility. Pilots are obliged to critically assess any relevant health changes themselves and to refrain from flying if necessary. The experience of recent years shows that this trust is evidently justified. There is no evidence of a significant increase in safety-related incidents due to medically induced absences.
With the MOSAIC project, the US aviation authority has gone one step further. In addition to greatly simplified certification standards for light aircraft, the medical requirements for sports pilots have also been further reduced. In many cases, a valid driving licence is now sufficient, without an additional medical examination. Restrictions only exist for more demanding types of operation such as night or instrument flying. Here, too, the basic idea remains clear: if you are deemed to be medically fit to fly on the road, you are generally also trusted with this responsibility in the air.
Great Britain: Utilising national leeway
The UK has also begun to move away from rigid international standards. National licences such as the National Private Pilot Licence are subject to medical requirements that are closely aligned with the standards for car drivers. This follows a similar approach to the USA, albeit within a narrower national framework.
These regulations show that safety is not necessarily synonymous with maximum regulation. Rather, the aim is to design medical requirements in a risk-based and practical manner without creating unnecessary hurdles for recreational and club pilots.
Germany: Personal responsibility already exists
It is worth noting that the principle of personal responsibility has long been a reality in Germany - but only in a very limited segment. Under certain conditions, pilots of extremely light aircraft are allowed to fly without a medical. The legal basis expressly obliges them to pay attention to health restrictions themselves and, in case of doubt, to waive their rights.
It is striking that no increased frequency of accidents due to health-related causes is known from this area. This suggests that pilots are very capable of realistically assessing their own fitness to fly if they are given this leap of faith.
Europe: Cautious opening, hesitant implementation
There is also movement at European level, albeit at a much slower pace. The medical requirements for the Light Aircraft Pilot Licence were already reduced in 2019. At the same time, the member states were given the option of having medical examinations for this licence carried out by general practitioners. The only requirement is access to the applicant's complete medical records.
Despite this clear legal basis, no European state has yet fully utilised this scope. The technical requirements, such as electronic patient records, have long been in place in many places. The reluctance seems increasingly difficult to understand, especially in comparison to the pragmatic solutions outside Europe.
The role of the ICAO: International limits to reform
The international level remains a major stumbling block for far-reaching reforms. The International Civil Aviation Organisation continues to adhere to strict medical standards. Attempts to establish alternative models such as BasicMed or MOSAIC internationally have so far failed. Many countries are clearly not interested in deviating from the existing regulations.
This means that the classic ICAO-compliant medical will remain indispensable for private pilots who wish to fly worldwide without restrictions for the foreseeable future. Surveys show that a significant proportion of pilots would like to retain precisely this international room for manoeuvre - despite the associated hurdles.
Where the journey could take us
The future is likely to be two-pronged. On the one hand, there is a growing need for reformed, practice-orientated medicals that focus on personal responsibility and take national and regional characteristics into account. On the other hand, the classic ICAO medical will have to continue to exist, but ideally without the additional bureaucratic burdens that are perceived as excessive, particularly in Germany.
The decisive factor will be whether politicians and administrators are prepared to follow international experience and make consistent use of existing room for manoeuvre. The examples from the USA, Great Britain and even from individual areas of German air sports show this: More trust in the responsibility of pilots does not have to be a safety risk - but can be a decisive contribution to maintaining a vibrant general aviation.
Source references:
Flieger.News
