Bill Wagstaff

As all lawyers know, the letter and the spirit of regulations are two very different things. FAR Part 67 outlines the medical requirements for first-, second- and third-class medicals. The JAA’s JARs (Joint Aviation Requirements) resemble Part 67 in many ways, with the major difference a tighter focus on the specifics of the airman’s physical. A brief rundown of the differences shows the increased room for grassroots interpretation offered to American AMEs. 
For instance, the JAR first-class medical certification requirement for vision requires “a comprehensive eye examination, including a measurement of intraocular pressure (which, if elevated, sometimes indicates the presence of glaucoma) during the examination for the first issuance of a medical certificate and again every five years until age 40 and every two years thereafter. Less comprehensive eye examinations are conducted during intervening examinations.
FAA regs are far more terse. FAR 67.103 (e) says there must be “no acute or chronic pathological condition of either eye or adnexa (tumor) that interferes with the proper function of an eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.”
Now, as a matter of course, a measurement of intraocular pressure is routinely a part of any contemporary eye exam. Except that the JAA is the only one to spell it out.
On the matter of cardiovascular health, the JAA is again a little tougher, requiring “a resting electrocardiogram (EKG) during the examination for the first issuance of a first-class medical certificate and again every five years until age 30, two years until age 40, annually until age 50 and every six months thereafter.”
As for the FAA, in FAR 67.111(b), a person applying for first-class medical certification must demonstrate an absence of myocardial infarction and other clinically significant abnormality on electrocardiographic examination at the first application after reaching the 35th birthday; and annually after reaching the 40th birthday
The JARs require a chest X-ray upon initial issuance of a first-class medical; Part 67 does not specifically demand it. The JARs call for a blood test for anemia; Part 67 does not.

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