Aviation Medicine Center

Aviation medicine is a specialized branch of medicine that examines the effects of aerospace environments on human physiology and deals with the protection and assessment of the health of pilots and flight crews. A comprehensive assessment of the physical and mental health of personnel serving in civil and military aviation constitutes one of the cornerstones of flight safety. Koru Hospital Aviation Medical Center, as a center authorized by the Directorate General of Civil Aviation (SHGM), provides comprehensive health examination and certification services to pilot and flight crew candidates.

What is Aviation Medicine?

Aviation medicine (aeromedicine) is a discipline that investigates the effects of aviation-specific environmental factors—such as altitude physiology, stress factors encountered during flight, cabin pressure changes, acceleration forces, noise, vibration, radiation, and circadian rhythm disorders—on human health and develops preventive measures against these effects.

The primary goal of this field is to maintain the physical and psychological health of aviation personnel at an optimum level to ensure the safety of flight operations. Pilots, cabin crew, air traffic controllers, and other aviation personnel undergo periodic comprehensive health assessments to meet the high performance standards required by their duties.

Pilot and Flight Crew Health Examinations

Health examinations performed by the aviation medical center are conducted in accordance with the standards set by international civil aviation organizations (ICAO) and the European Union Aviation Safety Agency (EASA). These examinations are carried out in different scopes depending on the class of the medical certificate.

Class 1 Medical Certificate (Commercial Pilots)

The Class 1 medical certificate is the most comprehensive health assessment required for commercial aviation pilots and airline transport pilots (ATPL). This examination is conducted to medically verify that the pilot can perform flight duties safely. During the initial application and periodic renewal examinations, a detailed physical examination, laboratory tests, cardiological assessment, eye examination, ear-nose-throat examination, neurological assessment, and psychological assessment are performed.

Class 2 Medical Certificate (Private Pilots)

The Class 2 medical certificate is the health assessment required for private pilot license (PPL) holders. Although relatively less comprehensive than Class 1, it includes screening for all health conditions that could affect flight safety. The cardiovascular system, respiratory system, digestive system, metabolic diseases, musculoskeletal system, neurological and psychiatric status, and sensory functions (vision and hearing) are evaluated comprehensively.

Class 3 Medical Certificate (Cabin Crew)

The Class 3 medical certificate is issued for cabin crew and certifies that this personnel is in a state of health capable of performing safety functions during duty. The scope of this examination includes the assessment of the physical and mental competence required for the cabin crew to implement emergency evacuation procedures, perform first aid interventions, and serve on long-haul flights.

LAPL Medical Certificate

Issued for Light Aircraft Pilot License (LAPL) holders, this certificate covers a simpler assessment process and can be provided by general practitioners or aviation medicine specialists. It aims to confirm the suitability of basic physical and mental health for flight.

Examinations Performed at the Aviation Medical Center

Cardiological Assessment

Cardiovascular health is one of the most critical parameters for flight safety. Electrocardiography (ECG) is performed routinely in all examinations, and stress tests (exercise ECG) and echocardiography are performed for Class 1 certificate applications and at certain age thresholds. Cardiovascular conditions such as coronary artery disease, heart valve diseases, rhythm disorders, and hypertension are evaluated in detail.

Screening and managing cardiovascular risk factors (hypertension, dyslipidemia, diabetes, obesity, smoking) constitute an important part of the preventive medicine dimension of aviation medicine. When necessary, advanced examinations such as 24-hour Holter monitoring, ambulatory blood pressure measurement, and cardiac magnetic resonance imaging can also be applied.

Ophthalmological Assessment

Visual functions are one of the most fundamental determinants of flight safety. In the aviation health examination, distance and near visual acuity, color vision, depth perception, visual field, intraocular pressure, and fundus (eye ground) examination are evaluated comprehensively.

Vision standards for commercial pilots are kept quite high, and refractive errors (myopia, hyperopia, astigmatism) are accepted within certain limits. The status of pilots who have undergone refractive surgery (LASIK, PRK) is evaluated with special protocols. Color blindness, glaucoma, cataracts, and retinal diseases are also among the important conditions that may affect flight fitness.

Audiological Assessment

Hearing functions are of critical importance for communication within the cockpit and with air traffic control. Hearing thresholds at different frequencies are determined via audiometry tests and compared with aviation standards. Noise-induced hearing loss is considered an occupational risk for pilots and cabin crew, and preventive measures are recommended.

Neurological and Psychiatric Assessment

Neurological health status is of vital importance for flight safety. Neurological conditions such as epilepsy, migraine, cerebrovascular diseases, multiple sclerosis, and peripheral neuropathy can directly affect flight fitness. In the psychiatric assessment, conditions such as depression, anxiety disorders, substance use disorders, attention deficit, and personality disorders are meticulously screened.

Protecting and supporting the mental health of aviation personnel is a topic that has come to the fore, especially in recent years. Managing occupational stress factors such as flight stress, jet lag, long-term separations, and high performance expectations constitutes one of the important areas of study in aviation medicine.

Laboratory Tests

Within the scope of the aviation health examination, complete blood count, fasting blood glucose, HbA1c, lipid profile, liver and kidney function tests, thyroid function tests, and urinalysis are performed routinely. Metabolic conditions such as diabetes, dyslipidemia, liver diseases, and kidney function disorders are evaluated in terms of flight fitness.

Aviation Physiology and Flight Safety

As altitude increases, the drop in atmospheric pressure causes a decrease in the partial pressure of oxygen and an increase in the risk of hypoxia. Adjusting cabin pressure in commercial aircraft to altitudes higher than sea level is mandatory for the protection of passenger and crew health. In unpressurized cabins, oxygen support must be used above certain altitudes.

Decompression sickness, barotrauma, spatial disorientation, the effects of G-forces, flight fatigue, and circadian rhythm disorders are the main physiological problems addressed by aviation medicine. Training aviation personnel and increasing their awareness on these issues play an important role in ensuring flight safety.

Medication Use and Flight Fitness

Medications used by aviation personnel are a subject that must be carefully evaluated in terms of flight safety. Many medications are not suitable for use during flight duties due to their side effects. Many drug groups, especially sedative drugs, antihistamines, some antihypertensive drugs, psychotropic drugs, and painkillers, can affect flight fitness.

The aviation medicine specialist determines appropriate treatment options by evaluating the medications that the pilot or flight crew needs to use from the perspective of flight safety. Decisions such as medication changes, dosage adjustments, or temporary grounding are evaluated on an individual basis.

Medical Certificate Renewal and Follow-up

The validity periods of aviation medical certificates vary according to the certificate class and the pilot's age. While a Class 1 certificate is generally renewed annually, or every six months for those over forty, a Class 2 certificate is renewed every two years, or annually for those over fifty. Regular periodic examinations are critical for the early detection of changes in health status and the maintenance of flight safety.

Personnel whose certificate is suspended or restricted due to an existing health problem are re-evaluated after the completion of the treatment process. In some cases, a certificate with special conditions (OML - Operational Multicrew Limitation or OSL - Operational Safety Pilot Limitation) may be issued.

Who Can Apply to the Aviation Medical Center?

• Commercial pilot candidates: Class 1 medical certificate for Airline Transport Pilot (ATPL) or Commercial Pilot License (CPL)
• Private pilot candidates: Class 2 medical certificate for Private Pilot License (PPL)
• Cabin crew candidates: Class 3 medical certificate for cabin crew duty
• Light aircraft pilots: LAPL medical certificate
• Air traffic controllers: ATC medical certificate
• Certificate renewal: All aviation personnel whose current medical certificate has expired
• Special assessment: Personnel requiring additional evaluation due to a health problem
• Flight students: Candidates who want to confirm their health fitness before starting pilot training

Examination Process and Appointment

The examination process at Koru Hospital Aviation Medical Center begins with making an appointment. During the application, an identity document, current medical certificate (for renewal applications), flight logbook, and previous health reports, if any, are requested. On the day of the examination, all tests and specialist evaluations are carried out in a coordinated manner, aiming to complete the process in the shortest possible time.

Examination results are transmitted to the Directorate General of Civil Aviation electronically, and the medical certificate issuance process is initiated. In cases requiring additional tests or specialist consultation, the process is accelerated by coordinating with the relevant departments within the hospital.

In the Koru Hospital Aviation Medical Center department, our specialist physicians provide comprehensive health assessment and certification services to pilot and flight crew candidates in accordance with international aviation medicine standards. You can apply to our center for aviation medical certificate applications or renewal procedures.