AAMedP-1.23 minimum requirements for flight surgeon training

What it is

AAMedP-1.23 is the NATO Allied Aeromedical Publication that sets the minimum aviation medicine training NATO nations agree their flight surgeons must complete. It exists so that a flight surgeon qualified by one nation is recognisable to another: the document's own aim is "to standardise the minimum aviation medicine training for flight surgeons in order to promote safety and efficiency in the operation of military aircraft." It is covered by STANAG 7231, the ratified agreement through which NATO nations commit to using it; AAMedP-1.23 itself is the technical training content that the STANAG gives force to once a nation adopts it. Edition A Version 1 was promulgated in November 2019.

Who it addresses

This is a document written as an agreement between NATO's nations, not as instructions to a commercial role. It never addresses a supplier, manufacturer or contractor at any point. It addresses flight surgeons directly, and the national military medical training establishments, instructors and authorities that prepare and assess them: instructors "are to have in-depth knowledge of the physiological and clinical aspects of aviation medicine," and ongoing training is approved or accredited by "the competent authority" or "the Medical Assessor," roles that sit inside a nation's own military medical service rather than anywhere a supplier operates.

How the agreement binds

Clause 1.2 sets out a three-part commitment nations make. Flight surgeons receive this training as a minimum. They must have completed it before being authorised to conduct aircrew medical examinations. And once qualified, they continue to receive periodic refresher training and engage in continuing professional development. Like other Allied Publications, nations can and do adopt it with reservations rather than word for word: this edition's front matter records specific reservations from the Czech Republic, France and the United States, each against a particular practical-training element, for example where a nation does not currently provide training on a centrifuge or in a ground-based disorientation trainer.

What the basic course has to cover

Chapter 1 sets four general points for the basic course: it must end in an exit examination to confirm sufficient knowledge has been gained; instruction on life-support and escape equipment should combine generic principles with training on the equipment specific to a flight surgeon's own aircraft type; instructors themselves must hold in-depth knowledge of the physiological and clinical aspects of aviation medicine; and, where possible, flight surgeons get practical experience of hypoxia, positive-G forces and disorientation.

Chapter 2 sets the syllabus: a minimum of 60 hours of theoretical and practical instruction across ten subject areas, running from the history and physics of aviation medicine through clinical aviation medicine, accident investigation, human and organisational factors, aviation medicine policy, survival and life-support equipment, aeromedical evacuation and civil aviation medicine, and closing with a set of recommended practical demonstrations. AAMedP-1.23 lists the detailed subjects under each of those headings; this page does not reproduce that syllabus, since it is training content for a medical audience rather than something a supplier needs to see.

Staying current: refresher training

Chapter 3 sets the ongoing commitment once a flight surgeon is qualified: at least 10 hours a year of refresher training or aviation-medicine-specific continuing medical education. That commitment can be met through hours provided by, or conducted under the supervision of, the competent aeromedical centre or the Medical Assessor; through attendance at scientific meetings and flight deck, jump seat, simulator or piloting experience approved by the competent authority; or through specific scientific meetings the competent authority is expected to accredit. The document names no fixed split between formal instruction and these more experiential routes, leaving that judgement to the competent authority.

How you are evaluated

There is no organisational certification anywhere in AAMedP-1.23; it is evaluated at the level of the individual flight surgeon, never a company or a unit. The basic course ends in an exit examination, and refresher hours, meeting attendance and accreditation of scientific meetings are approved by the competent authority or the Medical Assessor each nation names within its own military medical service. Authorisation to conduct aircrew medical examinations follows only once that training is complete. None of this is a scheme an organisation could hold: no accredited body audits a company against AAMedP-1.23, and the document names no certificate at all.

Standards it references

• [STANAG 7231](/standards/stanag-7231) - the NATO agreement recording nations'

commitment to use this publication; the cover that gives AAMedP-1.23 its force. AAMedP-1.23 is the technical training content; STANAG 7231 is the nations' agreement to use it.