Category 2 Aviation Medical Exam: What to Expect in Canada

The Transport Canada Category 2 assessment is a medical examination, not a written test. Only a physician designated by Transport Canada as a Civil Aviation Medical Examiner (CAME) can perform it; the CAME reports to Transport Canada, and Transport Canada issues the certificate. Prepare by booking with an approved CAME, bringing identification and a complete medical and medication history, and learning the renewal rules — telemedicine renewals, where eligible, cap validity at 12 months. If you are assessed unfit, reconsideration and appeal routes exist through Civil Aviation Medicine and, ultimately, the Civil Aviation Tribunal.

What the Category 2 medical examination actually is

It is a medical examination performed by a Civil Aviation Medical Examiner and assessed against CAR Standard 424 — there is no written knowledge test behind this credential.

To hold a Category 2 medical certificate you undergo a medical examination, and only a physician designated by Transport Canada as a Civil Aviation Medical Examiner (CAME) may perform it, unless you are outside Canada. Pilots, air traffic controllers, and flight engineers living abroad can be examined by a Transport Canada-accredited CAME, or by Canadian Armed Forces flight surgeons for eligible personnel.

A medical category describes the degree of medical fitness needed for a given aviation activity, and a medical certificate validates the licences that require those standards. The certificate is issued by the Minister of Transport once a CAME's report is assessed as fit, or fit with restrictions. The standards for initial issuance and renewal are basically the same.

Note the contrast with Category 4, which allows a self-completed medical declaration in defined cases. A Category 2 certificate is not on that route: you book a full examination with a CAME.

Which licence types map to Category 2, and the exact numeric standards for vision, hearing, and other systems, are set out in the regulation itself. Confirm those values directly in Standard 424 rather than relying on secondhand summaries, including this one.

Sources checked: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V, including 424.04–424.17, and Appendices I–III; How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements

Booking the exam and what to bring

Book with a CAME from Transport Canada's approved list; the examiner sets the exam fee, and you bring photo ID plus a complete medication and medical history.

Contact a CAME from Transport Canada's approved examiner list to make an appointment. The CAME charges a fee for the medical exam and will tell you the cost; Transport Canada does not set these fees.

Transport Canada may also invoice a processing fee, which you pay through the online invoice payment form using your customer number, invoice number, and payment amount. That fee is separate from the examiner's charge.

• Photo identification
• List of medications with dosage and frequency
• Copy of your lens prescription
• Name and phone number of your family doctor
• Current pilot permit or licence number, if you have one
• For pilots, your total flight time over the last 12 months
• Past medical history, including past tests, diagnoses, treatments, and dates of any earlier examination reports, audiograms, or electrocardiograms submitted for licensing
• Information about your family medical history

Sources checked: How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements

During and after the examination

You sign a declaration, answer the CAME's questions, and authorize disclosure; the CAME examines you, files a report, and Transport Canada then issues the certificate or requests more tests.

At the examination, every applicant must sign a declaration stating whether they have previously undergone a licensing medical exam and, if so, provide the results of the most recent one. You must also answer all of the CAME's questions relevant to your fitness, give written authorization to disclose medical information to a physician you name, and undergo any other tests the CAME requires.

The CAME examines you according to accepted medical practice and the licensing standards, records the findings on the Civil Aviation Medical Examination Report (Form 26-0010), and submits it to Transport Canada with any specialist or laboratory reports. A CAME is expected to be familiar with aeromedical assessment and to have practical knowledge of flight duties and the flight environment. If the CAME cannot reach a conclusion, no category is allocated and the report goes to Transport Canada's medical staff.

Transport Canada reviews the report. If more tests are needed, you will be contacted with the required next steps, and unfinished tests block certification. If you are assessed fit, your medical certificate arrives as a label for your aviation document booklet — aviation students receive a standalone certificate instead. Any restrictions, such as a requirement to wear glasses, are printed on the certificate. If Transport Canada cannot certify you as fit, you can request a description of the assessment and the appeal options available to you.

Sources checked: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V, including 424.04–424.17, and Appendices I–III; How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements

Renewal routes, telemedicine, and validity periods

Validity depends on your age and licence type; you renew either in person with a CAME or, if eligible since the March 2025 rule, by telemedicine with a maximum 12-month validity.

How often you renew depends on your age and the licence or permit you hold: medical exams are required as often as every 6 months for professional pilots 40 and over, or as seldom as every 5 years for private or balloon pilots under 40. The full list of validity periods sits in Standard 424.

Renewals happen either in person or by telemedicine — an assessment by telephone, audio, or video conferencing. As of March 4, 2025, you are eligible for telemedicine only if your previous examination was in person, subject to published exemptions. You must renew in person if you are a new applicant, your certificate's validity ended before March 17, 2020, your last examination was a telemedicine appointment, or your CAME or Transport Canada asks for an in-person exam.

Telemedicine renewals never carry the standard validity periods: all certificates renewed this way are valid for at most 12 months, or 6 months if you are 60 or older, or 40 or older and conducting a single-pilot operation with passengers on board. Routine testing such as ECGs, urine tests, audiograms, and vision checks may be waived when clinically appropriate, but any special medical report previously required as a renewal condition still has to be reviewed and submitted by your CAME.

Sources checked: How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements

Extensions, temporary certificates, and replacements

You can extend a certificate by up to 60 days past expiry under strict conditions, and Transport Canada issues temporary certificates and replacements through the same payment-and-email route using Form 26-0738.

An extension moves your expiry date by up to 60 days, but only if you request it at least 10 days before expiry and prove that completing a medical exam within the 90 days before expiry was not possible. You pay online, then email your closest Transport Canada Centre with the reason and your payment reference. Transport Canada emails a PDF temporary certificate that you print, sign, and carry with your aviation document booklet.

For a temporary medical certificate or a replacement for a lost or destroyed one, the route is the same: pay through the online payment system, complete the Application for Re-Issue of a Civil Aviation Licensing Document (Form 26-0738), and email it to a Transport Canada Centre with the payment reference. None of these PDF documents comes with a label for your aviation document booklet.

Processing does not start until payment is received, so build that into any timeline where your certificate is close to expiry.

Sources checked: How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements

If you are assessed unfit: reconsideration and appeal

Regional and headquarters medical staff can overrule a CAME's assessment, and an unfit decision can be reconsidered with new reports, reviewed by the Aviation Medical Review Board, or appealed to the Civil Aviation Tribunal.

Medical examination reports are assessed both by the CAME and by the Regional Aviation Medical Officer or Aviation Medical Officer. Where those assessments differ, the regional or headquarters assessment applies, and specialist reports may be referred to the Chief, Clinical Assessment for consultation.

If you are assessed unfit at the regional level, you can submit additional reports from CAMEs, specialists, and laboratories for reconsideration. You can also ask the Regional Aviation Medical Officer or Aviation Medical Officer to forward all reports to the Chief, Clinical Assessment for presentation to the Aviation Medical Review Board. Appeal to the Civil Aviation Tribunal is available where a holder is assessed unfit to exercise licence privileges or where renewal of a medical certificate is refused.

In practice, Transport Canada notifies you of the outcome, and an unfit decision triggers an email describing how to obtain the assessment details and how to appeal; for licence holders, a follow-up email explains the impact on the licence.

Sources checked: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V, including 424.04–424.17, and Appendices I–III; How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements

When you do not meet a standard: flexibility

Standard 424 allows flexibility in special circumstances when an accredited medical conclusion shows air safety is not likely to be affected, but the sourced pathways are category-limited, so treat them as case-specific.

Flexibility lets Transport Canada issue or validate a certificate for applicants who technically fail a standard — the regulation names circumstances such as monocular or paraplegic applicants. It requires an accredited medical conclusion that the failure is not likely to affect air safety, endorsement of the licence with any needed limitations, and the applicant's compliance with required conditions. In some cases a practical flight test is part of the evaluation, requested by a medical officer and approved by the Regional Director, Aviation Licensing.

The published pathways do not automatically extend to every category. The monocular route applies to permits and licences for which a Category 3 or lower medical is required, and the paraplegic route covers student, private, and recreational aeroplane credentials but expressly excludes Commercial and Airline Transport Pilot Licences. If you are pursuing a Category 2 certificate with a disqualifying condition, discuss your specific case with a CAME and Civil Aviation Medicine rather than assuming a published pilot pathway covers you.

Sources checked: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V, including 424.04–424.17, and Appendices I–III

How to prepare, honestly

You cannot study your way to a fitness finding — the outcome follows your medical facts — so useful preparation is administrative: complete documentation, accurate history, and full disclosure.

Fitness is determined by the examination, not by preparation, and paper readiness cannot substitute for the assessment itself. What you control is whether the examination can be completed in one pass. Gather the full document list, know the dates of your prior tests and reports, and be ready to disclose your previous licensing examinations, since the signed declaration requires it.

Transport Canada's handbook for medical examiners concentrates its detailed certification guidance in a small set of areas that commonly need scrutiny: neurology, cardiovascular conditions, diabetes, asthma, and psychiatry including SSRIs. If one of those applies to you, bring current documentation — control status, recent test results, specialist letters — so the CAME can assess your file without extra rounds of requests.

Finally, remember the decision chain: the CAME examines and reports, Transport Canada assesses and issues, and incomplete tests stall the certificate regardless of your health. Time-sensitive renewals should be booked well before expiry, with the extension rules and telemedicine eligibility checked before you commit to an appointment type.

• Book with a CAME from the approved list and confirm the exam fee in advance
• Assemble photo ID, medication list, lens prescription, doctor's contact details, licence number, and history notes
• Renewal applicants: check telemedicine eligibility before booking — otherwise plan an in-person exam
• If your certificate is near expiry, know the extension conditions: request at least 10 days before expiry and be ready to show why an exam was impossible
• If you were previously assessed unfit, collect any new specialist or laboratory reports before requesting reconsideration

Sources checked: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V, including 424.04–424.17, and Appendices I–III; How to apply – Medical fitness for aviation, Transport Canada — Initial applications, renewals, telemedicine, extensions, temporary certificates, and replacements; Handbook for Civil Aviation Medical Examiners – TP 13312 — Foreword and guideline sections (neurology, cardiovascular, diabetes, asthma, psychiatry)

Sources checked

Facts checked: Sep 18, 2026

• Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs)
• How to apply – Medical fitness for aviation, Transport Canada
• Handbook for Civil Aviation Medical Examiners – TP 13312

Next steps

• Practice material for this guide
• All study guides