What are the Categories of Medical Certification by Transport Canada?

(adapted from https://www.tc.gc.ca/eng/civilaviation/publications/tp185-6470.htm)

There are four levels of medical certification in Canada, appropriately enough known as categories 1 through 4. 

Category 1 Certification
Category 1 is for pilots engaged in commercial air operations; everything from instructing on light aircraft to flying for an airline. Of necessity, the medical standards for this group are quite high as the travelling public is putting their lives in their hands. These pilots will also likely be flying internationally into other countries.

In order to facilitate international commerce and flying, the International Civil Aviation Organization (ICAO) has established training, experience and medical standards that allow pilots to exercise the privileges of their Canadian licence in the other 190 signatory countries of the ICAO Treaty, without having to repeat their licensing exams and medical certification. While each country is free to implement the ICAO Standards and Recommended Practices (SARPs) as it sees fit, significant deviations from the Standards have to be communicated to ICAO and the other nations, and could result in those nations refusing entry of the aircraft. Canada has implemented all of the existing medical standards.

These standards are not unchanging and Canada has led the charge in making them less restrictive and more accommodating. Canada was the first ICAO nation to allow licensure (under special circumstances) of diabetics treated with insulin. Canada was also a leading nation in pushing for the licensure of pilots using SSRI anti-depressants for non-psychotic psychiatric conditions.

Category 2 Certification
Category 2 is used for the medical certification of air traffic controllers in Canada. Just to be confusing, it is equivalent to ICAO Class 3 certification.

Category 3 Certification
Canadian Category 3 certification is for PPL, which is equivalent to ICAO/European Aviation Safety Agency (EASA) Class 2 certification. The PPL, as currently constructed, is an ICAO compliant document that allows Canadian private pilots to engage in non-commercial flight operations in any ICAO signatory nation. The standards are set by international agreement and again, Canada has not filed any significant differences, which gives Canadian private pilots the maximal international flexibility, including flying into the United Sates.

Category 4 Certification
Several years ago, when ultralights and other recreational aircraft were starting to become quite popular, Canada decided to create a non-ICAO compliant medical certificate, Category 4. The only requirement needed to obtain this level of medical certification is a form of self-declaration similar to that of a driver’s licence. To that end, a screening medical questionnaire was created and the need to see a Civil Aviation Medical Examiner (CAME) eliminated. However, you need to have your family physician countersign the questionnaire if you want to carry a passenger on your aircraft. That’s right: no physical examination, unless of course you have or have had one of the conditions that we are concerned about, in which case you may need to see a CAME.

So what can you do with a Category 4 medical certificate? It is the medical document required to validate a Student Pilot Permit, a RPP, a U/L and a GPL. With an RPP you can fly day VFR, on a non-high-performance, four-seat or less single engine aircraft with a single passenger. In other words, virtually all of the aircraft most recreational pilots fly. So, if you are a light aircraft driver who doesn’t need or want to fly to the U.S. or IFR, you don’t need to visit your CAME. Unlike the Sport Pilot Permit in the U.S., it is possible to receive a Category 4 medical certificate if you have previously been denied a Category 1, 2 or 3 certificate, assuming of course the medical condition has been dealt with and does not pose a flight safety hazard. You don’t need to have a driver’s licence and any decision made by Transport Canada (TC) can be appealed. The certificate can also be issued with a restriction as well, unlike the U.S. where you get it or you don’t, such as “no passenger” if your medical condition warrants. In TC’s experience, over 90 percent of Category 4 applicants get the certificate, no questions asked. The other 10 percent may need to supply Civil Aviation Medicine with more information and less than 1 percent are denied. The standards are very close to those of a Class 5 driver’s licence in Canada, although TC is more stringent on issues such as respiratory disease requiring oxygen and seizure disorders.