Aviation and Space Medicine CESR Portfolio Guide

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
• Shares decision making with children and young people
• Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice at individual, team, organisational and system levels
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
• Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

• Performs medicals on aircrew and other aviation workers including air traffic controllers to ensure individuals are medically fit and reach the required medical standards.
• Defines the patterns of symptoms found in patients presenting with disease, and how these are related to aviation environment.
• Defines the pathophysiological basis of investigations, including those relevant to aviation, and functional prognosis.
• Interprets the results of investigations, especially to those relating to occupational attribution, functional prognosis and to licensing gain/retention.
• Understands the clinical conditions requiring secondary review procedures.
• Understands the clinical conditions which define the licensing requirements
• Understands the clinical conditions and their effect in the flight environment.
• Provides certification of individuals within the medical standards necessary to achieve and maintain a high level of aviation safety.
• Understands the requirements of aviation regulatory bodies and the implications of clinical conditions on the setting of regulatory policies.
• Understands the importance of evidence-based literature reviews to inform licensing and regulatory decision making.
• Understands how to effect policy changes at national and international level.
• Demonstrates knowledge of the limitations of statutory regulation on some clinical conditions.
• Demonstrates knowledge of the effects on health of travelling by air.
• Demonstrates knowledge of research and other relevant information on aviation health and to set priorities for areas which require further attention.
• Acquires practical knowledge and experience of the conditions in which flight deck crew and other operators, including air traffic control workers, carry out their duties.
• Issues or revokes aircrew and air traffic controller’s certificates to ensure medical standards are maintained
• Be responsible for identifying the clinical condition and licensing implications and take responsibility for these

• Understands the physical (e.g., acceleration, pressure change, low ambient pressures, temperature, impact), chemical, biological, ergonomic, psychosocial, and other hazards to health in the aviation workplace, and the illnesses, which they cause.
• Understands the military and civilian flight environment and the broader aviation working environments with the aim to have practical flight deck (or Simulator) experience.
• Understands the principles of toxicology, physical (including thermal, noise, vibration, and radiation) hazards, occupational hygiene and ergonomics.
• Knows about the clinical features and investigation of occupational diseases relevant to aviation.
• Recognises situations where specialist assessment of the aviation environment is needed and be able to seek and evaluate advice.
• Diagnoses work related ill health and provide advice on prognosis, prevention, and management.
• Customises assessments to subgroups (such as pregnant women) and to individuals.
• Understands the sources of information on and methods of evaluating and controlling risk.
• Understands the principles of health risk management in the aviation environment.
• Evaluates the implementation of health risk management in the aviation workplace.
• Undertakes assessments of the aviation working environment, recognise hazards, and provide preliminary advice.
• Undertakes quantitative measurements and advises on control measures for hazards in flight.
• Understands the importance of risk assessment to ensure those with medical conditions are fit to fly on commercial aircraft.
• Understands the health issues for passenger flying in commercial airlines and the hazards of microbiological and communicable diseases for commercial air travel.
• Carries out and evaluates health surveillance including biological monitoring for workers exposed to hazards on the ground or in the air.
• Understands aviation health standards, biological monitoring, and the principles of health surveillance.
• Understand the implications for military and commercial flying from global pandemics and biosecurity threats.
• Understands the management of inflight medical emergencies for commercial aircraft passengers and how to deal with on-board sick passengers.

• Understands the limitations of ground based clinical assessments, equipment investigation and research.
• Understands how flight environment (including in-flight or synthetic simulator) investigations may contribute to aero-medical decision making, formal equipment clearances and clinical fitness to fly judgements.
• Recognises the valuable contribution that flight environment assessment and rehabilitation offer, and the potential for error without consideration of in-flight factors.
• Has a thorough understanding of the flight environment, and the limitations involved with conducting such work on board aircraft.
• Is aware of all appropriate regulations.
• Writes flight protocols, in conjunction with experienced aircrew, for flight environment assessment, research or rehabilitation using skills and knowledge acquired from all aspects of Aviation and Space Medicine practice.
• Understands the various modalities of clinical and physiological monitoring that may be used in flight, and their principal limitations.
• Understands appropriate format and channels for reporting.
• Understands how monitoring can be integrated with aircraft systems to ensure there is no impact on flight safety or escape systems. Is familiar with the use of flight environment clinical rehabilitation assessment and its use in returning to fitness-for-flight.
• Determines areas of investigation that require flight environment assessment, or conditions where in-flight rehabilitation is justified and cost effective.
• Demonstrates an understanding of the physiological principles underlying monitoring techniques used.
• Describes the most appropriate parameters to be monitored and be familiar with the limitations.
• Identifies typical sources of error, and the problems associated with inflight instrumentation.
• Has knowledge of aircrew and passenger equipment procurement organisations and responsible bodies.
• Writes a report based on the findings of the assessment, with recommendations.
• Produces reports to a high standard of clarity and accuracy, comparable with those in peer reviewed scientific literature.

• Publishes and communicates internally and externally the results of research undertaken, to respond to and raise awareness of issues or directives.
• Delivers accurate and scientifically sound research
• Demonstrates curiosity and a critical spirit of enquiry
• Demonstrates the persistence needed to follow a project from inception to completion.
• Ensures that research is undertaken using relevant ethical guidelines.
• Applies for appropriate ethical research approval.
• Converts a problem into a researchable question.
• Demonstrates the ability to write a scientific paper.
• Can set up a hypothesis and test it.
• Knows how to design a research study.
• Carries out a literature search.
• Plans data collection for simple survey (sample selection and recording and storing data).
• Knows how to use appropriate statistical methods and utilise the knowledge of a statistician or epidemiological expert.
• Interpret scientific data in journals and from own research.
• Develops critical appraisal skills and apply these when reading literature.
• Demonstrates good verbal and written presentations skills

• Assesses how personal protective equipment works and how the physiological effects of hypoxia can alter aircrew performance.
• Conducts assessments of the fit and function of individual items of aircrew personal protective equipment under hypobaric conditions.
• Performs physiological monitoring necessary to assess the performance and limitations of protective equipment.
• Understands altitude chamber procedures, including medical fitness and contraindications.
• Demonstrates how personal protective equipment mitigates the effects of long duration acceleration of the human.
• Assesses the fit and function of individual items of aircrew personal protective equipment under increased acceleration.
• Demonstrates how the physiological effects of acceleration exposure can alter aircrew performance and how aircrew life support systems mitigate these effects.
• Operates a human centrifuge in a safe manner.
• Medically monitors human centrifuge exposures.
• Manages safely centrifuge emergency procedures.
• Conducts accurate and appropriate non-human subject tests of life support equipment.
• Assesses medical fitness to undergo high-G exposure and to detect medical conditions contra-indicating exposure.
• Assesses the performance of aircrew life support systems and health related medical investigations.

• Documents and records evidence during an investigation.
• Demonstrates cockpit/cabin crashworthiness structural assessments and identify hazards.
• Demonstrates assessments on the performance of restraint systems.
• Demonstrates assessments on the crashworthiness and energy attenuation capabilities of seat systems.
• Identifies morphological abnormalities and interprets autopsy and clinical findings in relation to the injury mechanisms.
• Can identify issues to be addressed by the clinical/autopsy examination.
• Assesses post-crash survivability.
• Assesses the performance and functioning of aircraft assisted escape systems and understands the associated injury mechanisms.
• Demonstrates how design and test failings can influence the causation of injury.
• Is conversant with current legislation and regulations relating to medico-legal aspects of accident investigations.
• Makes recommendations to improve flight safety and injury outcome.

• Describes the factors influencing human performance and the use of human error classification systems.
• Assesses the human factors issues associated with the design of flight decks.
• Delivers and enhances crew and management awareness of human factors.
• Understands the concept of risk as the product of event frequency and the application of as low as reasonably practical criteria (or likelihood and severity) to safety decision making.
• Describes the personal and organisation factors that affect safety.
• Demonstrates knowledge of safety and risk analysis, nature and location of aircraft accidents, benefits of aircraft warning systems, and reporting systems.
• Demonstrates knowledge of the factors influencing human performance and error, including the effects of fatigue, stress, individual differences, and medical conditions.
• Uses and interprets fatigue risk management systems and measures to mitigate the effects of fatigue.

• Understands how to aero-medically evacuate patients safely.
• Can identify the essential data and requirements for safe and effective aeromedical transfers.
• Understands the principles for the aeromedical transfer of the critically ill patient.
• Demonstrates an understanding of in-flight medical equipment and understands the rationale behind the aviation standards relevant to aeromedical equipment.
• Demonstrates how the environment can influence the physiology and pathology of disease processes.
• Is aware of the availability of in-flight resources and the influence on patient transfer and care.
• Understands the importance of the administration of medication during transit though different times zones.
• Understands the principles of transfer of patients with infectious diseases and those suffering from biological and chemical agents.

• Assesses the pathophysiological challenges of the space environment (including sub orbital and long duration space missions).
• Understands the hazards of radiation and micrometeoroids
• Understands the rationale and methods for rehabilitation from the long-term physiological effects of human spaceflight.
• Assesses how microgravity influences space adaption
• Demonstrates an understanding of the protection requirements for space flight.
• Understands of the constraints and challenges of delivering space medicine within a multinational operational environment such as the International Space Station.
• Understands of the role of the space medicine specialist within a wider team centred around crew medical support.
• Understands the behavioural consequences of prolonged space flight.

• Is able describe the structure and function of the healthcare system and medical regulation as it applies to Aviation and Space Medicine
• Demonstrates knowledge of the need for safety standards in aircraft operations.
• Understands the military and civilian aviation regulatory bodies and promote a culture where safety is paramount.
• Develops appropriate relationships that facilitates solutions to aviation workers health/licensing problems.
• Understands and interacts with the aerospace industry and demonstrates how it functions to enhance flight safety and aviation worker and passenger health

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents