Germany, Federal Republic (Air Force)
Dr Bernhard Groß
Brigadier General MC
The medical services of the Bundeswehr were centralized into the Bundeswehr Joint Medical Service in 2002. The responsibility for the medical support of the vast majority of the military was transferred to this major organisational element. However, because of the specialised needs of military aviation, an Aeromedical Service was retained within the aeronautical units maintained by the Air Force, Army and Navy of the Bundeswehr, and a centralised aeromedical institution under the leadership of the Surgeon General of the Air Force was established to provide specific support in the entire field of Aerospace Medicine.
German Air Force Centre for Aerospace Medicine (AFCAM)
By fusion of the former office of the Surgeon General German Air Force and the Air Force Institute of Aviation Medicine, a new institution was established in October 2013: the German Air Force Centre for Aerospace Medicine (Zentrum für Luft- und Raumfahrtmedizin der Luftwaffe (ZentrLuRMedLw). This centre covers all responsibilities for the “Aerospace Medicine” sector on behalf of the Bundeswehr including the Flight Medical Service of all flying units.
While the Surgeon General of the Air Force is the highest-ranking Flight Surgeon of the Bundeswehr, the Chief Flight Surgeons of the Army and the Navy are assigned to AFCAM, and the head of one of the three divisions of AFCAM is the Chief Flight Surgeon of the Air Force.
The duties of the Flight Medical Services include not only the medical examination, evaluation and support of military flight personnel but also the evaluation of pilots on behalf of civilian aviation authorities. The Centre for Aerospace Medicine has different fields of competence which are shown above. The selection of candidates for flying duties by means of computer and simulator-based testing of aptitude and trainability, the provision of national and international training courses in aerospace physiology and aviation medicine, as well as the testing of aircraft, aircraft equipment, flight clothing and aviation life support equipment with regard to their suitability for use by the flying crews. Further tasks include the forensic investigation of aircraft accidents, including toxicological and DNA analysis, the processing of all aspects of flight physiology, and intervention in crisis situations. As a science-based service provider, the AFCAM has to assure the quality of its services by conducting its own scientific research. All tasks relating to scientific aspects, research, testing and development in the Centre for Aerospace Medicine of the German Air Force are carried in one division.
The Surgeon General of the German Air Force is in command of the AFCAM, which comprises the personnel and facilities of the units of the former Institute of Aviation Medicine currently based in Fürstenfeldbruck, Manching and Bückeburg together with those of the previous Office of the Surgeon General of the German Air Force and the majority of those of the previous advisory services within the command units based at Köln-Wahn. The Flight Physiology Training Centre with its large-scale equipment typical for aerospace physiology, such as human centrifuge, high altitude simulation chamber and disorientation trainer, is currently located in Königsbrück, close to Dresden in Saxony. Based on the cooperation agreement between the Federal Minister of Defence and the German Aerospace Centre (DLR) in May 2014, parts of the AFCAM will move in a new building on the DLR compound in Cologne in October 2022. The AFCAM will become part of the aerospace medicine campus in order to develop a European competence center in future.
Close cooperation with the DLR will include the implementation and supervision of specific research projects, the mutual use of largescale equipment as a cost-saving measure, and the exchange of personnel for training purposes and to promote young researchers.
The AFCAM also issues medical guidance and direction to the flight surgeon units in the wings of the German Air Force and is additionally responsible for deployment support, healthcare, logistics, administration and training. In the areas of international and national joint projects, research orientation and quality management, the Surgeon General of the German Air Force has the support of a Scientific Coordinator.
The Flight Medical Service of the German Air Force
The Flight Medical Service of the German Air Force is responsible for providing flight medicine in all operational air wings, global mission support, health support administration, aeromedical training and medical equipment for our flight surgeon clinics as well as AE (aeromedical evacuation) onboard our various aircraft. The air wing’s flight surgeon clinics comprise of flight surgeons, flight surgeon assistants, physiotherapists and sports trainers. They provide medical support as family practitioners of our aviators and air traffic controllers as family practitioners and function as aeromedical examiners (AME), as well. Additionally, they support the German AE system as medical directors (MD) onboard our AE-aircraft. Command, support and guidance are provided by Division III, the Competence Centre for Flight Medical Service and the Chief Flight Surgeon of the Air Force.
The GAF operates Eurofighter and Tornado fighter jet aircraft, CH53, AS532 and H145M helicopter, A400M, C130J, A310 MRTT (Multirole Tanker Transport) as well as A319/A321/A340/A350 and Global 5000 aircraft and the Remotely Piloted Air System (RPAS) Heron1.
The Eurofighter wings are stationed at the airfields in Laage, Nörvenich, Wittmund and Neuburg a.d. Donau. In order to provide optimum coverage of German airspace, particularly over coastal and border areas, QRA (Quick reaction alert) units are permanently based at Neuburg a.d. Donau and Wittmund. The wings have been renamed as ‘tactical air force wings’ (TaktLwG) to reflect their multi-role capability, as opposed to the former “fighter” and “fighter bomber” wings.
The reconnaissance units of the Air Force, including its TORNADO aircraft and HALE/MALE UAVs, are concentrated at the Kropp/Jagel airfield in the TaktLwG 51 “Immelmann”. The Tactical Air Force Wing 33 stationed in Büchel retains its previous assignment, equipped with TORNADO aircraft.
The main objective of future air transport involves the fusion of strategic and tactical air transport capacities. The German Air Force will operate up to 53 multi-role A400M Airbus transport aircraft and up to 66 medium-lift CH53 transport helicopters. Because of its central location in Germany and the current framework situation, the main operating base of the A400M is Transport Airwing 62 in Wunstorf, just west bound of Hannover. The CH53 helicopters are combined in a helicopter squadron based at Laupheim and Schönewalde (Holzdorf airfield). Special flight services for the federal government and parliament are provided from Berlin Brandenburg International Airport and Cologne Airport by the Special Air Mission Wing MoD (Flugbereitschaft BMVg).
The aeromedical care of personnel who require a pilot license is provided by the flight surgeons within the wings of the individual military formations. Flight surgeons support flight operations, provide flight safety services and flight physiology training, and are responsible for the aeromedical health of flight crews. They advise their wing commanders and all their superior Air Force officers on matters relating to aviation medicine and general healthcare, and with their specialist medical skills, they contribute to the success of training, exercises and missions of airborne military formations. The Flight Medical Service of the Bundeswehr ensures that the health of flight crews is such that they retain their operational capabilities. Extensive aeromedical support, regular examinations and evaluations of the aptitude, suitability and ability of personnel with regard to their assignments help reduce health-related risk factors among flight crews to a minimum.
The aeromedical support provided also includes preventive inoculation, advice on travel medicine, help in the preparation for and follow-up of missions, rehabilitation measures, the promotion of a healthy lifestyle, and encouragement to participate in sporting activities.
The aim of all aeromedical measures is to establish and maintain the best possible level of operational capacity, flight safety, morale and health among aircrews. They improve individual resistance to stress and optimise performance capacity, enhancing the ability of aircrews to act appropriately in threshold situations and thus providing for sustainable efficiency and in particular safety during flight operations. Flight medicine, as provided by flight surgeons in operational flight units, combines aspects of clinical aeromedicine, flight physiology, flight psychology, physiotherapy, sports, nutritional and occupational medicine with direct experience of flight operations to form an integrated sub-process of health provision within the overall healthcare requirement.
Flight surgeons in the field / Aeromedical Evacuation
Appropriate and continuous aeromedical support is also an essential factor in successfully maintaining military flight operations at a deployed operating base. Special requirements thus apply with regard to the training, motivation and proficiency of flight surgeons stationed in the field. A deployed flight surgeon must also be capable of acting as an Aeromedical Evacuation Coordinating Officer (AECO), providing the aeromedical expertise required by the casualty evacuation chain.
A flight surgeon must have the abilities required to perform the duties of the Medical Director (MD) in all Tactical Aeromedical Evacuation (TacAE) and Strategic Aeromedical Evacuation (StratAE) missions and, like the civilian senior emergency physician, to coordinate the civilian emergency medical services during airborne evacuation. A Medical Crew Chief (MCC) is at hand to assist the flight surgeon. The Aeromedical Evacuation (AE) flight crew also includes the Medical Device Technician, whose job it is to ensure that onboard medical equipment and material are both functional and safe. The direct medical treatment and monitoring of wounded, injured and sick personnel being transported by aircraft are provided by the specialists of the Bundeswehr Joint Medical Service.
In order to ensure the best possible medical results for the patients in accordance with the fundamental guideline of the Bundeswehr Joint Medical Service, a particular focus is placed on Aeromedical Evacuation as a significant component of the evacuation chain. For this purpose, the German Air Force has a proved and tested system in place, which consists of various kinds of aircraft with different medical equipment, an aeromedical transport command system, and established standard operating procedures. The introduction of the A400M with its enhanced capacity and operational potential represents a significant extension of the spectrum of aircraft that can be used in StratAE and TacAE missions. To provide StratAE worldwide, the German Air Force maintains an A400M with full medical configuration and the corresponding personnel in rapid response status at all times. In 2022 the Airbus A310MRTT will be decommissioned. The multirole transport capacity (passenger and cargo transport, air-to-air refuelling and Aeromedical Evacuation) will be transferred to a multinational unit (Multinational Multirole Transport Tanker Unit (MMU)) operating up to 9 A330MRTT out of Eindhoven, NLD and Cologne, DEU airfield. One of the MMU´s aircraft in AE-configuration uses Cologne as home base. The fleet of the MMU is tasked by the EATC (European Air Transport Command). In its maximum configuration, the A330MRTT is able to carry up to 6 intensive care and 16 intermediate and low care patients.
(status: 12 January 2023)