Licensing Physicians for Practicing Medicine in Space

Remote healthcare in space. Credit: Canadian Space Agency.

Who should be allowed to practice medicine in space? The logical answer would seem to be ‘medical doctors’, but the actual answer isn’t as simple as that.

The reason: Medical licensing bodies require physicians to have a set number of required skills, and the definition of those required skills varies from jurisdiction to jurisdiction. And it isn’t even a matter of medical skills being clearly defined on a nation-by-nation basis. “Physicians in Canada practise under provincial licences, allowing them to practise medicine in support of patients in the province in which they are licensed,” says Western University Law professor Valerie Oosterveld. “These provincial licences do not cover areas beyond the province, which includes space.”

A team of Western University researchers are now looking into the issue of licensing physicians to practice in space. Specifically, Professor Oosterveld is working with Schulich School of Medicine & Dentistry professor Dr. Adam Sirek to examine possible solutions to the licensing dilemma. Along with students Valerie Nwaokoro and Alex Zhou, they have published an article in the IEEE Open Journal of Engineering in Medicine and Biology entitled, ‘Building a One Country One Licensure Framework: Applications for the future of Canadian Space Physicians’.

Based on their research, the Western team has discovered that current restrictions on physicians providing medical care in space are akin to those encountered by Canadian doctors providing healthcare in military bases and remote communities, and via out-of-province telemedicine. The Western team has concluded that Canada needs to improve its licensing framework to remedy restrictions associated with the provision of medical care. It also needs to add new rules to permit our doctors to practice medicine while in space, or to astronauts in space via Earth-based telemedicine.

“The global space economy is forecast to be a $1 trillion industry by 2040,” said the IEEE article’s abstract. “Its increased utilization will require additional legal healthcare support frameworks.”

Alex Zhou is a third-year medical student at Schulich Medicine & Dentistry. He said to move to widen physician licensing jurisdictions on Earth is already gaining ground. 

“Australia transitioned to a national licensure system in 2010,” Zhou said. “A national licensure for Canada would also need to include Space as a potential jurisdiction. More recently, the Canadian Medical Association has been pushing for a single licensure system as well.”

This being said, developing a whole-Earth medical licensing process may be more than a divided world can manage at this point in time. What may be more realistic is for space-faring nations and their partners to agree upon jurisdictions whose current licensing standards meet their needs, and accredit physicians licensed by them to serve their respective astronauts/cosmonauts.

In the meantime, NASA’s requirements for ‘Flight Surgeons’ are as follows: “A Flight Surgeon is a physician that has specialized training and board certification in Aerospace Medicine. Most flight surgeons are also board certified in an additional specialty such as family medicine or neurology and maintain their certifications in both specialties. This extensive academic requirement means that most flight surgeons will undergo an average of 12 to 14 years of undergraduate, medical, residency, and clinical training before earning the title.”

About James Careless

James Careless is an award-winning satellite communications writer. He has covered the industry since the 1990s.

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