NDA Eligibility

The Union Public Service Commission (UPSC) conducts the National Defence Academy (NDA) exam. The exam is conducted to recruit cadets and train them in three services, namely the Indian Army, Indian Navy and Indian Air Force (IAF).

Nationality

• The candidate must be an unmarried Indian citizen or a subject of Nepal, provided the candidate possesses a certificate of eligibility issued by the Government of India
• Candidate can be an Indian origin migrated person, migrated from Pakistan, Sri Lanka, Uganda, Zambia, Zaire, Vietnam, Burma, East African countries of Kenya, the United Republic of Tanzania, Malawi, or Ethiopia, with the intention of being permanently settled in India

Note: Candidates who belong to the Gorkha subjects of Nepal are not bound to display the certificate of eligibility.

Age Limit

• Applicants who want to apply for NDA should be born  between July 2, 2003 and July 1, 2006

NOTE: The date of birth that will be considered is the one entered in Secondary School Leaving Certificate (SSLC) certificate or in a certificate that fulfils the following conditions-

• It is recognised by an Indian University as equivalent to Matriculation
• It should be in an extract from the Register of Matriculates that is maintained by an institution that must be certified by the authorities of the university, or in the SSLC level of exam or an equivalent type of examination certificates

The above listed certificates need to be submitted after the release of the result of the written part of the exam. Any certificate such as affidavits, horoscopes, birth extracts from Municipal corporation, etc, other than the SSLC certificate, pertaining to age limit is not acceptable.

NOTE: Candidates should keep the following things in mind while fulfilling the eligibility criteria regarding age limit-

• No changes will be allowed once the date of birth, as per the Matriculation certificate, has been entered into the records of the commission in order to complete the admission process
• Candidates will be liable to face disciplinary action under the rules of commission, if variation of any kind is found at any stage of the exam pertaining to their age limit
• Thus, candidates are required to be careful while filling in the application form
• Once the application form is submitted, no further changes can be made by the applicant under any circumstances

Also see: 

• NDA Notification
• NDA Syllabus
• NDA Fees
• NDA Application Process

Educational Qualifications

The following conditions regarding educational qualifications must be fulfilled by candidates-

1. For the Army Wing of NDA – Candidates should have qualified 12th standard of the 10+2 pattern of school or equivalent exam that is conducted by a State Board or University.
2. For Air force and Naval Wings of National Defence Academy and for the 10+2 Cadet Entry Scheme at the Indian Naval Academy- Applicants must have passed 10+2 with Physics, Mathematics, and Chemistry from a 10+2 pattern of school or equivalent that is conducted either by a State Board of Education or University.

Applicants who are appearing in the 12th class are eligible to apply for the exam as well.

Candidates who have qualified for the SSB interview but have not produced SSLC/10+2/ or any equivalent certificate in its original form at the time of the SSB interview have to forward the duly self-attested photocopies. The copies need to be submitted within stipulated time. Failing to submit the document by the specified dates will lead to the cancellation of their candidature.

Candidates who are able to produce/have produced their required documents in original, at the time of SSB interview, and have got it verified by the authorities of the SSB, do not require to submit the self attested photocopies of the required documents to the Army HQ or Naval HQ.

In case the certificate has not been issued by the university or institution, candidates are allowed to submit a certificate that is issued by the Principal of the institution. However, the certificate should be submitted in its original form and photocopies will not be accepted.

In exceptional cases, the commission may treat a candidate as qualified, even though he/she does not possess any prescribed educational qualifications, provided his qualifications justify his admission to the examination in the opinion of the commission.

NOTE 1: Candidates who are pursuing class 11th or appearing for the same exam are not eligible to apply for this examination.

NOTE 2: Candidates who have not yet cleared their 12th exam are allowed to appear in the UPSC exam must know that it’s a special concession provided to them. Those candidates need to submit the proof of qualifying the 12th exam or equivalent by the specified date i.e. 24th December, 2022 at any condition. No extension of the date will be entertained on any ground such as late conduct of the Board/University, delay in declaration of results, or any other reason whatsoever.

NOTE 3: Candidates who have been debarred by the Ministry of Defence from holding any type of Commission pertaining to Defence Services will not be considered eligible for admission to the exam. If they get admitted, their candidature will be cancelled after taking the notice of the same.

NOTE 4: Applicants who failed PABT/CPSS earlier will be eligible for Air force in  Ground duty branches, if they display their willingness in the online application form that is available on the official website of the commission.

Applicants who were withdrawn or resigned on disciplinary grounds from any of the Armed Forces training academies will not be eligible to apply for the same.

Marital Status

• Candidates, male or female, who want to appear for the NDA exam should be unmarried
• Candidates must keep in mind that they are not allowed to marry until the completion of their training. Any participant who gets married subsequent to any level of examination, even if successful, will not be selected for his training or any participant who gets married in the middle of his training will be discharged from the same and liable to refund all expenses spent on him by the Government of India.

Physical Standards

Candidates are required to be physically fit as per the physical standards to get admitted to the National Defence Academy and Naval Academy Examination [I], 2022.

Physical fitness eligibility criteria-

Candidates must rectify the minor ailments listed below. It will help expedite the process of the medical examination conducted at the Military hospital,

• Hydrocele/Phimosis
• Wax (Ears)
• Under sized chest
• Gynaecomastia
• Varicocele
• Deviated Nasal septum
• Overweight/underweight
• Piles
• Tonsillitis

NOTE: Permanent tattoos are allowed only when it’s on the inner part of the forearm or if it’s from the inside of the elbow to the wrist and on the back side of the palm/dorsal side of the hand. Permanent tattoos on parts other than the mentioned ones are not acceptable. Candidates who belong to any tribe and have tattoo marks on body or face pertaining to their traditions may be eligible on a case to case basis. The Comdt. the selection Centre will be the competent authority for considering such cases.

Medical Examination of Female Candidates

1. 1. Candidates need to fill in the questionnaire that will ask questions regarding their gynaecological, menstrual, and Obstetric history.
   2. Candidates will have to go through a detailed physical and systemic examination.She would be examined by a lady Gynaecologist or female medical officer only.
   3. The detailed physical examination will include the following inspections –
      • External genitalia
      • Evidence of lump breast and galactorrhoea
      • Hernial orifices and the perineum
      • Any evidence of stress urinary incontinence or genital prolapsed outside introitus
   4. Unmarried female candidates will not be eligible for the speculum or per vaginal examination.
   5. Female candidates will have to go through ultrasound scans of the abdomen and pelvis during the initial medical examination.
   6.  Following conditions in female candidates may lead to them being declared unfit as per the physical standards set by the authorities-
      • Primary or secondary amenorrhea
      • Stress urinary incontinence
      • Congenital elongation of cervix or prolapse coming out of the introitus even after corrective surgery
      • Submucous fibroid of any size
      • Congenital uterine anomalies except for arcuate uterus
      • Pregnancy. Pregnancy will be a cause of rejection
      • Simple ovarian cyst more than six cm
      • Single fibroid uterus more than three cm in diameter; fibroids more than two in number (each fibroid not more than fifteen mm in diameter) or fibroids causing distortion of the endometrial cavity.
      • Complex ovarian cyst of any size
      • Broad ligament or cervical fibroid of any size causing pressure over the ureter
      • Endometriosis and Adenomyosis
      • Disorders of sexual differentiation
      • Acute or chronic pelvic infection
      • Severe Menorrhagia or/ and severe dysmenorrhea
      • Any other condition will be considered on the merits of each case by the Gynaecologist
   7. The following conditions are considered as FIT for female candidates-a)Minimal fluid in the pouch of Douglas.b)Unilocular clear ovarian cyst up to 6 cm.
   8. Laparoscopic surgery or laparotomy- Candidates will be considered fit if they have gone through cystectomy or myomectomy, provided the candidate is asymptomatic, ultrasound pelvis is normal, histopathology of tissues that have been removed is benign and operative findings do not indicate towards endometriosis. The fitness will be taken into consideration after 12 weeks of the surgery and when the wound has completely healed. Candidates will be declared fit after one year of laparotomy surgery.
   9. If any oddity related to external genitalia is found in female candidates, it will be considered as per the merits of each case. Significant hirsutism, or growth of hair on body and face, especially with a male pattern of hair growth, in addition to radiological evidence of PCOS, may warrant rejection of the application.

NOTE: To be considered medically fit, candidates must be in good physical as well as mental health. He/she should be free from any syndrome/disease/disability that could interfere with the efficiency of the candidate and hinder his/her performance of military duties in any climate, terrain, or season including air and sea, in austere conditions with no medical facilities, or in remote areas. Applicants should also not be afflicted with any medical condition that necessitates frequent visits to the doctor or require him/her to take medicine.

Medical Standards

The following things should be considered by candidates pertaining to medical standards-

1. 1. 1. Candidates should not have any evidence of weakness, any congenital deformities/syndrome/diseases/malformation, imperfect development of any system.
      2. Candidates must not have any swelling that includes tumours/swollen lymph nodes/cyst/ on any part of the body. In addition to that, they should also not have any sinus or fistula on the body.
      3. No hypo or hyper pigmentation or any other disability/syndrome/disease of skin is acceptable.
      4. Should not have hernia on the body.
      5. Should not have any scars that can hamper the functioning and may lead to disfigurement.
      6. No arteriovenous malformation is acceptable anywhere in the body.
      7. There should be no deformation on the face or head including asymmetry, scars indicating old operative interference, deformity from fractures or depression of the bones of the skull, and malformation like fistulae and sinuses, etc.
      8. Impairment of vision such as field of vision and colour perception is not acceptable.
      9. Hearing impairment, deformities in ears vestibulocochlear system is not permissible.
      10. Should not have impediment of speech because of any aetiology.
      11. Should not have any disease/congenital anomaly/disability/syndrome of the bones or cartilages of the nose, or palate, nasal polyps or disease of the naso-Pharynx, accessory sinuses, and uvula. Should also not have any nasal deformity and features of chronic tonsillitis.
      12. Any disability/disease/syndrome related to throat, gums, palate tonsils, or any disease that affects the normal function of either mandibular joint is not acceptable.
      13. Any disease or syndrome related to heart and blood vessels that may include congenital, organic, genetic including hypertension and conduction disorders is not acceptable.
      14. Should not have anything related to pulmonary tuberculosis or a history of this or any other disease or disability/chronic diseases of lungs and chest that includes immunological conditions, musculoskeletal deformities of chest, connective tissues disorder.
      15. Any disability regarding digestive system including abnormalities of liver, pancreas including endocrine, hereditary or genetic disease, congenital syndromes are not acceptable.
      16. Should not have any disease of any reticuloendothelial system, endocrine system.
      17. Any disease related to the genito-urinary system including atrophy/hypertrophy of any gland or organ, malformation is unacceptable.
      18. Should not have any active, congenital, or latent venereal disease.
      19. Should not be a patient of any mental disease, incontinence of urine or enuresis, or epilepsy.
      20. Should not have any syndrome related to musculoskeletal system and joints including spine, limbs, and skull.
      21. Should not have any history of congenital or hereditary disease or syndrome.

There are a few medical conditions that may lead to rejection. Those conditions are listed below-

1. 1. 1. Musculoskeletal deformities of spine, chest and pelvis, limbs, for eg. torticollis, scoliosis, kyphosis, deformities of ribs, clavicle, vertebrae, sternum, and other bones of skeleton, malunited fractures, deformed fingers, limbs, toes, and congenital deformities of spine.
      2. Deformities of limbs – Deformed toes, limbs, and fingers, deformed joints like cubitus varus, cubitus valgus, bow legs, knock knees, hyper mobile joints, amputated fingers or toes, and shortened limbs.
      3. Vision and eye- Hypermetropia, myopia, astigmatism, lens, lesions of cornea, retina, ptosis, and squint.
      4. Hearing ears, nose and throat- Substandard hearing capability, tympanic membranes, deviated Nasal septum, lesions of pinna, middle ear, and congenital abnormalities of lips, preauricular sinuses, palate, and lymphadenitis/ adenopathy of neck. The hearing capacity should be 610 cm for the conversational voice and forced whispering for each other.
      5. Dental conditions –
         • Incipient pathological conditions of jaws that are known to be recurrent or progressive.
         • Jaw discrepancies between upper and lower jaw that may hamper efficient mastication or/and speech can lead to rejection.
         • Symptomatic temporo- Mandibular joint clicking and tenderness. Dislocation of the TMJ on wide opening, and mouth opening of less than 30 mm measured at the incisal edges.
         • Potentially cancerous conditions
         • Clinical diagnosis for sub mucous fibrosis with/without restrictions on mouth opening
         • Poor oral health status in the form of visible and gross calculus, periodontal pockets or/and gum bleedings
         • Loose teeth- No more than two mobile teeth are acceptable
         •  Cosmetic or post traumatic maxillofacial surgery/trauma is considered unfit for a minimum of 24 weeks from the date of surgery or injury whichever is later
         • Malocclusion of teeth that hampers efficient mastication, general nutrition,  maintenance of oral hygiene, or performance of duties efficiently
      6. Chest – Evidence of tuberculosis, or tuberculosis itself, lesions of heart, lungs, musculoskeletal lesions of the chest wall.
      7. Abdomen and genito-urinary system- Undescended testis, hernia, varicocele, solitary kidney, organomegaly, horseshoe kidney, and cysts in the liver/kidney, gallbladder stones, ureteric and renal stones, lesions/deformities of urogenital organs, sinuses, piles, and lymphadenitis/pathy.
      8. Nervous system- Tremors, speech impediment, and imbalance.
      9. Skin- Vitiligo, warts, haemangiomas, corns, dermatitis, hyperhidrosis, and skin infection growth.

Height and Weight Standards for Female Candidates joining NDA (Army)

1. 1. 1. The minimum required height for female candidates who want to enter the Armed Forces is 152 cm. Candidates who are Gorkhas or belong to Hills of North Eastern region of India, Kumaon, and Garhwal will only be allowed to enter if their minimum height is 148 cm. Candidates who are below 18 years of age at the time of examination will be allowed a growth of 2 cm. A minimum of 163 cm height is required for the flying branch. There are other anthropometric standards for Flying Branch as well including sitting height, thigh length, and leg length.
      2. A weight for height chart is given below which pertains to all categories of personnel. The chart is based on the BMI and specifies the minimum weight required by candidates in accordance with their height. Candidates who do not have the minimum required weight will not be accepted under any circumstances. Candidates who weigh more than the limit will be accepted only if they display the documented evidence of body building, boxing, wrestling at the National level. In that case, the following conditions need to be met:
         • The BMI should be less than 25.
         • The waist hip ratio needs to be lower than 0.9 for male candidates and 0.8 for female candidates.
         • The waist circumference should be lower than 90 cm for male candidates and 80 cm for female candidates.
         • All parameters related to the biochemical metabolic system should be under normal limits.

Note: Candidates who are below 17 years will follow the height and weight measurements as per the guidelines by the ‘Indian Academy of Paediatrics growth charts for weight, height, and BMI for 05 to 16 year old children’ that is amended from time to time.

Height and Weight Standards for Male Candidates joining NDA (Army):

The height requirements may vary according to the stream of entry. The weight of the candidate should be proportionate to the height as per the following chart –

Note: Candidates who are below 17 years will follow the height and weight measurements as per the guidelines by the ‘Indian Academy of Paediatrics growth charts for weight, height, and BMI for 05 to 16 years old children’ that is amended from time to time.

To enter the Armed Forces, the minimum height requirement for male candidates is 157 cm or as per the guidelines of the respective recruiting agency. Gorkhas and candidates who belong to Hills of north eastern regions of India, Kumaon, and Garhwal will only be allowed if their minimum height is 152 CM.

Note: Male/female candidates who are less than 18 years at the time of examination will be granted an allowance of 02 CM. For the flying branch, the minimum height requirement is 163 CM. There are other anthropometric standards that need to be met by the candidates such as sitting height, thigh length, and leg length for the flying branch.

Candidates need to go through the following investigations that pertain to all officer entries and for pre-commission training academies. In addition to that, examining medical officer or medical board may carry out any other requisite investigation –

1. 1. • Complete haemogram
      • Chest X-ray
      • Urine RE
      • USG abdomen and Pelvis

There are certain standards that differ based on age and type of the entry viz standards for vision. The same is given below in the form of a chart-

Lasik or Equivalent Kerato- refractive Procedure

Candidates who have undergone any kerato-refractive procedure must have a certificate or operative notes issued by the medical centre in which he or she chose to undergo the procedure. It will specify the date and type of surgery.

Note- If the candidate fails to submit the certificate, the ophthalmologist may reject the candidate under the specific endorsement of  “unfit due to undocumented visual acuity corrective procedure”.

To be considered FIT, the following conditions need to be met-

1. 1. 1. 1. Minimum of 12 months post LASIK surgery.
         2. Axial length by IOL Master should be equal to or less than 26mm.
         3. Normal and healthy retina.
         4. Age should be more than 20 years at the time of surgery.
         5. The thickness of the Central cornea should be equal to or more than 450 µ.
         6. The residual deflection should be less than or equal to +/- 1.0 D including cylinder, provided that it is acceptable in the category the candidate has applied for.
         7. The additional criteria may also include corneal topography and ectasia markers.

Note- Candidates who have undergone radial keratotomy are considered permanently unfit.

NOTE: Fitness following surgery – Candidates can be considered fit after the surgery. However, there should be no complications, scars should be healthy, well-healed, and must have attained sufficient tensile strength. Candidates will be considered fit only after one year of open or laparoscopic surgeries for hernia and 12 weeks of laparoscopic abdominal surgery for cholecystectomy. In case of any other surgery, candidates will be considered fit after 12 weeks of the laparoscopic surgery and 12 months after an open surgery. Candidates will be declared unfit for any surgeries for injuries, meniscus tear of any joint and ligament tear, regardless of the duration of the surgery.

Medical Standards and Procedure of Medical Examination for Officer Entries into Navy

Physical Standards for Officers (Male/Female) on Entry

Candidates need to be fit as per the prescribed physical standards.

1. 1. 1. Candidates must possess good physical as well as mental health and be free from any disease or disability that may interfere with their efficient performance both ashore and afloat, under the conditions of war as well as peace in any part of the world.
      2. There should not be any bodily defects or weak constitution. Candidate should not be underweight, overweight, or obese.

Weight

Height weight chart: Navy

Notes for Male Candidates

1. 1. 1. The minimum as well as the maximum weight for height will be standard for every category of personnel. Any candidate who weighs less than the minimum specified requirement will not be accepted.
      2. Male candidates who weigh more than the specified limit will only be allowed if they present documented evidence of boxing, bodybuilding and muscular build or wrestling. In such cases, the following conditions need to be met –
         • The BMI should not be higher than 25
         • The waist hip ratio should be less than 0.9
         • Biochemical parameters including blood sugar fasting and PP, creatinine, blood urea, cholesterol, HbA1C%, etc. should be within prescribed limits,
         • Fitness can only be provided by a medical specialist
         • A minimum of 157 CM of height is required; however, height relaxation is granted to candidates who belong to the categories mentioned below –

Notes for Female Candidates

1. 1. • The minimum as well as the maximum weight for height will be standard for every category of personnel
      • Any candidate who weighs less than the minimum specified requirement will not be accepted
      • Female candidates who weigh more than the specified limit will only be allowed if they furnish documented evidence of boxing, bodybuilding, muscular build or wrestling. In such cases, the following conditions need to be met-
        1. The BMI should not be greater than 25.
        2. The waist hip ratio should be less than 0.8.
        3. Biochemical parameters including blood sugar fasting and PP, creatinine, blood urea, cholesterol, HbA1C%, etc. should be within prescribed limits.
        4. Fitness can only be provided by a medical specialist.
        5. A minimum height of 152 cm is required for female candidates. However, height relaxation is granted to candidates who belong to the categories that are mentioned below –

Candidates who wish to enter as officers into the Navy in Pilot/ Observer specialisations of the executive branch are not eligible for height relaxation.

The following principal points will be ensured during the medical examination of candidates –

1. 1. 1. The candidate must be sufficiently intelligent.
      2. No sign of any disease related to the ear, throat, or nose.
      3. The eye vision should be up to the required standard.
      4. The speech should be without impediment.
      5. No glandular swelling.
      6. The chest should be well-formed and the heart and lungs should be sound.
      7. The limbs should be well-formed and completely developed.
      8. No evidence of hernia in any form.
      9. All the joints should be perfect.
      10. Toes and feet should be well-formed.
      11. No congenital malformation or defects should be there.
      12. There should be no history of any acute or chronic disease that suggests an impaired constitution.
      13. A sufficient number of sound teeth for efficient mastication is required.
      14. No disease related to the genitourinary tract.

Some of the major defects that could lead to rejection are as follows –

1. 1. 1. Imperfect development, weak constitution, congenital malformation, and muscular wasting.
      2. Abnormal curvature of the spine, scoliosis of more than 10 degrees by Cobb’s method till less than 25 years of age and 15 degrees at more than 25 years of age.
      3. Any malformation of the head including deformity resulting from fracture or depression of the skull bones.

Note- The spine x-ray will not be carried out as a routine. It will be done on the recommendation of a surgical specialist wherever required.

• Skeletal deformity – acquired or hereditary – or any disease or impairment of the function of joints or bones.

Note – Rudimentary cervical rib that causes no signs or symptoms is acceptable.

1. 1. 1. Asymmetry of limbs or torso, abnormality of locomotion including amputation.
      2. Any deformity of toes or feet.

Eyes

1. 1. 1. Morbid condition of the eye or eyelids that is likely to recur or aggravate.
      2. Active trachoma or its complication.
      3. Manifest squint of any degree.
      4. Visual acuity less than prescribed standards.

Notes

Visual standards for NDA or Na entry are given as follows-

• Kerato- refractive surgery- candidates who have gone through any refractory surgery such as PRK/SMILE/LASIK can be considered fit for every branch, except diving, submarine, MARCO cadre, subject to the following conditions-

Ear, Nose, and Throat

1. 1. • Ear- Conditions such as a history of earache, impairment of hearing, tinnitus or vertigo, disease of the external meatus including atresia, exostosis or neoplasm prevent a thorough examination of the drum, aural discharge or sign of acute or chronic suppurative Otitis media, unhealed perforation of the tympanic membrane, evidence of of radical or modified radical mastoid operation

Notes:-

1. 1. 1. Candidates should be able to hear a forced whisper from a distance of 610 cm with each ear separately with back to the examiner.
      2. The tympanoplasty operation with or without the cortical mastoidectomy for dry Central perforation of the tympanic membrane is considered curative once the graft has taken up, provided panic membrane is intact, mobile with free field hearing of 610 cms in each ear separately, and a normal hearing threshold on pure tone audiometry. A three-month gap is considered proper after the operation and complete healing as well as graft stabilisation. To be considered fit, the candidate should show normal compliance in tympanometry.
      • Nose – Conditions such as marked nasal allergy, disease of the bones or cartilages of the nose, nasal polyps, disease of the accessory sinuses and nasopharynx, atrophic rhinitis.

Note:-  Minor septal deviation that does not interfere with nasal airway, simple nasal deformity that is not causing disfigurement, and small traumatic septal perforations that are asymptomatic are acceptable.

1. 1. • Throat – Disease of throat, palate, tonsils, tongue, gums, and injury or disease that affect the normal function of either mandibular joints.
      • Disease of the larynx and impediment of speech – The voice should be normal and candidates who suffer from pronounced stammer will not be accepted.

Dental Conditions –

Candidates need to ensure that a sufficient number of sound and natural teeth are present for efficient mastication.

1. 1. • A minimum of 14 dental points are required to be deemed acceptable while assessing the dental condition of a candidate. If any candidate has fewer than 14 dental points then it may lead to their rejection. For teeth in good opposition with similar teeth in the other jaw, the dental points are assigned as follows –
        • Central incisor, canine, lateral incisor, 1st Premolar, 2nd Premolar, and underdevelopment of the 3rd molar with 1 point each.
      1. 1st molar and 2nd molar and fully developed 3rd molar with 2 points each.
      2. There will be a total count of 22 or 20 points when all the 32 teeth are present, depending on whether the third molars are well developed or not.
      3. The following teeth must be present in good functional apposition in each jaw –
      4. Any 4 of the 6 anteriors
      5. Any six of the ten posteriors.
      6. All the teeth must be repairable and sound.
      • Candidates who are going through severe pyorrhea will not be accepted. In case the condition of pyorrhea is such that it can be cured without the extraction of teeth in the opinion of the dental officer, candidates may be accepted or allowed. A note about the affected teeth needs to be entered by the medical or dental officer in the medical documents.
      • While counting the dental points, artificial dentures are not included.

Neck

1. 1. • Conditions such as tubercular, enlarged glands, or due to other diseases in the neck or other parts of the body.

Note: Any scar of the operation that resulted due to the removal of tubercular glands will not lead to any rejection, on the condition that there has been no active disease within the last five years and the chest of the candidate is radiologically and clinically clear.

1. 1. • Disease or syndrome of the thyroid gland.

Skin and Sexually Transmitted Infection or STI

1. 1. 1. Skin disease unless trivial or temporary.
      2. Scars which due to their extent or position may cause marked disfigurement or disability.
      3. Hyperhidrosis – Plantar, palmar, or axillary.
      4. Congenital, latent, or active sexually transmitted diseases.

Note – In case of an old healed scar over the penis or groin, vagina that suggests a past STI, a blood test will be done for the STI (including HIV) to exclude the latent STI.

Respiratory system

1. 1. 1. History of bronchial asthma or chronic cough.
      2. Any evidence of diseases of lungs, bronchi, or pleurae, if found on radiological examination of the chest, will lead to disqualification of the candidate.
      3. Any evidence of pulmonary tuberculosis.

Note- An x-ray examination of the chest will be done.

Cardiovascular System

1. 1. 1. Conditions such as the presence of murmurs, organic or functional disease of the heart or blood vessels, or clicks on auscultation.
      2. Tachycardia or pulse rate persistently over 96 per minute at rest, bradycardia in which pulse rate persistently is below 40 per minute at rest, any abnormality or disease of peripheral pulse.
      3. Blood pressure that exceeds 140 mm Hg systolic or 90 mm Hg diastolic.

Abdomen

1. 1. 1. Abdominal conditions such as evidence of history of any disease related to the gastrointestinal tract, gallbladder or spleen, enlargement of liver, tenderness on abdominal palpation, or any history of peptic ulcer or previous history of extensive abdominal surgery. Candidates for office entry are subjected to the ultrasound examination of the abdominal and pelvic organs in order to detect the abnormality of any internal organs.
      2. Any form of hernia or inguinal, or tendency thereto.

Note – Candidates who have gone through any operation for hydrocele or hernia, varicose veins, or varicocele can be declared fit provided they fulfil the following conditions –

i) The procedure or operation for hernia was carried out six months ago and 6 weeks should have elapsed for other minor operations. Candidates need to provide documentary proof for the same.

ii) General tone of the abdominal musculature should be good.

iii) No recurrence of hernia or any other complication related to the operation.

1. 1. • Anal fissure, fistula-in-Ano, and hemorrhoids until a satisfactory treatment of the same has been carried out.

Genito-urinary System

1. Any evidence or history of disease related to genital organs.

2. Unilateral or bilateral undescended testis that is retained in the inguinal canal or at the external abdominal ring unless it is corrected by the operation.

Note – Absence of one testis may not lead to rejection unless the testis has been removed because of disease or its absence affects the mental/ physical health of the candidate.

3. Malformation or disease of the kidneys or urethra.

4. Lack of self control for urine and nocturnal enuresis.

5. Abnormality on the examination of urine including glycosuria or albuminuria.

Central Nervous System

1. 1. 1. Any organic disease related to the central nervous system.
      2. Candidates who have a history of recurrent attacks of headaches or migraine or any kind of fits are not acceptable.
      3. Tremors

Psychiatric disorders- Any evidence or history of nervous instability or mental disease in candidates or their family.

Medical Standards For NDA ( Air Force) (Flying & Ground Duty Branches)

General instructions

All the candidates should pass the physical examination test. The requirements of the medical examination are also essential for the positions.

General Physical Assessment

Any candidate should meet the basic requirements for performing the duties.

Candidates should be free from any types of fractures or injuries.

1. 1. • Spine injuries : cases of any type of spine injury or fracture is unifit
      • Nerve injury : injuries of the nerve such as nerves of the larger trunk, loss of functions is considered unfit
      • Keloids: presence of large or multiple keloids is deemed unfit
      • Surgical scars: minor and well-healed scars are suitable for employment. Any form of large scars are considered unfit
      • Birthmarks: hypo or hyperpigmentation of the birth marks is considered unfit for the position
      • Subcutaneous swellings: lipoma is deemed unfit unless it is interfering with function. Neurofibroma is considered fit for the position
      • Cervical rib without any neurovascular defect is considered fit
      • Craniofacial deformity: asymmetry of the face or head or uncorrected deformities of the skull, mandible, or face which comes in the way of proper fitting of oxygen mask, helmet or military headgear will be deemed unfit for the position
      • A candidate who has undergone an abdominal operation entailing extensive surgical intervention or partial or  total removal of any organ is deemed unfit

Measurements and Physique

Chest circumference: the minimum chest circumference should be 77 cm with an expansion of 05 cm required for candidates.

Height, Sitting Height, Leg Length and Thigh Length for Male Candidates .

157.5 cm is the minimum height required for the ground duty branches.

For gorkhas and individuals belonging to north eastern regions, and hilly parts of Uttarakhand, it can be 5 cm less. The minimum acceptable height is 2 cm less i.e. 155.5 cm for candidates from Lakshadweep Islands.

Body weight parameters

Candidates should refer to ‘annexure A’ for the detailed parameters. A maximum of 10% is allowed as variation from the ideal body weight.

Weight above the prescribed limit can be allowed for special cases in which there is evidence of wrestling, boxing, bodybuilding, etc. Such candidates would still have to meet the following criteria:

1. 1. • BMI should be less than 27
      • Waist hip ratio must be lower than 0.9 for males and 0.8 for females
      • Waist circumference for females should be lower than 89 cm and for males less than 94 cm

Height and Weight Standards for Female Candidates joining NDA (Air Force).

Minimum height required for the flying branch is 162.5 cm

The minimum height required for entry into Ground Duty branches is 152 cm. For Gorkhas and people belonging to the north earstern regions and hilly areas of Uttarakhand, it is 5 cm less. The minimum acceptable height for candidates from Lakshadweep Islands is 2 cm lower.

Body Weight Measurements

A maximum of 10% body weight variation from the ideal is acceptable for female candidates.

Weight above the limits is only applicable for special cases with evidence of wrestling, boxing, bodybuilding, etc.

Candidates must meet the following criteria:

1. 1. • BMI should be below 27
      • Waist circumference is less than 94 cm in males and 89 cm in females
      • All biochemical parameters should be normal

Male Ideal Nude Weights for Different Age Groups and Heights for NDA (Flying & Ground Duty) Candidates on Entry

(10% variation on higher side of average is acceptable)

Female Ideal Nude Weights for Different Age Groups and Heights for NDA (Flying & Ground Duty) Candidates on Entry

(10% variation on higher side of average is acceptable)

Cardiovascular system

Any history of fainting, breathlessness, palpitations, giddiness, rheumatic fever, etc. is considered for observation and assessment from the cardiovascular surgeon.

1. 1. • Pulse : rate, rhythm, volume and regularity of the pulse should be monitored. Persistent tachycardia and bradycardia are considered unfit for the position
      • Blood pressure : the examiner should try to avoid conditions that can lead to White Coat Hypertension. BP consistently higher than 140/90 mm of Hg should be considered unfit
      • Cardiac murmurs: evidence of the organic cardiovascular diseases must be considered unfit and can lead to rejection
      • ECG : proper assessment of the ECG (resting – 12 lead) must be completed. The examiner should take the resting ECG of the candidate
      • Cardiac surgery: Candidates with a past surgery of the cardiovascular system will be considered unfit

Respiratory system

1. 1. • Pulmonary tuberculosis: Any form of scarring in pulmonary parenchyma or pleura demonstrated by opacity on the chest radiogram can lead to rejection
      • Pleurisy with effusion: any evidence of the pleural thickening can lead to rejection
      • Bronchitis: any repeated attacks of the wheezing, cough and bronchitis can be a manifest sign of chronic bronchitis and can lead to rejection
      • Bronchial asthma: repeated attacks of bronchial asthma, or wheezing and allergic rhinitis can lead to rejection
      • Radiograph of the chest: radiological evidence of disease in the pleura, mediastinum, and lungs will lead to rejection
      • Thoracic surgery : Candidates with history of resection of lung parenchyma are considered unfit for the position

Gastrointestinal System

Examiner should examine the system for any ulcerations, mouth related diseases, tongue or throat problems

1. 1. • Head to toe examination : evidence of malabsorption, liver failure, oral mucosa, gum problems, any restriction of mouth opening, loss of hair, spider naevi, and flapping tremors must be examined properly
      • Gastro duodenal disabilities: candidates suffering from acid peptic disease or ulcers and past surgery involving complete or partial removal of an organ – barring gallbladder/vestigial organs – are considered unfit
      • Diseases of the liver: abnormality in the functions of the liver or jaundice and viral hepatitis is considered unfit for the position Candidates will be considered for the position after a minimum of 6 months has elapsed following full clinical recovery
      • Diseases of spleen : candidates who have undergone partial or complete splenectomy are considered unfit for the position
      • Hernia : any form of abdominal wall hernia is considered unfit for the position
      • Abdominal surgery: candidates having well healed scars or after a proper recovery  are deemed fit after one year of successful surgery, provided there is no likelihood of recurrence. Cases of abdominal laparoscopic procedures can be deemed fit following 8 weeks of successful surgery provided recovery is complete and the candidate has no symptoms

Anorectal conditions

Examiner should perform a digital rectal examination and rule out fissures, haemorrhoids, anal skin tags, polyps, rectal mass and fistulae. A candidate is fit if he/she meets the following criteria:

1. 1. • External skin tags
      • There should be no recurrent disease after following rectal surgery for polyps, haemorrhoids, fissure, fistula or ulcer

A candidate is declared unfit is he/she meets the following criteria:

1. 1. • Anal Fistula
      • Anal or rectal polyp
      • Anal stricture
      • Faecal incontinence
      • Rectal prolapse even after surgical correction
      • Active anal fissure
      • Haemorrhoids (external or internal)

Ultrasonography of the Abdomen

Liver

Fit conditions are:

1. 1. • Hepatic calcifications are considered fit if they are solitary and less than 1 cm
      • Solitary simple cyst of upto 2.5 cm in diameter
      • Normal echo-anatomy of the liver, IHBR, CBD, portal and hepatic veins

Unfit conditions are:

1. 1. • Portal hypertension
      • Portal vein thrombosis
      • Any Hemangioma
      • Multiple hepatic cysts of any size
      • Multiple hepatic calcifications
      • Solitary cysts of any size with thick walls, papillary projections, septations, calcifications and debris
      • Hepatomegaly
      • Fatty liver
      • Solitary cyst more than 2.5 cm

Gallbladder

Fit conditions are:

1. 1. • Post open cholecystectomy: candidates are considered fit if one year has passed since successful surgery
      • Candidates who have gone through laparoscopic cholecystectomy may be considered fit after 08 weeks of successful surgery
      • Normal echo anatomy of gallbladder

Unfit conditions are:

1. 1. • Cholelithiasis or biliary sludge
      • Choledocolithiasis
      • Polyp of any size and number
      • Choledochal cyst
      • Gall bladder mass
      • Gallbladder wall thickness > 05 mm
      • Septate gallbladder
      • Persistently contracted gallbladder on repeat USG
      • Incomplete Cholecystectomy

Spleen

Unfit conditions are:

1. 1. • Spleen more than 13 cm in longitudinal axis
      • Any Space Occupying Lesion in the spleen
      • Asplenia
      • Candidates who have undergone partial/ complete splenectomy are unfit, irrespective of the cause of operation

Pancreas

The unfit conditions are:

1. 1. • Chronic pancreatitis
      • Lesion or mass lesion
      • Structural abnormality

Peritoneal Cavity

The unfit conditions are:

1. 1. • A mass or cyst
      • Two or more lymph nodes of any size
      • Solitary mesenteric or retroperitoneal lymph node of more than 1 cm
      • Ascites

Major abdominal vasculature : Any structural abnormality or aneurysm and calcifications are considered unfit for the position.

Urogenital System

Examiners should examine the urogenital system properly. Any history or past evidence of sexually transmitted diseases or urethral discharge should be considered unfit.

Undescended Testis

Unfit

Any abnormality in the position of the testis is considered unfit.

Fit

Operatively corrected UDT can be considered fit for the position at least 04 weeks after successful surgery provided the testis is normal in location and the wound is well-healed

Varicocele

Unfit : all grades of varicocele are considered unfit.

Fit : postoperative varicocele with no residues of any varicocele and no post-surgical complication may be deemed fit after 04 weeks of surgery

Hydrocele

Fit: operated cases of hydrocele are considered fit for the position.

Unfit : current hydrocele on any of the sides.

Epididymal Cyst/ Mass, Spermatocele

Fit: post operative cases without any residue is considered fit.

Unfit : presence of cyst or mass.

Orchitis

Unfit : presence of current orchitis or tuberculosis is considered unfit.

Fit: after the treatment it is considered fit.

Epispadias/Hypospadias

Unfit : all forms are unfit, except ganular variety of hypospadias and epispadias

Fit: post operative at least after 8 weeks of successful operation and complete recovery.

Penile amputation : any amputation of the penis will make the candidate unfit.

Phimosis

Unfit: Current phimosis, if interfering with local hygiene and voiding and/ or associated with Balanitis Xerotica Obliterans.

Fit: Operated cases will be considered fit after 04 weeks of successful surgery, provided the wound is completely healed and no post-surgical complications are seen.

Meatal Stenosis

Unfit: Current condition, even if small enough, that interferes with voiding

Fit: mild disease without any voiding problems or postoperative after 4 weeks of operation  and recovery is considered fit.

Urethral fistula : any current cases or past evidence is considered unfit.

Intersex condition : unfit

Nephrectomy : all cases are considered unfit.

Renal transplant recipients: unfit

Urine examination

1. 1. • Proteinuria : proteinuria can be cause for rejection
      • Glycosuria: renal glycosuria is not a cause of rejection
      • Urinary infection : any past history of infections should be examined properly
      • Hematuria : candidates with past evidence of hematuria will have to undergo full renal investigation

Glomerulonephritis

1. 1. • Acute: candidate has no signs or symptoms after a minimum of one year of complete recovery is deemed fit
      • Chronic: any chronic form of glomerulonephritis is considered unfit

Renal colic or calculi :in this case complete renal test and examination is required.

Sexually transmitted diseases or HIV: any evidence will lead to rejection.

Kidneys, Ureter and Urinary Bladder

Unfit conditions are as follows:

1. 1. • Congenital structural abnormalities of kidneys or urinary tract including crossed fused/ ectopic kidney, Unilateral renal agenesis, Unilateral or bilateral hypoplastic/ contracted kidney of size less than 08 cm, malrotation of kidney, Ptosed kidney and Horseshoe kidney
      • Simple single renal cyst of more than 1.5 cm size in one kidney
      • Complex cyst/ polycystic disease/ multiple or bilateral cysts.
      • Renal/ ureteral/ vesical mass
      • Hydronephrosis or Hydroureteronephrosis
      • Calculi – Renal/ Ureteral/ Vesical

Fit conditions are solitary, unilateral or simple renal cyst of less than 1.5 cm

Scrotum and Testis

Following conditions are made unfit:

1. 1. • Bilateral atrophic testis
      • Varicocele (Unilateral or bilateral)
      • Any abnormal location of testis (Unilateral or Bilateral)
      • Hydrocele
      • Epididymal lesions e.g. cyst

Endocrine System

1. 1. • Candidates suffering from diabetes mellitus will be rejected
      • All cases of thyroid swelling showing abnormal iodine uptake and abnormal thyroid hormone levels will be deemed unfit
      • If clinical examination shows any current endocrine disease it can lead to rejection
      • Any past history or evidence indicative of endocrine disorders will warrant rejection

Dermatological System

• • • • To obtain a clear picture of the severity and nature of any dermatological condition found, the candidate has to go through interrogation and examination of the skin
      • Borderline skin conditions will be referred to a dermatologist
      • Candidates who have history of sexual exposure to commercial sex worker or a healed penile sore will be declared permanently unfit even if they do not have any overt STD conditions due to possibility of a repeat of similar promiscuous behaviour
      • Assessment of disease of the skin- Acute non- exanthematous and non-communicable diseases that generally last a short time will not be considered unfit
      • In addition to that, any trivial disease that does not interfere with the general health of the candidate and causes any type of incapacity will not lead to rejection
      • Under tropical temperatures, a few skin conditions are more likely to become active and impair
      • If the candidate goes through any chronic or recurrent skin disease or has a history of the same, he or she will be considered unfit

Some of these conditions are listed below –

1. 1. 1. 1. 1. An amount of palmoplantar hyperhidrosis is physiological, in view of the situation that recruits face during the medical examination. However, candidates who suffer from a significant amount of palmoplantar hyperhidrosis will be considered unfit.
            2. Mild or grade 1 acne that consists of a few comedones or papules that are limited only to the face may be acceptable. However if the degree of the acne is moderate to severe or nodulocystic type with or without keloid scarring and involves the back will be considered unfit.
            3. Any degree of palmoplantar keratoderma  manifested with hyperkeratotic and fissured skin over the palms, heels and soles will be considered unfit.
            4. Ichthyosis that involves upper and lower limbs, evidently dry, fissured, and scaly skin should be considered unfit. Mild xerosis or dry skin could be considered fit.
            5. Candidates who have any keloid will be considered unfit.
            6. Onychomycosis of toenails and fingers, that is clinically evident, is considered unfit, especially if it is related with nail dystrophy. Candidates who have a mild degree of distal discoloration that involve a single nail only without any dystrophy can be accepted.
            7. Giant congenital melanocytic naevi that is greater than 10 cm is considered unfit since there is a malignant tendency in such a large-sized naevi.
            8. Single corns or callosities or warts are considered fit, provided it has been 3 months after the successful treatment and there is no recurrence. Candidates with multiple corns or callosities or warts on palms and soles or diffuse palmoplantar mosaic warts, large callosities on pressure areas of palms and soles will be rejected.
            9. Psoriasis is a long-term skin condition that is known to relapse and/or recur and hence it is considered unfit.
            10. Candidates that suffer from a minor degree of leukoderma that affect the covered parts can be accepted. Vitiligo that is limited only to the glans penis and prepuce can be considered fit. Candidates who have an extensive degree of skin involvement especially when the exposed parts are affected, even if it is to a minor degree, will be considered  unfit.

Musculoskeletal System and physical Capacity

Candidate is examined on the basis of his/her general factors such as muscular development, height, weight and age. Additionally, the stamina of their body is one of the major parameters that is examined. The physical capacity of the candidate is affected by his or her overall physical development as well as any pathological or constitutional conditions.

Spinal conditions

Any evidence of past injury or diseases of the sacroiliac joints or spinal cord, with or without, any signs or symptoms can lead to rejection of the candidate.

Evaluation of Spine:

Clinical examination

Conditions such as normal thoracic kyphosis and lumbar/cervical lordosis do not generally come in notice and thus are not related to pain or restriction of movement.

1. 1. 1. If the clinical examination shows the deformities, restriction of spine movements, gaur abnormality, or tenderness of the spine, then the candidate will be considered unfit.
      2. Gross kyphosis that affects the military bearing  or restricts the full range of spinal movements or/and expansion of the chest is considered unfit.
      3. Scoliosis is considered unfit if the disability continues to stay on full flexion of the spine, when related to restricted range of spinal movements or due to any underlying pathological reason. A radiographic examination of the required part needs to be carried out if the condition of scoliosis or any pathological conditions of the spine is noticeable.
      4. Spina bifida: Below mentioned conditions should be examined properly, on clinical examination and supported with radiological evaluation:
      • Abnormal findings on the neurological examination
      • Palpable spina bifida
      • Presence of lipoma over spine
      • Congenital defects that overlays the spine, for instance, skin dimpling, hypertrichosis, haemangioma, dermal sinus, or pigmented nevus

Radiograph of the Spine

For the flying duties, proper radiographic examination (AP and lateral views) of thoracic, cervical, and lumbosacral spine should be carried out by the examiner. For ground duties, a radiographic examination of the spine can be performed if asked by the Medical specialist or officer.

Spinal conditions unfit for the Air Force duties (Both flying and ground duties)

Congenital/Development Anomalies

1. 1. 1. 1. Wedge vertebra
         2. Anterior central defect
         3. Spina Bifida: Of every type is considered unfit except sacrum and LV5 (if fully sacralised)
         4. Hemivertebra
         5. Cervical ribs (unilateral/bilateral) with demonstrable neurological or circulatory deficit
         6. Loss of cervical lordosis when examined with clinically restricted movement of cervical spine

•  Scoliosis

Traumatic Conditions

1. 1. • Schmorl’s nodes at more than one level
      • Intervertebral disc prolapse
      • Compression or fracture of vertebrae
      • Spondylolysis/ Spondylolisthesis

Infective

1. 1. • Tuberculosis and other Granulomatous diseases of spine (active or old)
      • Infective Spondylitis

Autoimmune

1. 1. • Rheumatoid Arthritis and allied disorders
      • Ankylosing spondylitis
      • Other rheumatological disorders of the spine, e.g- SLE, Polymyositis, Vasculitis

Degenerative

1. 1. • Spondylosis
      • Degenerative Disc Disease
      • Degenerative Joint Disorders
      • Osteoarthrosis/ osteoarthritis
      • Scheuermann’s Disease  (Adolescent Kyphosis)

Note: Any other spinal abnormality, if considered by the medical specialist.

Conditions Affecting the Assessment of Upper Limbs

Deformities of the upper limbs or any kind of disease can lead to rejection. Candidates with amputated limbs will not be accepted. However, the conditions of amputation of the terminal phalanx of the little finger on both sides is acceptable.

Healed Fractures

1. 1. 1. Following conditions are considered unfit
      • Fractures involving articular surfaces
      • Fractures associated with neuro-vascular deficit
      • Fracture causing impairment of function
      • Malunited fractures
      • Fractures with implants in-situ
      • Upper limb fractures that are presented 6 months after the injury with no sequelae as mentioned in the above section will be accepted after the assessment carried out by the orthopaedic surgeon

Fingers and Hands:

1. 1. • Syndactyly and polydactyly are considered unfit except when the condition of polydactyly is excised
      • Any disabilities and restrictions to movements are considered unfit

Wrist

Any painless restriction of movement of the wrist will be assessed on the basis of stiffness. Loss of dorsiflexion is considered a more serious condition than loss of palmar flexion.

Elbow

Slight limitation of movement is acceptable, provided there are no functional limitations. Ankylosis will lead to rejection and cubitus valgus needs to be presented when the carrying angle i.e angle between the arm and forearm in anatomical posture) is exaggerated. A carrying angle of up to 15 degrees in male applicants and 18 degrees in female applicants would be considered fit in the absence of functional impairment and an evident cause such as a fracture mal-uniom, fibrosis, or the like.

Note: Cubitus varus or > 5 degree is considered unfit.

Shoulder Girdle- History of recurrent dislocation or any deformities, with or without the corrective surgery, is considered unfit.

Clavicle

Nonunion of an old form of fracture of clavicle can lead to rejection. Mal-union clavicle fractures without the apparent disability or loss of function can be accepted.

Conditions Affecting the Assessment of Lower Limbs

1. 1. • Hallux valgus with any degree of corn and bunion or callosities is considered unfit. Also, hallux valgus with an angle > 20 degrees and first second metatarsal angle of > 10 degrees is considered unfit
      • Hallux rigidus will be unfit for service
      • Isolated single flexible mild hammer toe without symptoms can be accepted
      • Conditions such as fixed deformity or hammer toe related to corn, mallet toes, callosities, or hyperextension at meta tarso phalangeal joint (claw toe deformity) will be rejected
      • Loss of digits or toes entails rejection
      • Extra digits will warrant rejection if there is bony continuity with the adjacent digits. Conditions of syndactyly will not be accepted

Pes Planus (Flat feet)

1. 1. • If the arches of the feet of the candidate appear again on standing on toes, if the applicant can run and skip well on the toes and if the feet are supple, painless, and mobile, he/she will be accepted
      • The condition of rigid or fixed flat feet, gross flat feet, with planovalgus, eversion of heel, unable to balance him/herself on toes, unable to skip on the forefoot, prominent head of talus, tender painful tarsal joints will be unacceptable
      • Any restriction related to the movements of the foot will lead to rejection
      • If there is any rigidity of the foot, no matter what the shape of the foot, will be unacceptable

Pes cavus and talipes (Club foot)

1. 1. • A mild degree of idiopathic pes cavus without any functional limitations will be accepted
      • The conditions of moderate and severe pes cavus and pes cavus due to organic disease will lead to rejection
      • Any type of talipes or clubfoot cases will not be accepted

Ankle Joints

1. 1. • Any significant limitation to the ankle joint that is followed by previous injuries is unacceptable
      • Functional evaluation with imaging will be carried out wherever required

Knee Joint

1. 1. • Any ligamentous limitation is unfit. Candidates who have been through ACL reconstruction surgery are considered unfit
      • Genu valgum or knock knee with intermalleolar distance >5 cm in male candidates and >8 cm I’m female candidates is considered unfit
      • Bow legs or Genu varum with intercondylar distance >7 cm is considered unfit

Genu Recurvantum

1. 1. • Candidates can be accepted if the hyperextension of the knee is within 10 degrees and not accompanied by any other disability
      • True lesions of the hip joints or early signs of arthritis will lead to rejection

Peripheral Vascular System

1. 1. • Varicose veins: All the cases of the active varicose veins will be considered unfit and Post-op cases of varicose will be considered unfit as well
      • Arterial system: Any history of  abnormalities of the arteries as well as blood vessels, eg. aneurysms, and arteries and peripheral arteries are considered unfit
      • Lymphoedema: History or past/active evidence of the disease is considered unfit

Central Nervous System

If a candidate has any history of psychological afflictions or mental illness then a psychiatric referral will be needed. In addition to this a detailed investigation will take place. Normally, such cases are rejected. However, the history is not volunteered in most cases. The examiner or the medical officer should directly question the candidate which may or may not be result oriented. The prior history or family history of using medications holds relevance. On examining, the examiner should develop or create the impression of the personality of the candidate on a general level. He should test the reactions of candidates to stressful and difficult conditions

If the candidate comes with a persistent or recurrent history of sleepwalking, insomnia, phobias, bed-wetting or nightmares, then he/she will be rejected

If a candidate is suffering from migraine and that he/she consulted a doctor for that then it will be a case of rejection. Even if the candidate experienced a single attack of migraine which led to migrainous epilepsy or visual disturbance, then he/she will be termed unfit for training. There are few recurrent headaches which are due to migraine or head injury. Some other occasional headaches will be considered after knowing its cause

Candidate will be rejected if he/she has a history of epilepsy. If fits or convulsions are experienced by a candidate after age 5, then this will also lead to rejection. Some of the probable reasons for epilepsy are: stroke, traumatic brain injury, genetic factors, infection, birth defects, withdrawal seizures, substance abuse, demyelinating disorders, etc. There should be a proper enquiry by the examiner officer. It should not confine itself to occurrence or frequency of major attacks. Seizures should be considered like faints. The examiner should elicit the conditions and frequency of these faints. In such cases, the candidate will be termed unfit for service. If there is any isolated fainting then in that condition the factors between seizures and syncope will be distinguished. In case, a candidate goes through complex partial seizures wherein there is a vegetative movement such as periods of unresponsiveness, dazed appearance, staring, chewing and lip smacking then he/she will be considered unfit. If there are convulsions in infancy then it needs to be examined whether they are febrile convulsions or not. It should be noted that these convulsions are not associated with any neurological deficit

If the candidate has any history of hyperpyrexia or heat exhaustion or heat stroke and that these attacks are repetitive then this restricts the candidate from being employed for Air Force duties. This shows pure evidence of faulty heat regulating mechanisms. If the candidate suffered from a single severe attack and that there was no evidence of permanent sequelae then this will not be a reason behind rejecting the candidate from training

If a candidate has a history of severe head injury then he/she will be rejected. If a candidate displays other sequelae of head injury such as post traumatic epilepsy or focal neurological deficit or post-concussion syndrome then his /her associated subjective symptoms such as attention deficits, poor concentration, irritability, restlessness, insomnia, dizziness or headache should be noted. Candidate might suffer from post traumatic neuropsychological impairment such as psychological functioning, frontal lobe executive functions, mental flexibility, information processing speeds and deficit in attention concentration. To assess this, neuropsychological testing along with psychometry should be done. It should be noted that sequelaq might persist for some time and may become a permanent problem. If a candidate has a skull fracture  then he/she would not be rejected. But, rejection might happen if the candidate has a history of any residual bony defect in the calvaria or history of associated intracranial damage. Electroencephalogram needs to be done if the candidate has any history of associated convulsive attack or severe injury.If candidate has burr holes then he/she will be rejected for flying duties but not for ground duties. Every case or situation of the candidate will be examined and judged on an individual basis of merit. Opinions of both psychiatrist and neurosurgeon will be taken before accepting

If candidate has a history of mental disease or nervous breakdown or if there has been any suicide of a near relative then examiner needs to properly investigate their personal past history. This needs to be evaluated from a psychological viewpoint. If the examiner notices even slightest psychological instability in the present or past condition of the candidate, this may result in rejection. The candidate will be referred to a psychiatrist to evaluate further

If any one in the candidate’s family history has been admitted due to epilepsy, the examinee has to make an attempt to determine its type. If this situation is seen in a first degree relative then the candidate will be accepted. But, only if the candidate is not having any condition of neurological deficit, associated disturbance of consciousness, and that his or her electroencephalogram is normal

If a candidate is suffering from any stammering issue, he/she will not be taken for Air Force duties. His/her condition will be assessed by a psychiatrist, psychologist, speech therapist or ENT specialist in doubtful conditions

Candidates suffering from psychosis are subject to rejection. In case, the candidate is dependent on any drug then he/she will be rejected

If any neurological deficit is found in the candidate, then he/she will be rejected

Basal Electroencephalogram (EEG)

Candidates for aircrew duties will have to go through EEG in case there is any evidence of epilepsy in the family, history of head injury or/and any other psychological or neurological disability notes in the past. These conditions will be carefully examined. In case of other candidates wherever EEG is required by the medical examiner, will be taken. Candidates with the following EEG abnormalities in resting EEG or EEG under provocative techniques will lead to  rejection for aircrew duties:

Background activity:

Focal, excessive and high amplitude beta activity or hemispherical asymmetry of more than 2.3 Hz/ generalised and focal runs of slow waves that approach the background activity in amplitude.

Candidates suffering from focal spike pattern, spikes, slow waves and paroxysmal spikes are subject to rejection.

Photo Stimulation:

Candidates suffering from focal paroxysmal spikes or bilaterally synchronous spikes or slow waves persisting in post-photic stimulation suppression/period or driving response over one hemisphere are subject to rejection.

If a candidate is suffering from non specific EEG abnormality then a neurophysican’s or neuropsychiatrist’s opinion will be needed. The findings obtained for EEG will be noted in AFMSF – 2. If the EEG is noted as abnormal then the cadet will be referred to CHAF. A neuro physician will evaluate the cadet. The board at IAM IAF will also review the cadets

Ear, Nose and Throat

• History- Any evidence of otorrhoea, vertigo that includes tinnitus and motion sickness etc, hearing loss needs to be extracted

Note: The audiometer’s baseline zero and the external noise conditions under which the audiogram was acquired should both be considered when analysing the audiogram. An isolated unilateral hearing loss of up to 30 decibels may be accepted on the advice of an ENT specialist if the ENT examination is otherwise normal.

• Ears- A modified radical or radical mastoidectomy will lead to the rejection even if it is fully healed  and good hearing is restored. Conditions such as cortical mastoidectomy in the past with the tympanic membrane intact, sound  and normal hearing and no evidence of any disease will be accepted.
• External ear- The following conditions related to external ear will be declared unfit:

1. 1. 1. 1. Gross malformation of pinna that can affect the wearing of uniform or personal kit, protective equipment something that adversely affects the military bearing
         2. Condition of chronic otitis externa
         3. Exostosis, atresia/narrowing of the EAM or neoplasm that prevents a proper examination of the eardrum
         4. Exaggerated tortuosity of the canal, eliminating the anterior view of the tympanic membrane may lead to rejection
         5. Granulation or polyps in external auditory canal

• Middle ear- the conditions listed below will result in rejection:

1. 1. 1. 1. Attic, central or marginal perforation
         2. Current otitis media of any type
         3. Tympanosclerosis or scarring that affects more than 50% of the pars tensa of TM is considered unfit even if the tympanometry and PTA are normal. Evidence of the healed chronic otitis media in the form of tympanosclerosis or scarring that affects less than 50% of Pars tensa of TM will be examined by the ENT specialist and then become acceptable of the PTA and tympanometry and normal. Examination of the decompression chamber will be carried out for the air crew, divers or submariners, ATC/FC, if indicated.
         4. Any evidence of residual perforation in the case of old otitis media.
         5. Marked retraction in the TM mobility on pneumatic otoscopy.
         6. Evidence of hearing impairment in the forced whisper test.
         7. Deranged pure tone audiometry thresholds.
         8. Tympanometry that shows the patterns other than type A tympanogram.
         9. Implanted hearing devices such as cochlear implants, bone anchored hearing aids, etc.
         10. After middle ear surgery viz. Ossiculoplasty, stapedectomy, any type of canal-wall down mastoidectomy.

Note- If the PTA and Tympanoplasty are normal, healed healthy scars of neo-tympanic membrane involving less than 50% of the Pars Tensa caused by Type 1 Tympanoplasty (with or without Cortical Mastoidectomy) for Chronic Otitis Media (Mucosal type) and Myringotomy (for Otitis Media with Effusion) may be acceptable. Only after a minimum of 12 weeks, will operating cases be evaluated. If necessary, a decompression chamber trial for pilots, ATC/FC, submariners/divers may be conducted.

• Miscellaneous ear conditions- the following error conditions will also lead to rejection-

1. 1. 1. 1. Otosclerosis
         2. Vestibular dysfunction that includes nystagmus of vestibular origin
         3. Bell’s palsy following ear infection
         4. Meniere’s disease

Ophthalmic System

• Medical ophthalmic conditions and visual defects are the two major causes for rejection from flying duties. Thus, candidates have to go through an accurate and comprehensive eye examination, especially for flying duties.
• Personal and family history and external examination

Ocular muscle balance

• Candidates with manifest squint will not be accepted for commissioning. The examination of the latent squint or heterophoria in case of air crew will depend upon the assessment of the fusion capacity. Strong fusion sense ensures the maintenance of binocular vision in case of fatigue and stress any 10 it is the main criteria for the acceptability.

Concentration, worry, exhaustion, hypoxia, narcotics, and alcohol all affect ocular muscle balance. For the final evaluation, all of the following tests should be taken into account. Cases just over the Maddox Rod test’s maximum limits, but with a solid binocular response, good objective convergence with little variation from subjective convergence, and full and rapid recovery on the cover tests, for example, may be acceptable. Cases that are well within Maddox Rod test limitations but have little or no fusion capability, incomplete or no recovery on cover tests, and poor subjective convergence, on the other hand, should be excluded.

Any clinical evidence in the media (cornea, vitreous, or lens) or fundus of pathological nature and could progress is a cause of rejection. The examination for the same will be done by the slit lamp and ophthalmoscopy under mydriasis.

Visual Standards for male candidates at initial entry

Note 1: For personnels covered under serial number 1 and 2, ocular muscle balance will be in accordance with the standards laid down.

Note 2: The A1G1 F (P) standard should be followed by Air Wing Candidates at NDA and Flt Cdts of F (P) at AFA).

Note 3: The astigmatic correction factor will be included in the Sph correction factors listed above. Up to the given visual acuity level, a minimum correction factor can be permitted.

Visual Standards for Female candidates at Initial Entry

Standard of Ocular Muscle Balance for flying duties for male candidates

Standard of Ocular Muscle Balance for flying duties for Female candidates

Haemopoietic System

The following issues must be elicited in case of female candidates:

• History of easy fatiguability
• Petechiae/ ecchymosis
• Bleeding from gums and alimentary tract
• Persistent bleeding after minor trauma and menorrhagia
• General weakness

It is very essential to examine all candidates for detecting clinical evidence of hepatosplenomegaly, petechiae/ ecchymoses, purpura, malnutrition, pallor (anaemia),peripheral lymphadenopathy and icterus.

1. 1. • Candidates suffering from any ailment pertaining to haemoglobinopathies (Beta Thalassaemia: Major, Intermedia, Minor, Trait, Sickle cell disease,  and Alpha Thalassaemia etc.) and hereditary haemolytic anaemias (due to red cell membrane defect or due to red cell enzyme deficiencies) will be considered unfit for training
      • If candidates are suffering from any issues pertaining to von Willebrand‘s disease, history of haemophilia on evaluation will be considered unfit for training
      • If any candidate has a history of epistaxis, haemorrhage into the skin like ecchymosis/ petechiae, persistent bleeding after minor trauma,  bleeding from gums and alimentary tract, menorrhagia in females, tooth extraction,  lacerations, bleeding disorders or any family history of haemophilia then  a complete evaluation will be undertaken
      • Candidates with such issues will not be considered for training
      • If any clinical evidence of thrombocytopenia or purpura is found in candidates then they will be considered unfit for the training
      • If any female candidate has purpura simplex or simple easy bruising then she might be accepted for training
      • If any candidate is suffering from iron deficiency anaemia (mild microcytic hypochromic) or dimorphic anaemia, then initially they will be considered unfit for 4 to 6 weeks of time
      • In females it should be Hb < 10.5g/dl while in males it should be < 11.5g/dl)
      • Post 4 to 6 weeks, the candidate’s condition will be reviewed again
      • On testing, if the peripheral smear results, PCV and complete haemogram are in normal range then candidates will be considered fit and will be selected for the service
      • In case, candidates are suffering from megaloblastic anaemia then they will be considered unfit for training
      • As per laboratory tests in case of anaemia, the values should be <11.5g/dl in females and <13g/dl in males
      • In case, there is any differentiation then further tests and evaluations to ascertain type of aetiology and anaemia will be carried out
      • A complete haemogram (including Platelet count, ESR, reticulocyte count, DLC, TWBC, TRBS, MCHC, MCH, MCV, PCV and peripheral blood smear) will be done and other tests to establish aetiology will be undertaken
      • Other tests such as haemoglobin electrophoresis, proctoscopy, endoscopy, upper GI, ultrasonography of abdomen to check gallstones, etc will be carried out and as per the results, the fitness of the candidate will be indicated

Dental Fitness Standards

1. 1. • While examining, the examiner should check about any presence of past dental alterations or procedures
      • Any infection of tongue, past history of ulceration, throat or gums will be noted
      • Any historical presence of premalignant pathologies or lesions that have high probability of recurrence should be elicited
      • Dental Standards:

Candidates should abide by the following dental standards to get selected for training. In case, any candidate fails to adhere to these dental standards then he/she will be rejected.

1. 1. 1. It is a must for candidates to have a minimum 14 dental points. Candidate should have either any six of the ten posterior or any four of the six anterior in the upper jaw of the candidate. They should be in a good functional opposition corresponding to the teeth in the lower jaw.
      2. One dental point value will be given to the presence of 1st premolar, 2nd premolar, canine and incisor. They should have the corresponding teeth in the opposite jaw.
      3. Two dental points value will be given for both 1st and 2nd molar as well as 3rd molar if properly developed. They should have the corresponding teeth in the opposite jaw.
      4. If the 3rd molar is not properly developed then it will get one dental point.
      5. Depending on whether the 3rd molar is well developed or not, 20 to 22 points will be given in case all 16 teeth are there in the upper jaw and in opposition to corresponding teeth in the lower jaw.
      6. While oral examining, dental prosthesis will be removed. Candidates will not get any dental points. In case any ex-serviceman is applying for re-enrolment then dental points will be given for well fitting removable prostheses.

Extra Oral Examination

In case, there are any scars, hard tissue defects, soft tissue defects, gross asymmetry or any pathological condition of the jaw then the candidate will be rejected.

Functional examination

Ii. Temporomandibular joint (TMJ): If any candidate is suffering from dislocation of the TML, tenderness or symptomatic clicking on wide opening then they will be rejected. Also, TMJs will be bilaterally palpated for tenderness and/or clicking.

Guidelines for awarding dental points in special situations

a. Dental Caries:

If a candidate’s teeth has caries and that they have issues pertaining to restoration, sinuses, teeth with abscesses, pulp exposure, broken down crowns, residual root stumps, etc… then dental points will not be given to them.

b. Restorations:

If a candidate’s teeth have been restored and that they appear discoloured or broken or improper then they will not be given any dental points. In case, the teeth is restored with the help of periapical pathology, doubtful marginal integrity, temporary or fractured restorations or inappropriate materials will not be given any dental points.

c. Loose Teeth:

In case, a candidate’s teeth is mobile or loose and is suffering from clinically demonstrable mobility then dental points will not be given to them. In case a candidate has periodontally splinted teeth then they will not get any dental points.

d. Retained deciduous teeth:

Candidates with retained deciduous teeth will not be awarded any dental point.

e. Morphological defects:

Candidates having structural defects who experience inefficient mastication will not get any dental points.

f. Periodontium:

• Candidates with generalised calculus, extensive swollen and red gums, with or without exudates, will be rejected. 
• If the individual teeth of candidates have visible calculus or have swollen, infected or red gums, then they will not get any dental points. 
• The candidates will be awarded dental points only if the condition of their teeth and gums is healthy. The gums should be pink in colour. Their teeth should be firm when it comes to consistency. There should not be any  visible calculus. Gums should be firmly resting against the necks of the teeth. 

g.  Malocclusion:

If candidates are suffering from malocclusion which is affecting the phonetics and efficiency of mastication then they will not be selected for training. No dental points will be given for teeth in open bite. If candidates are suffering from any visible malocclusion or reverse overjet or open bite then they will not be finalised for training. Candidates will be termed fit only if the dental officer examines their teeth and states that malocclusion is not affecting general nutrition, maintenance of oral hygiene, phonetics, efficiency of mastication, etc…  The following are some criteria that will be considered and assessed in examining malocclusion

Edge to edge bite:

If there is edge to edge biting then it will be taken into consideration as functional apposition

Anterior Open Bite:

If there is anterior open bite then it will be considered as lack of functional opposition of involved teeth

Cross Bite:

If the teeth is in cross bite but it is still in functional occlusion then it might be awarded

Traumatic bite:

If the anterior teeth of the candidate is involved in deep impinging bite and it is leading to traumatic indentation on the palate then dental points will not be awarded

h. Soft and hard tissues:

Soft tissues of tongue, palate, lips, cheek and mandibular bony apparatus, maxilla and sublingual region must be examined. It will be examined in order to check submucous fibrosis, white patches, scars, ulcers, discoloration, swelling, etc… In case, any potential malignant lesions are found then it will lead to rejection. Sub mucous fibrosis will be clinically diagnosed. If it is present with or without restriction of mouth opening then it will lead to rejection. The bony lesion (s) will be examined and checked by the dental officer. It will check for physiological and pathological nature. Accordingly, the examiner will comment. In case of soft tissue or hard tissue lesion then it will lead to rejection.

i. Orthotic appliances:

If candidates are wearing any removable or fixed orthodontic appliances then they will be considered unfit for training. If a candidate is wearing fixed orthodontics lingual retainers then it will not be regarded as periodontal splints. The teeth which are included in these retainers will be given dental points for fitness.

j. Dental implants:

If any candidate’s single missing tooth is replaced by an implant supported crown then dental points will be awarded for prosthesis if and only if the prosthesis is in functional apposition and the integrity of the implant is confirmed.

k. Fixed Partial Dentures (FPD)/ Implant supported FPDs:

The fixed partial denture of candidates will be assessed clinically. It will be examined radiologically for checking periodontal health of the abutments, functional apposition to opposing teeth and its firmness. Dental officers will check all the parameters and then award dental points if they are found satisfactory.

I. Tooth supported FPDs

• 3 units, Prosthesis: Candidates with pontic and abutments will be awarded dental points
• More than 3 units, Prosthesis: Candidates with abutments will be awarded dental points. Pontics will not get any award.
• Cantilever FDPs: Abutments will be awarded dental points

II. Implant support FPDs:

• 3 units, Prosthesis: Pontic, implant and natural teeth will be awarded dental points
• More than 3 units, Prosthesis: Only natural teeth will be awarded dental points. Implant (s) or Pontics will not get any points
• 2 unit, cantilever FPDs: Only implants will get dental points

Candidates can only have a maximum of 2 implants. If it exceeds then no dental points will be given. If any candidate is having more than 3 implant supported prosthesis or implants then the dental officer will award marks according to his/her clinical judgement.

A candidate will be declared unfit in following situation:

1. Oral Hygiene: The oral health of the candidate is deemed poor when suffering from bleeding gums, periodontal pockets, and gross visible calculus. Such  candidates will be considered unfit.
2. Candidates reporting maxillofacial trauma/post maxillofacial surgery: If a candidate has undergone any post-traumatic maxillofacial trauma/surgery or any cosmetic surgery then he/she will be considered unfit for a period of minimum 24 weeks from date of injury/surgery. Once this period is over, the candidate will be examined for functional deficit or residual deformity. The dental officer will assess and accordingly give the result.
3. If a candidate is suffering from any gross abnormality of jaw or teeth or acute ulcerative gingivitis, active lesions of pyorrhoea, numerous caries, dental arches, etc then he/she will not be selected.