Dr Gary Gray

Born in 1944 in Palmerston, Ontario, Gary William Gray attended McGill University’s medical school and enrolled in the RCAF Medical Officers Training Program in 1965. A year prior to earning his degree in 1968, he was posted to the Canadian Forces Institute of Aviation Medicine (CFIAM) in Toronto, which was then beginning a high-altitude research program in the Yukon on Mount Logan, Yukon – the highest peak in Canada. Gary recognizes this was an “incredible opportunity” for a third-year medical student, which opened the door for him to pursue a career with the armed forces that combined research with clinical and aerospace medicine.

Gary was particularly interested in acute moderate hypoxia. His first article relating to this work, “Retinal Hemorrhage at High Altitude”, was published in the New England Journal of Medicine in 1970, the same year he earned his Flight Surgeon Wings with the air force. Over the next half-century, he would go on to produce more than 100 publications comprising scientific papers, reports, handbooks, and academic articles and book chapters on aviation medicine.

Before earning his wings, Gary spent a year at CFB Edmonton, where he worked in support of 435 Squadron and then at CFB Moose Jaw, where he had the chance to fly the CT114 Tutor. Gary was next posted to CFIAM, during which time he pursued a doctorate from the University of Toronto studying altitude illness. He earned his PhD degree in 1976, concurrently completing his residency training in Internal Medicine.

In 1978, now an Internist, Gary joined the Canadian Forces Environmental Medicine Establishment (CFEME). As head of the Central Medical Board (CMB), he recognized that the military’s existing medical standards for aircrew selection and review were outdated. “In the past,” he has explained, “medical certification of aircrew with medical problems was determined most commonly by committees of flight surgeons, with decisions based on ‘accredited medical conclusion’. My goal was to move beyond dispositions based on consensus group conclusion towards evidence-based decisions, first by defining the required standards, and then by developing a process for quantifying aeromedical risk assessment against those standards.”

The reforms that Gary helped develop included improved assessment and screening tools to allow more aviators to remain flying, and changes to methods of evaluating the physical health of pilot applicants. In the case of eyesight, for example, his reforms enabled the approval of the use of contact lenses by jet pilots, and later, the approval of safe and effective corrective eye surgeries such as LASIK. Thanks to Gary’s promotion of appropriate medical evaluation for diabetic pilots, the RCAF was the first organization in the world to allow pilots with diabetes to return to flying duties. He also assisted with the development of a new protocol addressing mental health, which allowed pilots diagnosed with depression to return to flying duties while being treated with anti-depressants. Another important reform was the development of a multi-factor ‘aeromedical risk matrix’ to ensure a fairer process for aircrew medicals. Gary’s novel approach created task-specific assessment criteria, ensuring a more appropriate risk-assessed evaluation for pilots.

No matter the reform, and whether it be the treatment of conditions as varied as diabetes, cancer, or heart disease, Gary’s philosophy boiled down to one simple principle: if treated successfully, with an appropriate risk assessment, most pilots should be able to continue flying. He is pleased to note that “adopting an evidence-based risk assessment approach has allowed safe medical recertification – sometimes with an operational restriction – for hundreds of military and civilian pilots with medical issues.”

In 1983, when Canada’s National Research Council (NRC) launched this country’s astronaut program, they requested medical support from the Canadian Forces (CF). The Surgeon General of the CF tasked Gary to direct and lead the medical screening of astronaut candidates. Gary’s reputation as a leading expert in aerospace medicine meant he was able to work closely with NASA Flight Medicine to obtain and develop Canada’s medical certification process and standards in less than a year – a success that allowed astronaut Marc Garneau (CAHF, 2008) to reach space in NASA’s Space Shuttle Challenger in 1984.

A year later, having served two decades in uniform, Gary took his release from the CF. He continued to head the CMB, however, and also to serve with the Canadian Space Agency (CSA) on the health and medical status of Canada’s astronauts, work that ensured that each of Canada’s original astronaut team members assigned space flights were able to conduct them as planned.

Gary re-joined the forces as a medical officer in 1990 (he would permanently retire in 1998 and continue to work closely with the military as a consultant). Commander Gray again retained his position and responsibilities with the CMB and with the CSA. In 1992, the CSA started to select a new group of astronauts, and Gary resumed his role overseeing and conducting the medical screening of the candidates, many of whom would eventually work aboard the International Space Station (ISS). As part of Canada’s commitment to the ISS, Gary chaired the station’s Medical Standards Working Group; as well, he continues to serve as our country’s representative on the ISS Multilateral Space Medicine Board, which provides medical certifications for all crew members and visitors to the space station.

During his career and while working with NASA, the NRC and CSA, and the RCAF, Gary recognized that Canada lacked sufficient formal expertise in aerospace medicine, and he set about promoting the need a formal training program in this specialized field. In time, this work led to the creation of a specialty committee in Aerospace Medicine that applied for recognition from the Royal College of Physicians and Surgeons of Canada. The Royal College eventually recognized the formal discipline of Aerospace Medicine and began granting diplomas (DRCPSC Aerospace Medicine); Gary is one of the Royal College diplomates.

Gary’s work in aviation and aerospace medicine followed in the footsteps of Dr Wilbur Franks (CAHF, 1983), and he has become a similarly influential leader in the field. As a teacher and mentor, Gary has taught most of the CF flight surgeons who attended the military’s School of Aerospace Medicine since 1970. He has also taught many commercial airline flight surgeons, and is involved in the development of a formal training program in Aerospace Medicine through the University of Toronto. Internationally, Gary has directed and lectured at the NATO Lecture Series on Cardiology in Aircrew. As a Civil Aviation Medical Examiner (CAME), he continues to lecture as requested at CAME seminars.

Gary’s exceptional career has afforded him opportunities rarely available to civilian physicians. He has flown in many Canadian military aircraft, including the Chipmunk, Harvard, and Musketeer as well as the CF-5, CF-101, CF-104, CF-18, and the Argus, Buffalo, and Hercules. And he has acted as physician to royalty during Canadian royal tours, caring for Queen Elizabeth II and Prince Philip, the Queen Mother, and Princess Margaret.

For more than fifty years Dr Gary Gray has provided medical assessments and certifications for over 10,000 RCAF aircrew. His work is widely valued by his peers, and he has been recognized as a fellow of the Canadian Society of Aviation Medicine, the Aerospace Medical Association, and the Royal College of Physicians and Surgeons of Canada. In further recognition of his work, he has received the Ad Astra Award for exceptional contributions to the Canadian Human Spaceflight Program from the Canadian Space Agency, the Wilbur Franks Award in recognition of outstanding contributions to Aerospace Medicine in Canada from the Canadian Society of Aerospace Medicine, and the Aerospace Medical Association’s Theodore Lyster Award for excellence in aerospace medicine by the Aerospace Medicine Association. His decorations include the Order of Military Merit, a CD with clasp, and the Silver Jubilee Medal.