CMA driver's guide/The editor-in-chief of the CMA driver's guide responds

I have concerns about the CMA's guidelines on determining medical fitness to drive.1 All Canadian provinces and territories currently use the medical standards produced by the Canadian Council of Motor Transport Administrators (CCMTA)2 to determine the medical fitness of drivers. There are considerable discrepancies between the CMA and CCMTA guidelines, resulting in confusion for both clinicians and patients. For example, according to the CMA driver's guide, someone who has experienced a single unprovoked seizure requires a neurological assessment, an electroencephalogram (awake and asleep), neuroimaging (CT scan or MRI) and a seizure-free period of at least 3 months before returning to driving. In contrast, the CCMTA guidelines state that a neurological assessment and an electroencephalogram would be required before this person could drive again, with no seizure-free period specified if the electroencephalogram is normal. Although the CMA driver's guide does state that provincial and territorial motor vehicle licensing authorities follow CCMTA standards, the CMA does not present the CCMTA standards in its driver's guide, nor does it document where its guidelines differ from the CCMTA standards or provide justification for these differences. The CCMTA and the CMA communicate closely in the production of both the CCMTA licensing standards and the CMA driver's guide. The current and past chairs of the CCMTA Medical Advisory Committee served on the Scientific Editorial Board for the /th edition of the CMA driver's guide, and the CMA has long had a representative at the CCMTA Medical Advisory Committee's meetings. In many instances, this close communication has allowed the CMA to influence the licensing standards.