Fatigue, Aerospace Medicine, and Operational Safety
Season 2, Episode 13 | July 7th, 2026
Guest: Dr. Carlos Salicrup Captain, Aerospace Physician, and Fatigue Specialist.
Executive Summary
In this episode of Altitude, Nicolas Rhoads and Arturo Duhart welcome Dr. Carlos Salicrup--airline captain, aerospace physician, and fatigue management specialist--for a high-level discussion on one of aviation's most important safety and performance challenges: human fatigue. The conversation examines the role of aerospace medicine in operational safety, the continued importance of the human factor in a highly automated industry, the science behind fatigue, the evolution of Fatigue Risk Management Systems (FRMS), and the opportunity for data, artificial intelligence, and predictive analytics to support healthier and safer airline operations. The episode also translates these lessons into practical guidance for frequent travelers, while reinforcing a central message for airline leaders: fatigue is not only a medical concern; it is a strategic operational risk that must be managed with discipline, science, and organizational commitment.
OPENING
NICOLAS
Welcome to Altitude, the space where we analyze the issues transforming aviation from a strategic, operational, and leadership perspective.
I am Nicolas Rhoads, joined as always by Arturo Duhart, with Daniel behind the soundboard making the magic happen so these episodes come out with the quality you have come to expect.
Today we will address a topic that directly affects safety, operational performance, and the well-being of the people who make it possible for millions of passengers to reach their destinations every day: health in aviation and, in particular, fatigue management.
Exactly one year ago, in Episode 4, we discussed fatigue from an operational perspective. However, given the growing importance of this topic and the way the industry has evolved in this area, we wanted to revisit it with a much broader and more specialized perspective.
To do so, we are joined by Dr. Carlos Salicrup, one of the most recognized voices in aerospace medicine and fatigue management in our industry. Carlos brings a rare combination of experience: he is a physician, airline transport pilot, specialist in aerospace medicine and human factors, and has dedicated much of his career to the study of flight physiology, operational safety, and the scientific management of fatigue.
His career has allowed him to work with airlines, operators, international organizations, and academic institutions on issues related to occupational health, human performance, FRMS programs, and safety culture, bringing a perspective that integrates both the clinical view and the operational reality experienced every day by pilots and cabin crews.
Carlos, thank you very much for joining us on Altitude. It is a true pleasure to have you with us.
CARLOS
[Open remarks]
ARTURO
Carlos, welcome from my side as well. Thank you very much for joining us and for sharing your experience with our audience.
BLOCK 1 - AEROSPACE MEDICINE AND ITS IMPORTANCE
ARTURO: To begin with the fundamentals: when we talk about aerospace medicine, many people think only about the medical examinations pilots must complete. However, its scope is much broader. How would you define aerospace medicine, and why is it such an important discipline for operational safety?
CARLOS [Response]
NICOLAS: Aviation is probably one of the safest and most highly regulated industries in the world. However, despite all the technology available today, we still depend on human beings making critical decisions. From your perspective, what role has aerospace medicine played in the extraordinary improvement in safety levels we have seen over the past several decades?
CARLOS [Response]
ARTURO: Beyond pilots, which other groups within the aviation ecosystem benefit directly from the principles of aerospace medicine?
CARLOS [Response]
BLOCK 2 - THE HUMAN FACTOR IN A HIGH-PERFORMANCE INDUSTRY
NICOLAS: We often talk about new aircraft, artificial intelligence, digitalization, or airport infrastructure. However, at the end of the day, there are still people operating increasingly complex systems. How important does the human factor remain in modern aviation?
CARLOS [Response]
ARTURO: When we analyze incidents or accidents, we often find elements related to human performance. What are the main physiological or medical factors that can affect the performance of pilots and crew members?
CARLOS [Response]
NICOLAS: We live in a culture that often glorifies sleeping less and working longer hours. From a medical perspective, do you believe we still underestimate the importance of sleep and physical recovery?
CARLOS [Response]
BLOCK 3 - UNDERSTANDING FATIGUE
ARTURO: Let us now move into the central topic of our conversation. From a medical and operational perspective, how would you define fatigue?
CARLOS [Response]
NICOLAS: Many people associate fatigue simply with feeling tired. What is the difference between being tired and being truly fatigued from a scientific perspective?
CARLOS [Response]
ARTURO: What happens in our brain and in our body when we operate under fatigue conditions?
CARLOS [Response]
NICOLAS: If you had to explain to a CEO or a Board of Directors why fatigue should be considered a business and operational risk, and not only a medical issue, what would you tell them?
CARLOS [Response]
BLOCK 4 - FATIGUE AND AIRLINE OPERATIONS
ARTURO: What are the main sources of fatigue that pilots and cabin crews face today?
CARLOS [Response]
NICOLAS: Modern aviation operates 24 hours a day, crosses multiple time zones, and increasingly depends on long-range operations. What are the most complex challenges this creates from the perspective of human physiology?
CARLOS [Response]
ARTURO: In recent years, we have heard more and more about Fatigue Risk Management Systems, or FRMS. What exactly are they, and why do they represent an evolution beyond traditional flight time and rest regulations?
CARLOS [Response]
NICOLAS: When we talk about fatigue, we frequently think immediately of pilots and cabin crew. However, many other professionals make critical safety decisions: air traffic controllers, flight dispatchers, maintenance personnel, operational control center teams, and even executives who manage complex 24-hour operations. From your perspective, how widespread is fatigue risk across these other functions, and what lessons can the industry learn to manage it in a more integrated way?
CARLOS [Response]
NICOLAS: Based on your international experience, what are the most advanced airlines doing better when it comes to fatigue management?
CARLOS [Response]
ARTURO: Is there a direct relationship between an airline's organizational culture and the effectiveness of its fatigue management programs?
CARLOS [Response]
BLOCK 5 - FATIGUE FROM THE PASSENGER PERSPECTIVE
NICOLAS: So far, we have mainly talked about pilots, crews, and airline operations. However, fatigue also affects millions of passengers who travel for business or leisure, especially on long-haul flights or when crossing multiple time zones. From your experience as an aerospace physician, what practical recommendations would you give passengers to prevent or mitigate the effects of fatigue, jet lag, and other factors associated with air travel?
CARLOS [Response]
NICOLAS: There is a lot of information circulating about hydration, supplements, melatonin, exercise, caffeine, and even apps designed to adjust sleep cycles before a trip. Which of these practices are truly supported by science, and which are mostly myths or solutions with limited benefits?
CARLOS [Response]
ARTURO: Thinking specifically about frequent travelers--executives, consultants, crews, or people who regularly cross several time zones--what habits would you recommend they incorporate to minimize the accumulated impact of fatigue over time?
CARLOS [Response]
BLOCK 6 - THE FUTURE OF HEALTH AND FATIGUE IN AVIATION
NICOLAS: We are entering an era in which data, artificial intelligence, and predictive analytics are transforming virtually every airline process. Do you see opportunities for these technologies to help better manage crew health and fatigue?
CARLOS [Response]
ARTURO: Which medical or scientific advances do you believe will have the greatest impact on fatigue management over the next ten years?
CARLOS [Response]
NICOLAS: If we look at the industry in perspective, do you believe fatigue is better understood today than it was twenty years ago, or is there still a long way to go?
CARLOS [Response]
ARTURO: Finally, if there were one message you would like to leave with both pilots and airline executives regarding the importance of health and fatigue, what would it be?
CARLOS [Response]
CLOSING
ARTURO: Carlos, thank you very much for joining us.
Today we learned that aerospace medicine goes far beyond a medical certificate or a regulatory requirement. It is a fundamental discipline for protecting human performance in an industry where safety depends on thousands of decisions being made correctly every day.
We also understood that fatigue is not simply feeling tired. It is a real operational risk that must be managed with the same rigor used to manage technical, financial, or operational risks.
And perhaps one of the most relevant messages for all of us as travelers is that fatigue does not affect only pilots and crews. Better understanding how our bodies function during travel allows us to make better decisions and travel in a safer, healthier, and more efficient way.
Thank you for helping us better understand such an important topic for modern aviation.
NICOLAS: Carlos, this has been an extraordinarily enriching conversation.
Thank you for sharing your experience, knowledge, and passion for a topic that directly affects safety, human performance, and the sustainability of our industry.
And thank you to all of you for joining us for a new episode of Altitude.
We will speak again very soon as we continue exploring the ideas, trends, and challenges defining the future of aviation.
Until next time.
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