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BasicMed is Turning Five!

How It Works, and How It’s Making a Difference

By Tom Hoffmann, FAA Safety Briefing Magazine

BasicMed logo.

On May 1, 2017, the FAA ushered in a new alternative to airman medical certification. BasicMed marked a tremendous shift in how some pilots can meet required medical qualifications for conducting lower-risk, non-commercial flying. Nearly five years later, more than 50,000 pilots (myself included) are currently flying under BasicMed.

While it has been popular for many pilots to pursue this alternative medical certification, some users still have a learning curve, especially as many near the first set of renewal periods for operating under BasicMed. We can help. We’ll review key steps you’ll want to consider for both starting and maintaining BasicMed coverage. We’ll also look at some of the research the FAA has completed in its five-year look back report to Congress to see how the program is making a difference in the aviation community.

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The Basics

BasicMed permits certain pilots flying certain aircraft to conduct certain operations without holding a current medical certificate. (Don’t worry, we’ll be “certain” to explain those conditions below.) It is important to recognize upfront that BasicMed is an alternative to the third-class medical certificate. It is not a replacement, and it is not a “fourth-class” certificate.

Relief measures that come with choosing BasicMed include using a valid U.S. driver’s license as a means of maintaining medical compliance with the program (provided you’ve held an FAA medical after July 16, 2006) and using a state-licensed physician (like your regular family doctor) to perform the exam and sign off on your fitness for flight. Both provisions were aimed at lowering costs and enhancing the convenience and efficiency of the medical certification process.

The Requirements

BasicMed has specific requirements for the airman, the type of aircraft you fly, and the type of operations you can perform. Here’s the breakdown:

Airman: You’ll likely qualify for BasicMed (most pilots do), but here’s what you’ll need:

  • A current and valid U.S. driver’s license.
  • A valid FAA medical certificate, held at any point after July 14, 2006. If that medical certificate was associated with a Special Issuance, the expiration of the Special Issuance must be after July 14, 2006. Your most recent medical certificate must not have been suspended or revoked, and any Special Issuances must not have been withdrawn. Also, if you’ve since applied for another medical certificate, that completed application cannot have been denied.
  • Pilots who have ever had certain mental, cardiac, or neurological health conditions will need a one-time-only Special Issuance medical certificate for each condition. Suppose you haven’t had a Special Issuance for that condition, and you currently have, or you are newly diagnosed with, one of the cardiovascular, neurological, or mental health conditions described in the list of special conditions. In that case, you may not use BasicMed until you have been issued a medical certificate with an authorization for Special Issuance. For the list of special conditions, see Medical Conditions Requiring One Special Issuance at faa.gov/go/basicmed.
Photo of small aircraft.
Photo of small aircraft.

Aircraft: Under BasicMed, you may fly aircraft that:

  • Has a maximum certificated takeoff weight of not more than 6,000 pounds.
  • Is authorized under federal law to carry not more than six occupants. Please note that in the last four years, supplemental type certificates are now available for certain aircraft certificated for more than six seats so that they qualify for BasicMed. Visit the main FAQ for more details at bit.ly/BasicMedFAQ.

Operations: BasicMed permits flights of any distance or duration, any time of the day, under visual or instrument flight rules, but there are a few operational limitations:

  • No more than five passengers, regardless of the number of seats.
  • No flying above 18,000 feet mean sea level (MSL) or beyond 250 knots (indicated).
  • No flights outside the United States (unless authorized by the country in which the flight is conducted).
  • No operations for compensation or hire (note: flight instructors may receive compensation for instructing while operating under BasicMed).

The Appointment

Photo of doctor.
Photo of doctor.

Okay, so you’ve established that you, your airplane, and the types of flying you do are covered under BasicMed. Next up is an appointment with a state-licensed physician of your choice (preferably one who’s familiar with your medical history). Before the appointment, you must first complete your portion of FAA Form 8700–2, Comprehensive Medical Examination Checklist (CMEC) found here: bit.ly/BasicMedCMEC. If the section you’re required to fill out looks familiar, it should — it’s derived from a previous version of FAA Form 8500–8, the medical certificate application form that now exists in MedXPress.

Section 2 of the form requires you to answer questions about your medical history. Your physician will review your responses to those questions and address any medical issues or medications taken as they apply to operating an aircraft or motor vehicle. Your physician will also conduct a medical examination of the items listed in section 3. These items are similar to what an Aviation Medical Examiner would check for during a third-class medical exam.

If your physician is satisfied that you present no medical conditions that would interfere with your ability to safely operate an aircraft, they will complete and sign the form, including their state license number. Legibility is key as you will need this information to print your medical education course completion certificate. Store the completed CMEC in your logbook.

If you’re considering BasicMed for the first time, or if perhaps you’ve switched doctors recently and need to get renewed, have a look at the article in our July/August 2017 issue titled “Doctor, Doctor, Let Me Give You the News.” It provides excellent advice for how to approach your doctor about the BasicMed process.

Finally, remember that to act as PIC under BasicMed, you must have completed a medical examination in the preceding 48 months. As I write, I’m days away from my first BasicMed recheck with my doctor — a gentle prod from my BasicMed online course provider was a helpful reminder. Filling out the CMEC was easy. Just be sure to note any recent conditions (including COVID-19 infections), medication changes, and any visits you made to a health professional in the last three years. Your doctor should be able to complete and sign the form during your checkup.

The Online Course

The final step is completing the BasicMed online medical course and quiz. There are currently two course providers (AOPA and the Mayo Clinic). The course is required every 24 months to remain covered under BasicMed, but it’s not a bad idea to review the material more often.

There are currently two options for the online BasicMed course — AOPA and the Mayo Clinic.

Once you complete the course, you will be required to enter information about yourself and the physician who completed the CMEC. You’ll also need to electronically certify that you:

  • Allow the FAA to access your driving records,
  • Are being actively treated for any medical condition that affects your ability to fly,
  • Have completed the CMEC, and
  • Understand your obligations under 14 CFR section 61.53 regarding the operation of an aircraft during a medical deficiency.

When you click submit, this information is transmitted to the FAA, and you will get a course completion certificate to retain in your logbook.

A Checkup on BasicMed

Logo.
Logo.

As part of the FAA Extension, Safety, and Security Act of 2016 that created BasicMed, the FAA, in coordination with the National Transportation Safety Board (NTSB), is required to submit a report to Congress that “describes the effect of the regulations issued or revised […] and includes statistics with respect to changes in small aircraft activity and safety incidents.” In response to this mandate, the FAA and NTSB have just completed a report summarizing findings of the first three years of operations under BasicMed.

The report considered survey data for airmen, aircraft, and flight operations most closely correlated to operations conducted under BasicMed, and looked at shifts in accident trends in this same general category of operations. So did BasicMed lead to more pilots flying more airplanes in this category? Was there any measurable impact on safety?

In terms of aircraft, BasicMed did not appear to impact the number of aircraft most likely to be operated under BasicMed. There was modest growth in four years before implementation; numbers subsequently stabilized. There was also no measurable impact on the number of flight hours, which showed an equivalent activity level before and after the study period.

In terms of airmen, the study indicates that BasicMed has returned approximately 30,000 airmen to flying status. Data also revealed that BasicMed pilots are older than the average pilot with a Class III medical (61 years) and are much more likely to have required a Special Issuance.

While this data could suggest that pilots using BasicMed are in a higher category of risk for incapacitation and medically-related deaths, that’s not the full picture. Notably, the study concluded there was no difference in the risk for BasicMed and third-class airmen to have an aviation accident. Their report also found no difference between these two groups when looking at the accident phase of flight, fatal versus non-fatal outcomes, and fatal injury autopsy results. It is still early, though, so the FAA will continue to monitor trends.

“BasicMed is a great example of the FAA applying risk-based regulation and oversight, shifting responsibility back to the pilot,” says FAA Aviation Safety Analyst Brad Zeigler, who is also the FAA General Aviation and Commercial Division’s BasicMed program lead. “This responsibility allows the pilot to work openly with their physician to objectively assess medical fitness for flight.”

IMSAFE checklist.
IMSAFE checklist.

In the end, safety depends on the airman to accurately and honestly assess fitness for flight before getting into the flight deck, no matter how recent your last checkup was (use the IMSAFE checklist). Whether you operate under BasicMed, or with an FAA medical, remember that 14 CFR section 61.53 prohibits you from acting as PIC if you know, or have reason to know, of any medical condition that would make you unable to operate the aircraft in a safe manner.

If you have any questions or comments about the FAA’s BasicMed rule, please contact us at 9-AWA-AFS-BasicMed@faa.gov. You can also find answers to frequently asked questions at bit.ly/BasicMedFAQ.

Tom Hoffmann is the managing editor of FAA Safety Briefing. He is a commercial pilot and holds an A&P certificate.
This article was originally published in the January/February 2022 issue of FAA Safety Briefing magazine. https://www.faa.gov/news/safety_briefing/
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