Building the Right Team
By Dr. Susan Northrup, FAA Federal Air Surgeon
Approximately seven years ago, my predecessor, Dr. Mike Berry, penned an article discussing the FAA medical certification team. While excellent, it’s time for an update.
As Berry explained, medical certification is a process that involves more than simply receiving a sheet of paper. Pilots benefit most by building a partnership with an Aviation Medical Examiner (AME) who will serve them better in the long run over the course of multiple medicals and their career. This is especially important if you have underlying medical conditions.
Medical certification involves at least three team members: You, your AME, and the FAA. Your AME is often your liaison between the FAA and medical specialists in the community when additional evaluations are necessary. Therefore, your AME can be critical to how smoothly your medical certification goes.
AMEs, like any large group of professionals, have different strengths and weaknesses. Many AMEs practice another specialty and perform FAA medical examinations as a “labor of love” typically because they enjoy aviation and interacting with pilots. Many are pilots and aircraft owners themselves. In fact, we draw many of our medical consultants (cardiology, ophthalmology, pulmonology, etc.) from these AMEs. However, if you have any significant medical issues, it is best to have a short discussion with the AME before beginning the examination to ensure that you and the AME will be a good fit. For individuals with multiple medical conditions or high-risk conditions such as cardiac, neurology, or drug and alcohol issues, it isn’t unusual to spend significant time preparing an airman’s application and supporting documents to ensure smooth passage with the FAA. Not all AMEs can expend that much effort on FAA exams; believe it or not, the high office overhead for many sub-specialists can easily consume the basic fee they charge you.
Another thing to consider is that we review and update our policy on an ongoing basis. If you have medical issues that complicate your certification, an AME may not be as up to date on the latest FAA policy, which is outside their specialty area. Thus, your medical certificate could be deferred or denied unnecessarily. On the other hand, the AME might be very interested in helping you with a problem in their specialty area. Communication with your AME early in the certification process is critical.
Unfortunately, it’s not uncommon to see cases in which the AME unnecessarily deferred issuance of the medical to the FAA. We also see cases where the AME could have been more helpful with obtaining the correct medical documentation. This can mean delays for you and more work for the FAA. So, what can you do?
If you are in generally good health without a significant medical history, any AME should be able to issue a medical. We recommend that you consider building a relationship with an AME who is familiar with current FAA policy, willing to spend the time necessary, and can provide you with the best possible certification experience. Various aviation organizations often have individual AMEs whom they recommend. Your fellow aviators can also be an excellent resource for a recommendation. Additionally, your regional flight surgeon (RFS) can be very helpful. RFSs know which AMEs in your local area have expertise for specific conditions. Even if you don’t currently have a problem, it can be good to work with someone who may be able to help you avoid problems with certification.
Both the Aerospace Medical Certification Division (AMCD) in Oklahoma City and the RFS can also help if your medical certificate is deferred. Both have added new physicians, and sometimes they can review and provide a disposition to your case while you are in the office. This saves time for you and can allow the FAA to be more efficient in working your case and coming to a certification decision. Helpful hint: To account for any unexpected issues, build some time in your schedule to wait in the AME’s office while they try to contact the FAA. Make sure that you bring all the necessary medical documentation with you as well.
I hope that these tips can help you have a better experience during your next exam.
Dr. Susan Northrup received a bachelor’s degree in chemistry, a medical degree from The Ohio State University, and a master’s degree in public health from the University of Texas. She is double board-certified by the American Board of Preventive Medicine in Aerospace Medicine and Occupational Medicine. She is a retired U.S. Air Force colonel and a former regional medical director for Delta Air Lines. She is also an active private pilot and aircraft owner.
