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The Pizza Principle

FAA Safety Briefing
Cleared for Takeoff
4 min readDec 29, 2021
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By Susan K. Parson, FAA Safety Briefing Magazine

It’s no secret that pilots have long been frustrated by many aspects of the aviation medical certification process. Yes, it’s true that a majority of aviators leave their AME’s office with a shiny new medical certificate in hand. But I’ll bet many of them approach these periodic visits with a certain amount of trepidation: what if “they” find something that requires referral to the Aerospace Medical Certification Division (AMCD)?


I know the feeling. During an aviation conference many years ago, a speaker reminded the audience that “we are all just one medical away from flying as sport pilots.” Like most everyone else in the audience, I nodded sagely (or was it smugly?) while I thought sympathetically of those who could “only” fly with the driver’s license medical option. Little did I know that life was about to give me a visceral appreciation for that statement, and even greater appreciation for the many medical certification options available to today’s pilots.

Not long after that conference, a subtly accumulating collection of odd symptoms drove me to the doctor and eventually led to a diagnosis of relapsing-remitting multiple sclerosis (MS). My aviation friends all understood completely that my most immediate concern was not so much about the potentially dire consequences of the disease itself. They got it: I was most afraid of its implications for my FAA medical certification. Lucky for me, several pilot pals (one of whom had preceded me into the “MS Pilot Club”) knew that MS didn’t have to spell the end of my PIC flying days. In addition to handing me hankies, they provided solid information and support as I began to navigate this strange new world of health and aeromedical management.

Tracking Tools

You can track a pizza you order online through every stage from assembly to delivery. So why can’t you do the same with your FAA medical?


Those needing to navigate that world will soon have some brand-new tools. Historically, the drill was to complete the required exams, send the requested documentation to AMCD, and wait … and wait … and wait. The authorization would eventually arrive, but it always felt like a nail-biter. That’s why I was silently cheering when, during the “Meet the Administrator” session at last year’s AirVenture, Federal Air Surgeon Dr. Susan Northrup explained how the FAA is working on a system that will provide the kind of clarity and transparency that pilots crave. “You can track a pizza you order online through every stage from assembly to delivery, so why can’t you do the same with your FAA medical?”

After eighteen years in the FAA, I’ve heard the jokes. Having also attended several years’ worth of the Administrator’s meetings with air show audiences, I’ve also heard lots of the frustration that pilots experience when medical issues result in delays or (occasionally) denial of the vital medical certification. But I hope you will be encouraged to know that the people who count — that would be Federal Air Surgeon Dr. Susan Northrup and her team, many of whom are pilots — are determined to make it better. Working for the FAA has given me the privilege of coming to know Dr. Northup and some of her staff not as names but as real people, and I can assure you that they are people who care. Their work and their decisions have profound implications not just for pilots, but for the public. But it is heartening to know that Dr. Northrup and her team are all about getting to “yes” wherever possible.

Thank you, colleagues, for all you do to help keep so many of us flying.

Susan K. Parson ( is editor of FAA Safety Briefing and a Special Assistant in the FAA’s Flight Standards Service. She is a general aviation pilot and flight instructor.
This article was originally published in the January/February 2022 issue of FAA Safety Briefing magazine.
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FAA Safety Briefing
Cleared for Takeoff

Official FAA safety policy voice for general aviation. The magazine is part of the national FAA Safety Team (FAASTeam).