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Aeromedical Advisory: Building a Lasting Relationship

Source:, By James Fraser, M.D., Federal Air Surgeon

You won’t be surprised to hear that the way the FAA evaluates a potential Aviation Medical Examiner (AME) is a little different from the way you approach this task. The FAA looks for a competent physician who can fairly, correctly, and efficiently apply our policies. Most airmen look for the most convenient and most affordable AME. And, yes, we know that you also want to find the AME who is least likely to “hassle” you.

That strategy might work well enough for a young and reasonably healthy airman, but it might be a bit short-sighted — and counterproductive — as the years accumulate. One of the most disheartening things I learn at events like AirVenture is the number of airmen whose AME denies or refers a case to the FAA when the condition could have been, and should have been, handled at the AME level.

Such issues occur when the AME isn’t fully up to speed with the latest FAA policy. Unfortunately, the airman pays the price for it. An FAA study on the Conditions AMEs Can Issue (CACI) revealed that AMEs were not properly using this option in 39 percent of the cases. We are working on it, but you should do your part by ensuring that you choose an AME who knows FAA policy and how to apply it.

Finding the Right AME For Now and the Future

One of the first things to look for in an AME is knowledge of current guidance. If you spot a well-worn, decades-old copy of the AME Guide on the desk, that’s probably not a good sign. We constantly update our policies to reflect improvements to medical certification options and procedures, so a good AME will have the most current guidance.

You should also look for an AME who is proficient. That may sound odd, but an AME can be out of practice. FAA standards for AME currency include initial training, recurrent training, and a requirement to conduct at least 10 exams a year. But just as you can be legally current as a pilot without necessarily being proficient, an AME can be in the same situation. Ideally, you want an AME who conducts many exams and works continuously with the FAA.

How Do I Know if an AME is “Good?”

Proficiency is an easier issue to scout, because you can always ask how many FAA exams a given AME conducts each year. Determining “good” is harder. Your best bet is to approach AME selection in the same way you approach looking for a good investment: ask around! Ask your fellow pilots for information and advice. If there were some problems, how did the AME handle them? A good AME should be willing to check the latest FAA guidance or call the Regional Flight Surgeon (RFS) for additional assistance.

If you have a condition that might require a more extensive exam, either now or in the future, you probably want to find an AME who is familiar with that condition. One of the best ways to do that is to call the RFS office. The RFS can help by pointing you to an AME adept at handling that condition.

Our system of medical certification oversight is very good at detecting cases when an AME issues a certificate that should have been denied. Unfortunately, it is not very good at detecting the opposite situation — a case in which the AME could have, or should have, issued a medical certificate. That’s where we need your help. Please check places like the CACI website and even the AME Guide to see if your medical concerns are addressed. If you don’t believe your AME is properly handling your certification, please let us know. We’ve now achieved a 92 percent success rate for airmen walking out of the AME’s office with a ticket in hand, but we need your help to push that rate even higher.

James Fraser received a B.A., M.D., and M.P.H. from the University of Oklahoma. He completed a thirty year Navy career and retired as a Captain (O6) in January 2004. He is certified in the specialties of Preventive Medicine (Aerospace Medicine) and Family Practice. He is a Fellow of the Aerospace Medical Association and the American Academy of Family Practice.

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