Transcript Ask the Aviation Medical Examiner

Ask the Aviation Medical
Examiner
Sergio B. Seoane, M.D., Col., CAP
Chief, CAP National Health Service
FAA Senior Aviation Medical Examiner
AME – Aviation
Medical Examiner
Aviation Medical Examiner (AME) is a physician
designated by the FAA and given the authority to perform
flight physical examinations and issue aviation medical
certificates.
AMEs are practitioners of Aviation Medicine
Many AMEs are also qualified in other medical specialties
The International Civil Aviation Organization have
established basic medical rules for determining whether a
pilot is fit to act in that capacity, and they are codified in
Annex 1 to the Convention on International Civil Aviation.
Must be a Physician to be an AME, cannot be ARNP or PA
Assisted Special
Issuance Process (AASI)
A several years ago, FAA introduced the Aviation
Medical Examiner Assisted Special Issuance process
(AASI)
AASI permitted AMEs to issue applicants a special
issuance certificate at the time of examination, provided
the applicant had complied with a previously defined set
of conditions.
The AASI process eliminated the wait time for a subset
of airmen, but there were still a large number of pilots
who had to wait for the FAA to make a decision in their
case.
New and Improved FAA
Aeromedical Certification
In 2011-2012, the Federal Air Surgeon, Fred Tilton MD
decided to reduce the number of medical conditions
requiring a special issuance.
Dr Tilton has identified 18 medical conditions that will no
longer require a special issuance,
Protocols for 11 of them have been issued to AMEs
The rest will be published in 2013-2014
These 18 conditions account for 10 to 15 percent of the
special issuances.
April 2013 AME Changes
Conditions the AME Can Issue (CACI)
Conditions that previously required an
initial FAA Special Issuance authorization
before the AME could issue a medical
certificate
Now, the AME is authorized to directly
issue the medical certificate. The pilot
does not need to wait to receive the
Medical Certificate from the FAA
April 2013 AME Changes
Conditions the AME Can Issue (CACI)
Arthritis
Asthma
Glaucoma
Hepatitis C
Hypertension
Hypothyroidism
Migraine
Chronic Headaches
Pre-Diabetes (IFG)
Metabolic Syndrome
Impaired Fasting Glucose
Glucose Elevation
Renal Cancer
April 2013 AME Changes
The criteria and the required medical
documentation has NOT changed
The only difference is that the local AME
can issue the medical certificate without
approval from FAA Aerospace Medical
Certification Division in Oklahoma City
This should result in the Airman obtaining
the FAA Medical Certificate sooner
April 2013 AME Changes
The recovery time after coronary artery
stenting has been decreased from 6
months to 3 months
Legal Authority of Designated Aviation
Medical Examiners
Title 49, United States Code (U.S.C.)
(Transportation), sections 109(9), 40113(a), 4701-44703,
and 44709 (1994) formerly codified in the Federal Aviation
Act of 1958, as amended, authorizes the FAA Administrator
to delegate to qualified private persons; i.e. designated
Examiners, matters related to the examination, testing, and
inspection necessary to issue a certificate under the U.S.C.
and to issue the certificate.
Designated Examiners are delegated the
Administrator's authority to examine applicants
for airman medical certificates and to issue or
deny issuance of certificates.
Aviation Medical Examiner Population
(3,465 as of March 31, 2012)
90
countries
Domestic
84%
(Includes Guam, Marshall Islands,
Saipan, Pacific Island Trust Territories,
Puerto Rico and Virgin Islands)
Internationals
9%
Military
4%
Federal
1%
Official
2%
AMEs who are pilots 47%
Female AMEs 7.5%
5/7/12
Distribution of AMEs by Region
Central
5%
Great Lakes
14%
International
9%
Western
Pacific
8%
NW Mountain
10%
Military/Fed
6%
Official
2%
Alaska
2%
Southwest
12%
New England
3%
Eastern
11%
Southern
20%
5/7/12
Nine FAA Regions
Similar to CAP Regions
13
Distribution of AMEs by Region
AMEs/Senior AMEs
700
AMEs
600
Senior AMEs
60% Senior AMEs
500
400
300
100%
200
0%
100
0
AK
CE
EA
GL
NE
NM
SO
SW
WP
Mil
Intl
Fed
Off
5/7/12
Distribution of AMEs by Medical Specialty
Family Practice / General Practice
Internal Medicine
Aerospace Medicine
Occupational / Industrial Med
General Surgery
Ophthalmology
49%
19%
8%
6%
3%
2%
Emergency Medicine, Orthopedic Surgery,
Otorhinolaryngology, OB/GYN, Urology
All others
1%
<1% (ea)
5/7/2012
AME Age Trends
Average Age
61
60
59
58
57
56
55
54
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Distribution of AMEs by Number of Medical
Exams Performed Annually
39%
1496
AME Population
1500.0
30%
1145
1000.0
500.0
4.3%
18%
Percent of AMEs
690
Number of AMEs
5%
2%
164
187
0.0
70
0.8% 1.4% 0.05%
31
52
2
Number of Exams
2/14/11
AME Distribution by Length of Service
700
AMEs
600
Number of AMEs
270
500
Senior AMEs
184
151
352
400
300
101
200
308
144
100
363
294
181
99
79
36
197
23
246
141
64
18
70
0
4
18
1
0
5 or < 6-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 >55
Years of Service as AME
2/14/11
AME Exams – CY 2011
200000
180000
160000
140000
120000
100000
80000
60000
40000
20000
0
Exams Performed
AME Issued
AME Deferred
Class I
Class II
Class III
1/26/12
Aeromedical Certification Requests
Class I
Class II
Class III
TOTAL
# of Requests (100,000)
500
400
300
1095 applications per day (2011)
33,312 applications per month (2011)
200
100
88 89 90 91 92 93 94 95 96 97 98 99 '00'01'02'03'04'05'06'07'08'09'10'11
Fiscal Year
1/26/12
Certificates Not Issued
16000
14000
12000
10000
Class I
8000
Class II
6000
Class III
4000
2000
0
AME Denied AME Deferred Reversed by Special Issues
AMCD
56
18,971
1616
35,421
Issued by
Appeal
6322
1/26/12
Most common causes for problems with issued
certificates Jan to June 2011 compared to prior period
Block
Description
Occurrences
July–Dec 2010
Occurrences
Jan–Jun 2011
17
Unacceptable Medication
7
13
58
ECG
15
21
18h
High or low Blood Pressure
6
6
18V
DUI
1
18a
Headache
1
18M
Mental/Depression
1
18X
Rheumatoid Arthritis
1
18 g
Heart Problem
18J
Kidney stone
18u
Admission to Hospital
18x
Prostate cancer surgery,
parathyroidectomy, cataract surgery
18D
Retinopathy /DM on treatment
1
42
Arthritis
1
1
1
1
1
1
Please note that there can more than one error in a single case
Final Denials for 2011
Total Denials:
5,012
Denial for Failure to Provide or
Failed to Pursue:
4,646
92% of Airman Fail to Provide info!
Final Denials (When all
information requested is provided):
366
400,000 only 366 Denied by FAA
.09%
1/26/12
Final Certification Denials
Denial Ratio
480
0.4
460
0.35
440
0.3
420
400
380
360
0.25
0.2
0.15
340
0.1
320
0.05
300
0
Denial Ratio (%)
# of Appliations (Thousands)
Total Applications
2/14/11
Medical Certificate
Timeline
FIRST CLASS:
• Airline Transport Pilots
• Valid for 12 months under 40, 6 months 40 and over
SECOND CLASS:
• Commercial Pilots, Flight Navigators and Flight Engineers
• Contract Air Traffic Control Tower Operator
• Valid for 12 months
THIRD CLASS:
• Private and Recreational Pilots
• Valid for 60 months under 40, 24 months age 40 and over
FAA Authority to Disqualify
1994, Bullwinkel vs. FAA & NTSB, challenged
FAA authority to disqualify medications in absence
of a disqualifying medical condition
As a result, the Federal Air Surgeon was given the
authority to deny any “medications or other
treatment that (a) makes the applicant unable to
safely perform the duties or exercise the privileges
of the airman certificate that the applicant holds or
for which the applicant is applying; or (b) may
reasonably be expected, within 2 years after the
finding, to make the applicant unable to safely
perform those duties or exercise those privileges.”
Not everyone is Healthy
650,000 Pilots in the USA
400,000 Medicals Issued by FAA every year
They are not all healthy
The number of prescriptions for Type II Diabetes
Drugs has doubled between 2002 and 2005, in
children ages 5-19 years. From 0.3 per
thousand to 0.6 per thousand.
There was a 106% increase in prescriptions for
diabetic drugs in children ages 10-14 years from
2002-2005.
How Healthy do you
need to be?
You do not have to be very healthy
You need to be good enough
Kind of like being a pilot….
You need to be healthy enough so you are
not going to suddenly become
incapacitated while operating an aircraft
Key Word…”Sudden Incapacitation”
FAA Concerns
Aeromedical Significant
Disorders
Occurs suddenly or unpredictably
Is or may be incapacitating
Progresses at an unpredictable rate
May degrade flight safety
The aviation environment is
very complex and dynamic
Good Health is critical functioning is this
environment.
Two key elements for safe flying
Aircraft Performance
Airman Performance
Both need to be adequate
Medical Certification of Airmen
Special Issuances – Cardiovascular (2005)
Problem
Class 1
Class 2
Class 3
Total
Bioprosthetic
Valves
33
38
135
206
Mechanical
Valves
33
33
169
235
Pacemaker
37
53
276
355
Defibrillator
0
0
2
2
FAA Policy on Medications
FAR 61.53, prohibits acting as pilot-in-command or in any other
capacity as a required pilot flight crewmember if that person:
“Knows or has reason to know of any medical
condition that would make the person unable to meet
the requirement for the medical certificate necessary
for the pilot operation, or:
“Is taking medication or receiving other treatment for
a medical condition that results in the person being
unable to meet the requirement for the medical
certificate necessary for the pilot operation.”
FAA Policy on Medications
In addition, FAR 91.17, prohibits the use
of:
“any drug that affects the persons faculties
in any way contrary to safety.”
“Severe Head Cold” maybe a “medical
deficiency” under FAR 61.53
Why the FAA Denies Certain
Medications
Not exclusively the Medications, but rather
the underlying medical condition
associated with the Medications
Potential for Sudden Incapacitation
All Medications are evaluated based on
this concept
Generally Disallowed
Medications
Anticoagulants
Antiviral Agents
Anxiolytics (anti-anxiety)
Barbiturates
Chemotherapeutic Agents
Hypoglycemic
Mood Altering
Antidepressants (exceptions,
4/2/2010: Fluoxetine (Prozac),
Sertraline (Zoloft), Citalopram
(Celexa), or Escitalopram
(Lexapro)
Narcotics
Sedating Agents
Antihistamines
Decongestants
Tranquilizers
Stimulants (Diet Medications)
Experimental or Investigational
Medications
Muscle Relaxants
Motion Sickness
Anticonvulsants
Steroids
Lomotil
There is no “Official FAA
Medication List”
The condition is often the
disqualifying issue, not the
medication
Over The Counter
Medications
Antihistamines and Decongestants
Any drug that produces drowsiness or
other central nervous system effects and
experimental or investigational drugs are
prohibited
Medications NOT
Authorized
Anticoagulants (Maybe Yes, Maybe No --but ASA, Plavix
OK…warfarin/coumadin…it depends…often yes)
Mood Altering Medications
Sedatives
No investigational Drug Treatments
No one currently receiving Radiation Treatment
Anti-seizure Medications
Antidepressants (off smoking cessations medications for
30 days before flying is OK)
Except –need “SI”..Fluoxetine (Prozac), Sertraline
(Zoloft), Citalopram (Celexa), or Escitalopram (Lexapro)
AOPA Database
This database is compiled by the AOPA Medical
Certification Department and is based upon confirmation
with the FAA Aerospace Medical Certification Division in
Oklahoma City. The list includes both allowed and nonallowed medications and, for the allowed medications,
the conditions under which the drug is considered
acceptable for flight duties. Although a medication might
be listed as allowed, there are variables with each
individual's situation that could render a particular
medication inappropriate for flying because of case
history or adverse side effects. For example, some
medications are used "off label," meaning that a drug is
prescribed for symptoms that do not fall within the FDA's
approval guidelines for that drug. The FAA might not
allow an otherwise acceptable drug in this circumstance.
http://www.aopa.org/members/databases/medical/search_faa_meds.cfm
What the FAA doesn't
know will not Hurt you
In a fatal crash, the remains of the crew will be
tested for Prescription and Over the Counter
Medications
140,000 substances can be screened for by the
FAA Civil Aerospace Medical Institute
In General Aviation, several hundred substances
are routinely screened for after an accident
In Commercial Aviation, several thousand
substances are screened for
DNA in the future – Genetic Markers to
determine: Fatigue, Lack of Sleep
It’s a Crime to
Lie or Mislead
Whoever in any matter within the jurisdiction of any department or
agency of the United States knowingly and willfully falsifies,
conceals, or covers up by any trick, scheme, or device a material
fact, or who makes any false, fictitious or fraudulent statements or
representations, or entry, may be fined up to $250,000 or
imprisoned not more than 5 years, or both" (Title 18 U.S. Code.
Secs. 1001; 3571).
TWO TYPES OF FALSIFICATION
Intentional False Statement – A False Representation of a Material
Fact Made with the Knowledge of Falsity
Fraudulent Statement
– A False Representation of a Material Fact Made with the Knowledge of
Falsity
– Made with the Intent to Deceive and Relied Upon by Another
FAA Form 8500-8
No more paper Form 8500-8
Only online as of: 10/1/2012
If you make a false statement..60 day
suspension
Revocation of your Medical
The revocation will always show up on your
airman record, you will never get another
Medical from the FAA
FAA Policy Regarding
Falsification
Revocation of BOTH Medical Certificate
and Airman Certificate
Revocation of Airman Certificate because
you the Lack of Qualification of Hold
Airman Certificate
Honesty Best Policy
If you are taking a prohibited Medication and you
LIE, and the FAA finds out, they may press
charges, but you will NEVER get another
Medical under ANY circumstances.
If you are taking a prohibited Medication and you
state the truth, your Medical will be denied, if you
apply at a future date and are not longer taking
the Medication, you will almost certainly be
approved for an FAA Medical.
FAA wants to encourage honesty, punish those
who are not honest
Follow the Rules
If you Fly with prohibited substance, you
are in violation of your Medical and FAA
regulations
Any Life Insurance, Accident Insurance,
Aircraft Insurance, Liability Insurance will
no longer be valid since you are not in
compliance with FAA Regulations
Certification of Airman
Approximately 400,000 applicants
annually
Approximately 25,000 Special Issuances
per Year
400 Pilots in USA with Diabetes requiring
Insulin (3rd Class Medical)
Cardiovascular conditions most common
in Airmen
Final Denial are approximately 0.1%
Privacy of
Medical Information
Within the FAA, access to an individual's medical information is
strictly on a "need-to-know" basis. The safeguards of the Privacy Act
apply to the application for airman medical certification and to other
medical files in the FAA's possession. The FAA does not release
medical information without an order from a court of competent
jurisdiction, written permission from the individual to whom it applies,
or, with the individual's knowledge, during litigation of matters
related to certification. The FAA does, however, on request, disclose
the fact that an individual holds an airman medical certificate and its
class, and it may provide medical information regarding a pilot
involved in an accident to the National Transportation Safety Board
(NTSB) (or to a physician of the appropriate medical discipline who
is retained by the NTSB for use in aircraft accident investigation.
FAA Aviation Medical Examiner Guide, Version IV, July 31, 2005
Disqualifying
Medical Conditions
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Angina pectoris
Bipolar disorder
Cardiac valve replacement
Coronary heart disease that has required treatment or, if untreated,
that has been symptomatic or clinically significant;
Diabetes mellitus requiring insulin or other hypoglycemic
medication
Disturbance of consciousness without satisfactory medical
explanation of the cause
Epilepsy
Heart replacement
Myocardial infarction
Permanent cardiac pacemaker
Personality disorder that is severe enough to have repeatedly
manifested itself by overt acts
Psychosis
Substance abuse and dependence;
Transient loss of control of nervous system function(s) without
satisfactory medical explanation of cause
Did not pass
your Medical?
SODA
– Statement Of Demonstrated Ability (SODA) may be granted in
lieu of an Authorization
– Medical condition or defect that is static and nonprogressive
– One time test, usually not repeated
Assisted Special Issuance
– For Disease Protocols
Special Issuance
– An airman who is medically disqualified for any reason may be
considered by the FAA for an Authorization for Special Issuance
of a Medical Certificate
One Eyed Pilot
One Arm Pilot
Can you get a Medical with only one Eye or with
one Arm?
Can you get a Medical with Skeletal Deformities
or after a Stroke?
What about a Prosthesis?
Deafness?
For medical defects, which are static or
nonprogressive in nature, a Statement of
Demonstrated Ability (SODA) may be granted in
lieu of an Authorization.
SODA
Statement Of Demonstrated Ability
At the discretion of the Federal Air Surgeon, a Statement of
Demonstrated Ability (SODA) may be granted, instead of an
Authorization, to a person whose disqualifying condition is static or
nonprogressive and who has been found capable of performing airman
duties without endangering public safety. A SODA does not expire and
authorizes a designated Examiner to issue a medical certificate of a
specified class if the Examiner finds that the condition described on the
SODA has not adversely changed
In granting a SODA, the Federal Air Surgeon may consider the person's
operational experience and any medical facts that may affect the ability
of the person to perform airman duties including
Essentially a Flight Test performed by FAA Examiner
Cardiovascular Disease
in Pilots
Disease
MI
CABG
PTCA
PTCA with Stent
1st
2nd
3rd
Class
Class
Class
420
373
385
477
398
358
295
390
2916
3149
1810
2460
Cardiovascular
Disease I
10,000 Pilots Flying in USA with Heart Disease with
Special Issuance
Pacemaker, most pilots certified with Special Issuance
(wait 2 mo & stress test)
Heart Murmurs usually OK if evaluation negative
Most Valvular Heart Disease OK (Mitral Insufficiency,
Mitral Regurgitation, MVP, Aortic Insufficiency, Aortic
Stenosis)
Atrial Fibrillation OK
Hypertension OK (30,000 Pilots fly with HTN on
Medications)
Coronary Artery Disease OK (if < 50% Lesion, LV ok,
Stress Test normal)
Cardiovascular
Disease II
Heart Attacks (MI), OK but need to wait 6
months, need cath and nuclear imaging –
no ischemia
Heart Valve Replacement OK (wait 6 mo)
Medical Certification of
Airmen
Special Issuances – Substance Abuse (2005)
Problem
Class 1
Class 2
Class 3
Total
Alcoholism
979
354
542
1,875
Drug
Dependence
43
13
17
73
Medical Certification of
Airmen
Special Issuances – Monocularity (2005)
Medical
Condition
Monocularity
Class 1 Class 2 Class 3
209
476
1,912
Total
2,597
Medical Certification of
Airmen
Special Issuances – Diabetes (2005)
Medical
Condition
Non-Insulin
Insulin
Class 1 Class 2 Class 3
Total
493
988
3,819
5,300
0
0
425
425
Epilepsy - Seizures
Generally Speaking - No Way
Sometimes possible, but this rare
Diabetes
Usually Possible
If no medications and Diet controlled – OK
If on medications, need Special Issuance
Commercial
Space Flight
Orbital Crew
– Crew: To Be Determined
– Passengers: Medical Questionnaire with
physical examination and laboratory studies
Suborbital Flight
– Crew: Second Class Medical Certification with
endorsement
– Passengers: Medical questionnaire without
routine physical or laboratory studies
Authorization for Special
Issuance of a
Medical Certificate
Granted by the Federal Air Surgeon
Valid for a specified period
Granted to a person who does not meet the established medical
standards
Federal Air Surgeon may consider the person's operational experience
Individual must satisfy of the Federal Air Surgeon that the duties
authorized by the class of medical certificate applied for can be
performed without endangering public safety during the period in which
the Authorization would be in force.
The Federal Air Surgeon may authorize a special medical flight test,
practical test, or medical evaluation for this purpose. A medical
certificate of the appropriate class may be issued to a person who fails
to meet one or more of the established medical standards if that person
possesses a valid agency issued Authorization and is otherwise eligible.
An airman medical certificate issued in accordance with the special
issuance section of part 67 (14 CFR § 67.401), shall expire no later than
the end of the validity period or upon the withdrawal of the Authorization
upon which it is based.
Aeromedical
Certification 2004
442,498 Applications Processed
12,076 Special Issuances (waivers) for
significant medical conditions
Airman Certification and
Hypertension
American Heart Association
Normal BP < 120/80
Pre-Hypertension 120-139/80-89
Hypertension > 140/90
FAA- should not exceed, seated
155/95
66
Initial Protocol for Hypertension
Guide for Aviation Medical Examiners
AME-- conduct an evaluation OR review report by the
attending physician.
Personal and family medical history
Assessment of risk factors CHD
A clinical exam and 3 BP readings separated by 24
hours !
Resting EKG
67
Initial HTN (Continued)
Glucose, Lipid Profile, K+ and
Creatinine
Medications used, dosage and
adverse effects
Airman to wait 2 weeks upon initiation
of medication or change in dosage
Summarize results of evaluation in
box # 60
68
Can You Fly Without a
Medical?
Glider and Free Balloon Pilots are not required
to hold a medical certificate of any class. To be
issued Glider or Free Balloon Airman
Certificates, applicants must certify that they do
not know, or have reason to know, of any
medical condition that would make them unable
to operate a glider or free balloon in a safe
manner.
Sport Pilot
Operational Limits
- Max. Gross Weight 1,320 Lbs.
- Max. Stall Speed 45 Knots
- Max. Speed 120 Knots
- Max. Two-Place
- Day VFR Only
- Single, Non-Turbine Engine
- Fixed Landing Gear
January 21, 2011
Sport Pilot (Continued)
Medical Requirements
- FAA medical certificate or a valid U.S. driver’s
license
- An individual may not use a driver’s license if:
- A certificate was not issued with the
individual’s most recent application;
- The individual’s most recent application has
been denied, suspended, or revoked;
- The individual’s most recent Authorization for
a special issuance medical certificate has
been withdrawn
Sport Pilot - Medical
Hold valid airman medical certificate or a current and valid U.S.
driver’s license
Must comply with each restriction and limitation on their U.S. driver’s
license and any judicial or administrative order applying to the
operation of a motor vehicle.
Cannot have been denied the issuance of at least a third-class
airman medical certificate (if they have applied for an airman
medical certificate)
Must not have airman medical certificate revoked or suspended
Must not have had an Authorization withdrawn (if they have ever
been granted an Authorization)
May not use a current and valid U.S. driver’s license in lieu of a valid
airman medical certificate if they know or have reason to know of
any medical condition that would make them unable to operate a
light-sport aircraft in a safe manner.
Sport pilot medical provisions are found under 14 CFR §§ 61.3, 61.23 , 61.53, and 61.303). For more information
about the sport pilot final rule, see: http://dmses.dot.gov/docimages/pdf89/289219_web.pdf LAST UPDATE: July
Antidepressants
Mild to moderate depression only - no history of psychosis
or suicidal thoughts
4 authorized medications: Fluoxetine, Sertraline,
Citalopram, Escitalopram
Special Issuance
- Single medication only
- Stable on medication for minimum of 1 year
- Close monitoring
Applications
- 17 in certification review process
- 3 denied
Which type of pilots do not
need an
FAA Medical Certificate?
Free Balloon Pilots
Glider Pilots
Ultralight Pilots
Sport Pilots
Tips for your AME Medical
Examination
Establish long term relationship with an AME
Take your flight physical 4-6 weeks prior to the
expiration of your medical certificate
Bring all your medical documentation
Do not drink coffee or soda prior to exam…only
water
Bring eyeglasses, hearing aids, seeing eye dog
Bring a list of all medications and dosage (the
prescription bottle)
Tips for your AME Medical
Examination
Make sure your vision is good, have your vision
checked few weeks prior to flight physical,
minimum is 20/40 for 3rd class, 20/20 for 1st /2nd
class
If you do not feel well or are ill….do not take the
flight physical, reschedule it
Check your blood pressure 4-6 weeks prior to
your flight physical, must be < 155/95!
Once you start the flight physical exam never
leave
Tips for your AME Medical
Examination
Chose an AME that will be your advocate
Bring any doctors notes, MRI, CT and x-ray
report, all recent ER Visits
Bring all recent lab reports and Hospital Records
Do not get your FAA Physical if you are ill or do
not feel well
Be Patient…if you have a medical problem it will
take time to collect and review the information
Tips for your AME Medical
Examination
The vast majority of physicians do not understand
anything about flying an aircraft and even less about
the FAA Aeromedical Certification process
If you acquire a medical condition, call you AME 810 weeks prior to your medical. It is ok to make an
appointment with an AME to review your medical
status prior to obtaining your Flight Physical.
If possible, go to an AME that is a pilot, he/she will
be sympathetic to your desire to keep on flying (my
personal opinion)
Office of Aerospace Medicine (AAM)
Aviation Safety (AVS)
Headquarters
Federal Air Surgeon
Frederick E. Tilton, M.D.
Deputy Federal Air Surgeon
James R. Fraser, M.D.
Civil Aeronautical Medical
Institute (CAMI)
Melchor J. Antunano, M.D.
New England Region
Regional Flight Surgeon
Paul H. Clark, M.D.
Deputy Regional Flight Surgeon
Joseph H. Ray, M. D.
Southern Region
Susan E. Northrup, M.D.
Medical Specialties Division
Michael Berry, MD
79
Medications Authorized
by FAA
New Medications - Will authorize any
medication if it has been out for ONE year
All Antihypertensive Medications OK
All Asthma Medications OK, including
steroids (prednisone) if dose < 20mg qd
All anti-cholesterol Medications OK
Future Changes to FAA
Aeromedical Certification
Special Issuance List (2014?)
Kidney stones
Carotid artery stenosis
Colitis
Irritable bowel syndrome,
Colon cancer
Bladder cancer
Leukemia
Hodgkin’s disease
Lymphoma
Airman Medical Certification Review and Appeals Process
AME
AEROMEDICAL CERTIFICATION
DIVISION, CAMI
FEDERAL AIR SURGEON
NATIONAL TRANSPORTATION
SAFETY BOARD


ADMINISTRATIVE LAW JUDGE
FULL BOARD
U.S COURT OF APPEALS
SUPREME COURT
REGIONAL
FLIGHT SURGEON
Ask the Aviation Medical
Examiner
Sergio B. Seoane, M.D., Col., CAP
Chief, CAP National Health Service
FAA Senior Aviation Medical Examiner