Tips on Getting and Keeping Your Medical Certificate


By Richard R. Grayson, M.D., Senior Aviation Medical Examiner

Geneva, IL.


Question: I am a pilot and I have developed a medical condition.  Where can I go to check into this before my next FAA medical exam?


(The following is from The Federal Air Surgeon’s Medical Bulletin, Vol. 44, and No. 3,  2006,  and is reprinted verbatim.  The author is Warren S. Silberman, DO, MPH, manager of the Civil Aerospace Medical Institute’s Aerospace Medical Division.)


“1. Tell your airmen that when AMCD (Aeromedical Certification Division) re­quests specific testing to provide the ones we specify, performed the way we request. If their treating physician wants to deviate from our recommendations, they would do best by calling a “time out” and discussing this with you, the Regional Medical Office, or Medical Certification in Oklahoma City. The perfect example that comes to mind is exercise stress testing. We want applicants to discontinue their beta-blocker or other medications that can blunt the exercise response. Obviously, they should to do this under the guidance of their treating physician. We emphasize that they are to exercise for a minimum of nine minutes and at 100 per cent of their maximal heart rate. However, we often contend with applicants whose physicians have ignored our specifications. We want these tests performed a specific way for an aeromedical reason. You should inform your airmen that failure to perform requested testing according to our guidelines may result in our not accepting a waiver request or even denying medical certification.


2. Please inform your airmen of Web sites that are good aeromedical reference sources. The individuals that provide infor­mation to these sites generally work with us and know our requirements.

·­quarters_offices/avs/offices/aam/ (especially, the online Guide for Aviation Medicine Examiners)





AOPA (Aircraft Owners and Pilots' As­sociation) and EAA (Experimental Aircraft Association) require that you to be a member to access their online medical advice. The airman should go to the Web site and print out the specifications for their particular medical condition and take them to their treating physician so as to inform the phy­sician of what the FAA requires to make a waiver determination. The FAA makes every attempt to request only those evaluations and tests that they and their consultants determined provide the most benefit to make a certification decision. Please note that I am definitely not attempting to belittle the intelligence of those of you who really understand how we in Aerospace Medicine decide what testing to request for a specific medical condition that allows us to deter­mine whether a particular condition has a propensity for sudden incapacitation. We receive many comments from airmen (or their physicians) that question our reasoning for requesting a particular test. If you, the AME, want to know why we have requested a particular test, please feel free to phone us or your Regional Office and ask.

3. Probably the most irksome thing that treating physicians do is to tell their airmen patients that they “can see no reason why you cannot pilot an aircraft” and should return to flying. I never thought I would say this because I did not like it when a specialist did it to me, but the fact is that if physicians do not understand how high altitude affects the human body or know what the FAA requires of airmen with a particular medical condition, they should not say anything! I admire those physicians (and I have seen a few of them) that in their final conclusions state, for example, that they bow to the FAA for final determination as to the suitability for flying for their patient with a seizure disorder on Tegretol or their patient with a cardiomyopathy and ejection fraction of 25 percent!

4. Please reinforce to your certification ap­plicants that, when they are to provide the FAA with testing and medical evaluations, to collect all the documentation and send it to us it in one packet. This goes with issue number one (above). I cannot tell you how many times they provide us results in dribs and drabs. What we end up doing necessi­tates re-reviewing their cases and resending information request letters. This will surely result in delayed decisions. Something that goes hand-in-hand with this is when we re­quest a “current” status report or test result. Perhaps you know that the FAA’s definition of current is an evaluation or test performed within the previous 90 days.

I recommend that you copy these four comments and hand them out to your applicants when they initially pres­ent for an FAA medical examination. It will definitely reduce the processing time for us here and will provide the airmen with a quicker decision.”


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