Your medical: How can you make the system work for you? Some advice and tips from OKC’s top man

Aviation Medical Examiners, like any other type of medical specialist, are very different.

There are some who, when confronted with a pilot who doesn’t have a perfect health history, will walk over to a phone, call a doctor at the Aerospace Medical Certification Division in Oklahoma City and get approval for that pilot right there and then.

“Then there are the others who won’t even talk to you,” said Dr. Warren Silberman, manager of the FAA’s Aerospace Medical Certification Division. “They’ll mail the stuff off to OKC. That’s the AME I want to go bye-bye.”

There is a “strong move afoot to weed out bad AMEs,” Silberman added during a seminar at this summer’s AirVenture.

There’s also a lot of effort to streamline the medical process for pilots, who often complain that their special issuance paperwork languishes in OKC.

Efforts to tackle the problem are ongoing. The backlog was cleared up last year when the FAA convened groups of flight surgeons to process cases that needed review. “Other groups will be convened whenever necessary to deal with future backlogs,” said FAA Administrator Marion Blakey.

Silberman added he instituted a new policy that requires any case sent to OKC “to be touched” within 30 days.

The FAA also expanded the AME assisted special issuance process, which allows AMEs to issue waivers for specific medical conditions. “We increased it from 20 conditions to 35 conditions, including renal cancer, melanoma, bladder cancer, heart attacks, and bypass surgery, to name a few,” Blakey said.

There’s also discussion about creating Super AMEs, doctors with extra training who can issue waivers from the start, Silberman said, noting that OKC will perform “quality control” on those decisions.

“That’s about two years into the future,” he reported. “The name of the game is to try to put a lot more responsibility on the AMEs.”

That increased responsibility may make some AMEs uncomfortable, Silberman acknowledged. “You need to make a decision whether to keep that AME,” he said.


So how do you find an AME who is not only comfortable with the increased responsibility, but who is willing to be your advocate?

Ask your friends. Ask others in the medical community. Realize that the best AMEs are often pilots, Silberman noted, so ask your AME if he flies. If you have a heart condition, look for a heart specialist who is also an AME.

But while finding the right doctor is key to keeping your wings, you must be PIC when it comes to your medical certificate. “The onus is on you,” Silberman said.

That means ensuring that you do what you have to do before you even make an appointment with your AME. If you have a condition — say you’ve had a heart attack — you must bring certain documents to your next AME appointment. To find out exactly what documents are required, you can call your AME’s office or go to several websites, such as,,, or, Silberman advised.

“If you have all the necessary material and you still hear your AME say he has to defer the decision to OKC, you need to go to another AME,” he added.

Sometimes it’s not the AME who is the problem, but the specialist who treated the pilot’s condition in the first place.

“We need a good paper trail of what’s going on with you,” Silberman explained. “What we get is crap. ‘Joe had LASIK and he sees great’ — give me a break. Some of these notes come in on prescription pads,” he said, shaking his head in disbelief.

AMEs need this information to decide whether you are safe to fly, explained Dr. Jack Hastings, an AME in Tulsa who is also a member of EAA’s Aeromedical Council.

He told the story of a young pilot, just 17, with a benign pituitary tumor that is causing no trouble. “All he wants to do is fly,” he said. “But what I get from his doctor, who is a professor of neurosurgery, is a note on a prescription pad that says ‘I think he can fly.’ I’m trying to help this kid and my biggest stumbling block is his doctor.”

Often those doctors claim they don’t have time to write such reports or take umbrage that their claims that a person is fit to fly are questioned.

“A lot of times a doctor says ‘Joe is good to go,’ but these guys aren’t aerospace specialists,” Silberman said. “Joe may be good to go on terra firma, but a lot of people don’t understand the difference between driving down the road and flying at 8,000 feet. If a doctor is not a pilot and he tells you you’re good to go, blow him off. If I tell you you’re good to go, then you’re good to go.”

AMEs can often help you get information from your treating physician. They also can give those physicians advice on what the FAA is looking for.

“What we want is what any consulting physician would want,” Silberman said.

They want to see your records. Notes and reports should be typewritten, not handwritten — and especially not handwritten on prescription pads. (That seems to be a sore point with those docs in OKC!)

The bottom line? It’s up to you to ensure that you have all the records and other documentation when you walk into your AME’s office. If you don’t, prepare to be ground bound for awhile — but not too long, Silberman promised.

“If you are denied for not providing information, just provide the information and you are good to go,” he said. “We are the good and friendly FAA.”

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