AMEs: "More Than Purveyors of Medical Exams"

Editorial, by Jon L. Jordan, MD, JD

In my discussions with new Aviation Medical Examiners (AMEs) attending the basic seminars at the Civil Aerospace Medical Institute, I have come to realize that some perceive the scope of their involvement in the aeromedical certification process along somewhat narrow medical lines.

A not insignificant number of the physicians believe that the Federal Aviation Administration's expectation is that they will conduct medical certification examinations, apply the medical standards, and either issue or deny medical certificates. While this may be the principal responsibility of the examiner, it by no means encompasses the complete and appropriate role of the designated AME.

To be designated as an AME, the individual must be a Doctor of Medicine or Osteopathy and must possess an unrestricted license to practice medicine in the locality where the designation is sought. As a general rule, the physician must be engaged in the clinical practice of medicine and must be readily available to the public for the purpose of conducting airman medical certification examinations.

Our reasons for these requirements are fairly straight-forward: We expect our examiners be more than purveyors of medical examinations. We expect them to serve not only as representatives of the Federal Aviation Administration in the application of safety standards, but as resources for airmen and others in matters related to aviation. For this reason, we seek as AMEs not simply those who are professionally qualified, but those who have expressed a general interest in promoting aviation safety and providing a service to the public.

In the conduct of medical certification examinations, the AME should be able to provide multiple services to the airman. He or she must:

  • not only have the skills to examine airmen and identify abnormal physical findings, but also to assess the aeromedical significance of medical histories, including various forms of medical treatment,
  • understand the pharmacology and the effects of medication, and learn the principles and practice of aviation medicine,
  • be in a position, upon request, to provide treatment and consultation to applicants,
  • refer applicants to other physicians for specialized medical assessments or treatment, when indicated.
As to the relationships AMEs have with airmen and the FAA, we expect the AMEs to assume non-adversarial roles. While correct application of FAA standards and policies is essential, AMEs should also provide all possible assistance to airmen in obtaining medical certification. This includes:

  • informing airmen of certification requirements and of the procedures for review when those requirements are not met
  • assisting airmen in obtaining necessary medical information
  • and serving as the airman's intermediary with the agency.
Our ultimate goal is aviation safety. In pursuit of that goal, we also have a duty to assure appropriate and equitable treatment of airmen. This latter duty must not be forgotten.

JLJ