Pilot Mental Fitness

Thursday, June 9, 2016

U.S. airline pilots must hold a Federal Aviation Administration (FAA) airman and medical certificate in order to fly.

What are the FAA’s medical requirements for airline pilots?

The FAA’s regulations require airline pilots to undergo a medical exam with an FAA-approved physician called an Aviation Medical Examiner (AME) every six or twelve months depending on the pilot's age. Captains are required to have a first class medical certificate and First Officers (co-pilots) may have a first or second class medical certificate. Most, if not all, U.S. airlines require a first class medical certificate for all of their pilots. A first class medical certificate must be renewed every year if the pilot is under the age of 40 and every six months if the pilot is 40 years or older. A second class medical certificate is renewed each year. General aviation pilots apply for third class medical certificates.

In order to apply for an FAA medical certificate, a pilot must complete an official FAA medical application form and have a physical examination with an AME. The FAA’s Guide for Aviation Medical Examiners outlines the application process, examiner responsibilities, examination techniques, aeromedical decision considerations, and resources. There are more than 3,000 AMEs in the United States.

How does an AME assess mental health?

The FAA medical application form includes questions pertaining to the mental health of the pilot. An AME may ask questions about psychological conditions as part of his/her assessment Pilots must disclose all existing physical and psychological conditions and medications or face significant fines if they are found to have falsified information. They must report any health professional visits during the previous three years. The AME will use this self-disclosure to ask additional questions about mental health issues. The AME can order additional psychological testing, or defer the application to the FAA Office of Aerospace Medicine if he or she is concerned that further evaluation is necessary.

Additionally, if the FAA receives information from another source that a pilot may have a mental health issue, the FAA's Office of Aerospace Medicine can direct the pilot to provide specific documentation and/or a psychiatric and psychological evaluation from a mental health care professional in order to make a determination about the pilot's suitability for certification.

If a pilot experiences an incident that appears medically related, the FAA will request additional medical information to determine the eligibility of the pilot to hold a medical certificate.  If an FAA flight surgeon determines that a pilot with a valid medical certificate no longer meets the medical standards, the flight surgeon will then recommend that FAA counsel revoke or suspend the medical certificate.

Certain medical conditions such as a psychosis, bipolar disorder and severe personality disorder automatically disqualify a pilot from obtaining an FAA medical certificate and prohibit them from flying. However, many pilots have conditions that are treatable. Several U.S. airlines already have reporting and monitoring programs that provide the pilot with a path to report their condition, be treated for it, and return to the cockpit once the FAA has determined – through a rigorous evaluation – it is safe to do so. The FAA addresses the medical certificates of those pilots on a case-by-case basis.      

The FAA does not release medical records on living pilots, including the results of any pilot’s medical testing, because medical information is covered by privacy laws.  

How will the Aviation Rulemaking Committee (ARC) report on pilot mental fitness change the medical certification process for airline pilots?

AMEs are approved by the FAA and complete specialized basic and refresher training. An Aviation Rulemaking Committee report outlines recommendations on pilot medical fitness. In January, the FAA began enhancing training for AME’s so they can increase their knowledge on mental health and enhance their ability to identify warning signs. The FAA will issue guidance to airlines to promote best practices about pilot support programs for mental health issues. The FAA will also ask the Aerospace Medical Association to consider addressing the issue of professional reporting responsibilities on a national basis and to present a resolution to the American Medical Association. Reporting requirements currently vary by state and by licensing and specialty boards. 

Airlines and unions will expand the use of pilot assistance programs. The FAA will support the development of these programs over the next year. These programs will be incorporated in the airline’s Safety Management Systems for identifying risk.  The FAA will also work with airlines over the next year as they develop programs to reduce the stigma around mental health issues by increasing awareness and promoting resources to help resolve mental health problems. 

What are the results of U.S airline pilot medical exams?   

The majority, 96 percent, of pilots receive their medical certificates at the time of their AME physical examination. Only 1.1 percent of all applications are initially denied. However, only 0.05 percent of applications are finally denied after the FAA receives all the medical information requested by the agency. In 2015, there were 378,263 total applications and 212,617 of these were for First Class Medical Certificates (which includes airline pilots). Of these, 33,604 required a Special Issuance Medical Certificate, and 15,992 of these were for First Class Medical Certificates.