My impression over past 22 years is that AMEs have been leaving the business because of a combination of
I would also say the last one regarding GPs… I realise their job is pretty sh1tty, with a) not enough time to see patients properly and b) most patients could not give a toss about their own health.
A few, very few, AMEs I have known were really good, and they were working hard, lots of airline pilots, and making loads of money.
In the meantime, FAA reported to Congress last week that they are happy with Basic Med
My understanding nearby countries accept it, Mexico, Bahamas, Canada
https://www.aopa.org/news-and-media/all-news/2023/march/24/faa-report-validates-basicmed-safety
My understanding nearby countries accept it, Mexico, Bahamas, Canada
Not Canada, but otherwise yes.
The medical form for the BasicMed is here.
It sounds pretty much like the medicals you could get for the national PPL in the UK before the self-declaration route was introduced. I certainly heard several stories of people who couldn’t get their GPs to do them, though I don’t know how widespread an issue this was. It also leaves some discretion to the doctor, which could be a problem: I think it would be quite reasonable for a non-specialist doctor to say ‘I don’t know anything about specific aviation risks of blood pressure medicines so I can’t sign your form’.
Someone that I know was told by his GP that he should be fine to scuba dive despite having epilepsy and being on medication, because his seizures were generally well controlled. Personally I would have wanted to know a lot about the interaction between nitrogen narcosis and sedative anti-epilepsy drugs, and the effects of pressure and increased partial pressure of oxygen on seizure thresholds, before signing someone with epilepsy off as fit to dive. Any system that depends on finding professionals willing to advise outside their sphere of competency is dysfunctional.
BasicMed does allow a physician to decline, without impact on the applicant who can then go to another physician who is better informed, including an AME who can do BasicMed like any other physician if both parties want it.
The form for BasicMed is identical to that for the FAA 3rd class medical. What is different in its application is that except for a small, explicitly listed number of issues issuance under BasicMed in relation to all remaining issues is subject to the discretion of the physician, not FAA processes, and similar to a biennial flight review there are no FAA medical records. If the applicant has never held an AME issued 3rd class or if their record contains any of the limited number of disqualifying issues, then they are referred back to FAA for one 3rd class (special issuance if appropriate) before being eligible for BasicMed.
The original intent of BasicMed was to extend FAA Sport Pilot to a larger increment of private pilots, based on real world experience – and Sport Pilot has never required any medical or paperwork process other than holding a current drivers license, the primary purpose of which is to prohibit drunks from flying. That original intent was politically scuttled by the AMEs and others, and the political compromise was to involve the same physicians who certify commercial drivers while moving the FAA largely out of the picture. I’m not sure the AMEs got what they wanted either, which was obviously to maintain their relevance and cash flow from most private pilots, but that’s how it ended.
What would be fundamentally correct is no medical at all for private pilots, as has been the case for FAA Sport Pilots for going on 20 years without issue. No system at all is required based on the facts, and therefore any system is dysfunctional by definition. However while rules removing rights can be created and enforced quickly by government, human nature means it takes longer to reverse those rules when they no longer make sense, in this case because basic 21st century preventative and screening medical care goes much beyond the requirements of the 3rd class and as the Sport Pilot record shows medical certification of most private pilots no longer adds any value.
BasicMed may eventually be the second of three FAA increments, the third reaching the original intent of no medical certification requirement except a drivers license for private plots operating up to 18,000 ft, six passengers etc except evaluation in real time by the pilot before each flight.
In the US there has always for a hundred years continuously been a large proportional of pilots whose training cost was paid by themselves, not by the military or government in general. As a result the culture of government medical certification conflating private pilots with raw material about to be pushed irreversibly through a very expensive taxpayer funded training program never arose, because for a majority of pilots there was no financial risk for the government that could be reduced by screening them like young athletes. Therefore no EKG for private pilots, less rigor overall and less to beat back to an appropriate level in the modern world.
As in most things, following the money gets you most of the truth.
While we’re discussing medical certificates: The FAA and ICAO systems both have three classes of medical certificates: 1, 2 and 3, but they are not the same.
In the ICAO system class 2 is sufficient for a PPL, while class 3 is used for ATC. In the FAA system, obviously class 3 is sufficient for a PPL.
But how do the FAA class 1 and 2 medicals relate to the ICAO classes?
Peter wrote:
See here for a previous discussion on FAA Class 3 being equivalent to EASA Class 2. The UK CAA at least accepted that.
Yes, that’s what I wrote. My questions was about FAA classes 1 and 2.
hammer wrote:
It feels great to flex and say that we are too fit to pass a medical.But this doesn’t help the OP who is feeling down about his experience with his medical.
Exactly. And it is usually people who have never had a weight problem who gloat over those who do and “know all about” how they can improve their lives.
Being one of those who struggle with weight, I’d say unless those giving advice have gone through the same experience or are trained professionals who know, they should shut up about it. This includes tons of “nutrition advisors” who in most cases make things worse.
Shaming of people which do not conform to some arbitrary set idea of lifestyle is called discrimination. And framing people, like it happened to the OP is imho a violation of duty by that AME. Body shaming has caused much more harm than it has caused people to actually slim down, most of those who are regularly shamed
