2025 NBAA National Safety Forum Highlights Aeromedical Updates, Best Practices

Oct. 15, 2025

At the 2025 NBAA National Safety Forum experts provided a clearer understanding of aeromedical issues, regulations and best practices surrounding topics such as mental health, physiologic conditions and certification policies.

NBAA Director of Safety and Flight Operations Mark Larsen explained that aeromedical issues affect business aviation professionals differently than commercial airline professionals. NBAA began receiving more calls and questions from members about aeromedical issues during the COVID pandemic, in large part because member organizations often do not have company resources to assist with these issues.

NBAA represented the business aviation community in the 2023/2024 Aviation Rulemaking Committee (ARC) on aeromedical issues and is actively advocating for positive changes in the aeromedical issues in legislation, through the FAA Reauthorization Bill and other legislative activities.

Related: NBAA Welcomes ARC Recommendations Addressing Aviation Mental Health

Dr. Ian Fries, MD, and an orthopedic surgeon and a senior FAA Human Intervention Motivation Study (HMS) aviation medical examiner (AME), said he primarily works with special issuance medical certificates, and more than half of his patients are not airline pilots.

Fries said he offers advises his patients to be patient with the process.

“This process will take longer and be more complex than you’d like,” Fries explained. “Unfortunately, it can also be a costly process, since insurance companies aren’t going to pay for tests sometimes required by the FAA.”

Fries recommended attendees review the AME Guide prior to their appointment so they arrive prepared with the right paperwork and information. He cautioned attendees to verify they are referencing the most recent version, since the AME Guide is typically updated once a month.

Important Updates

Larsen shared a recent update on antidepressant medications in the AME Guide, adding use of vilazodone (Viibryd) under certain conditions and with additional testing as a conditionally acceptable medication. An HIMS AME is necessary to get a medical while using antidepressant medications.

Last year, the FAA updated the CACI list to include certain mental health diagnoses, in certain situations.

NBAA Flight Operations Specialist Laila Stein led a lively Q-and-A session with attendees and expert panelists, addressing questions on a variety of mental health-related topics.

These issues can have a major impact on organizations, particularly small flight departments, as losing a pilot – even temporarily – due to a delay in medical certificate issuance can create significant disruption, Larsen explained.

NBAA provides a “preflight” checklist to help members prepare for their next FAA medical exam to help ensure a successful exam.