I was brand new to aviation when I received my first Federal Aviation Administration (FAA) medical certificate. I can still vividly remember sitting in the waiting room next to my mom, who was patiently filling out the paper 8500-8 form (now known as FAA MedXPress). I asked her why the FAA needed to know if I had seasonal allergies or what doctors I had seen in the past three years – a question she did not, and does not, have the answer to.
Five years later, I still have those same questions, but now, my mind is consumed by, “What if…?” and “What happens if I say yes?” or “Will this end my career?” I do not go to the doctor very often, I have no new prescriptions, and no new surgeries to report. My goal is to get in, get my medical certificate and get out with as few questions as possible. One out of every two aviators feels similarly, according to a 2022 study published in the Journal of Occupational and Environmental Medicine – and it’s called “health care avoidance.” Health care avoidance is when we do not seek care, delay care or seek alternative forms of medicine due to fear of losing our certificates.
There is recognition in the industry and at the FAA that the way our current medical system operates encourages people to avoid, hide or even lie about seeking health care. Progress has been made in allowing aviation medical examiners (AMEs) to issue certificates for situations that previously would have had to be sent to the FAA for approval, such as some types of cancer.
An AME also has the power to advocate for a certificate to be issued if a deferral is required to the FAA. To avoid having your medical certificate being unnecessarily denied or deferred, there are some things that you can do now to ensure you are able to advocate for yourself and your medical certificate. Taking care of yourself needs to be the first priority, and your medical certificate should be second.
“The myth that you have to be perfect to be a pilot is just that, a myth. There are pilots who wear contacts and glasses, controllers who take antidepressant medications and drone operators who have diabetes. They are safer operators because they sought out the care they needed, even though the process was potentially long and arduous.”
Where to Start
The FAA Guide for Aviation Medical Examiners is a roughly 770-page document that outlines the current standards and procedures for obtaining a medical certificate. It is what the AME looks at when determining if they are able to issue your medical, or if they have to defer it to the FAA or deny it. This is the best place to start if you have questions about a diagnosed condition or are on any type of medication. It also outlines what documentation you may need to provide to the FAA or your AME about your condition or medication that will allow them to issue you your certificate. The Guide for Aviation Medical Examiners is updated at the end of every month, so an unfavorable answer now is not an unfavorable answer forever.
If you do need to provide more information, get your documents from the appropriate medical professionals together early and double check you have everything required. Arriving prepared for your medical appointment will enable the AME to approve your application faster, or submit your deferral to the FAA with all required information, reducing the time spent waiting for a decision.
Finding an AME
It is also important that you choose your AME wisely. AMEs are tasked by the FAA to ensure you are healthy enough to be a safe aviator, but they should also be your advocate when working with the FAA. Many AMEs allow for consultations, where you can sit down and discuss your case with them prior to applying for your medical certificate. You are not locked into using the AME closest to you, so feel free to consult with several before choosing one to use and understand what class of AME is appropriate for the class of medical certificate for which you are applying. Specific medical conditions, including substance dependence, or the current use of prescription antidepressant medications, may restrict the AME you can use.
The myth that you have to be perfect to be a pilot is just that – a myth. There are pilots who wear contacts and glasses, controllers who take antidepressant medications and drone operators who have diabetes. They are safer operators because they sought out the care they needed, even though the process was potentially long and arduous.
Many organizations such as the Experimental Aircraft Association, the Aircraft Owners and Pilots Association and NBAA offer medical resources to members. And many more organizations are advocating for a better system that will allow you to get the care that you need, when you need it. Ultimately, most people end up receiving a medical certificate, but looking at the Guide for Aviation Medical Examiners, getting your documents in order and finding an AME you trust can go a long way in making the process easier.
There are thousands of pilots that have made it through the FAA’s complex medical system and are flying today. There are also many folks advocating for a better system that does not encourage us to avoid seeking out the health care that we deserve. But until substantial changes are made, it is up to us to advocate for ourselves.
Laila Stein is a certified flight instructor and a graduate of Western Michigan University. After serving as an NBAA Safety Intern in 2024, she accepted a full-time position at the association as a flight operations specialist.