Pointers in Taking Medicals



Take your physical examination well before due date

Often, pilots wait until the last several days before their medical certificate lapses to schedule another physical examination. Sometimes, an examination cannot be scheduled prior to the lapse of the pilot's previous medical certificate. If a medical condition arises that requires additional information, obtaining that information may take several days. Often, the aviation medical examiner will hold the certificate for several days pending receipt of additional information in hopes of issuing a medical certificate to the pilot. If the physical is scheduled early in the month, the pilot has sufficient time to gather that information and take it to their AME's for subsequent issuance of a new medical certificate prior to expiration of their previous medical certificate.

DO NOT take a physical examination if feel you are not medically fit

There are no adverse consequences of allowing your medical certificate to lapse. As long as you are not operating an aircraft without the appropriate class of medical certificate. If you do take a physical and have a disqualifying condition, the AME is obligated to deny or defer your application. This can result in significant administrative delays even if your medical condition resolves. If you have a disqualifying medical condition when your next physical is due, it is usually better to allow you medical certificate to lapse. When the condition has resolved, bring appropriate documentation from your treating physician to your physical and present it to your AME after noting the treatment on the front of the application. You may then expect to leave the office with a new medical certificate in hand.

Contact an aviation medicine specialist early for any questions you may have

Many AME's are very knowledgeable and have assisted many pilots. Most questions can be addressed with a simple phone call, which avoids administrative delays and anxieties at a later date.

Understand reporting responsibilities on your medical application

The medical application requires pilots to report all medicines, prescription and non-prescription, that the pilot is using. If this is your first time reporting the use of a medication, be sure to include a statement about the absence of any side effects, if true. Over-the-counter "nutritional supplements" are not reportable

Likewise, the pilot is required to report all visits to health care providers within the last three years, along with the name, address and reason for visit. If a pilot has or has ever had conditions listed, a check mark in the "yes" block is required. If this information has been previously reported, an annotation in the remarks section, "previously reported, no change" is acceptable if there has been no significant change in the medical condition. The pilot may list a referencing of the condition if one has been assigned to the pilot. If this is a new condition or there has been a change, bringing the appropriate documentation as mentioned above will alleviate most questions regarding certification

Prepare for the examination

Pilots who have a medical examination should be well rested and should avoid high sugar meals, caffeine, tobacco and stimulant type medications before their physical examination. Meals high in sugar may cause an erroneous result in the urinalysis that raises a suspicion of diabetes. Complex carbohydrates and proteins before an examination will stabilize blood sugars and decrease the risk of an abnormal urine result in helping individuals. Fasting is not necessary, unless cholesterol or glucose tests are required.

For those pilots requiring electrocardiograms, be well rested, avoiding caffeine, tobacco and stimulant medications, such as decongestants, decreases the risk of abnormalities on the ECG. Although in most cases, these abnormalities are shown to be not clinically significant, the time and expense, not to mention the anxiety, associated with obtaining the required evaluation can be avoided by simple preparation.

Bring glasses, contact lenses or hearing aids, if required

An aviation medical examiner is not authorized to issue a new medical certificate if a pilot does not meet the standards. Pilots using glasses or contact lenses should bring them to the physical examination to optimize their chances of passing those respective tests. Likewise, pilot's using hearing aids (which are authorized during flying with a limitation on the medical certificate) should also bring them to the exam.

Bring appropriate documentation

If you have had medical evaluations or treatment since your last physical examination, bring documentation of the treatment and the resolution of the condition to your medical examination. This may help avoid any delays in issuing a new medical certificate if all aeromedically relevant questions are answered. For example, if you have had surgery on a knee or an appendix removed or were hospitalized for an infection, the hospital discharge summary and a signed, dated follow-up note from your treating physician indicating you can return to full activity is usually sufficient. Some conditions, such as cancer, heart disease, neurologic and psychiatric conditions requiring hospitalization require additional documentation and review. In general, the more documentation available, the easier it is to make a favorable certification decision. Again, submission of complete information is CRITICAL to timely certification decisions.

Establish a long term relationship with an AME

An AME who knows you and your medical history well and who is also willing to make the extra effort to help you keep your medical certificate is an invaluable resource. Many times, the convenience of scheduling an appointment for a physical on short notice will save you time or missed flying days. Medical problems that have been previously addressed will be familiar to this AME and not a source of anxiety for you or your AME when you report them on your physical. Additionally, the AME will have a file of all correspondence regarding your medical certificate. An AME who knows you well is more likely to answer questions for you over the phone about your use of medications, medical conditions and flying.

Select an AME that you and other pilots are comfortable using.

The AME should be knowledgeable about aviation medicine and willing to work with the pilot, the pilot's treating physicians, and national offices if necessary, to help you retain your medical certificate. Many AME's do relatively few examinations each year and have a very busy office practice.

Understand the three possible outcomes of an Aviation Medicals

First, the expected outcome for a physical examination is that the medical certificate will be ISSUED.

A second result is a DENIAL of the medical certificate.

The third possible outcome is an intermediate decision termed a DEFERRAL.

Be prepared to send further information upon request

Occasionally, pilots will receive a letter after they have been issued a medical certificate by their AME. The letter states that the appropriate aviation authority is unable to determine their eligibility for an airman medical certificate based on incomplete information regarding some medical condition. The authority specifically requests information and/or further studies to be submitted prior to an eligibility determination. Usually, there is a 30-day suspense from the date of the letter on this submission requirement. Attempt to comply with this time line and submit all requested information. If it is impossible to complete this requirement prior to the 30-day extension, a call to the authority requesting a 30-day extension is all that is needed. The pilot may continue to operate an aircraft with a current medical certificate issued by the AME pending a final determination from the appropriate authority.

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