by Dr. Bill Blank, MD
Senior Aviation Medical Examiner
© Copyright 2024. All rights reserved!
Published in Midwest Flyer Magazine February/March 2024 Digital Issue
The FAA is acutely aware that its certification delays are excessive. It has made efforts on several fronts to speed up the process. Issuing guidelines for Aviation Medical Examiners (AMEs) to certify various conditions which previously required an FAA decision is an example. Conditions AMEs Can Issue (CACIs) are one result. There are now 24 CACIs. These are conditions considered to be low risk and routinely issued. Policies for other conditions, which are more complicated and riskier to certify, have been developed. I want to discuss one in detail.
Attention-Deficit Hyperactivity Disorder (ADHD) is a condition characterized by varying degrees of inattentiveness, difficulty concentrating and focusing, hyperactivity, and impulsiveness. These symptoms can have an effect on aviation safety. It is frequently treated with varying degrees of success with stimulants such as Ritalin. Out of an abundance of caution, the traditional certification process for ADHD has been complicated, long, and thorough. This, of course, delays certification. Recently a Fast Track process has been added for applicants who meet certain criteria. These include no treatment with ADHD medication for the last 4 years, no instability in academic, occupational or social functioning in the last 4 years, and no other current or historical psychiatric diagnosis or condition. If these criteria are met, the applicant can use the Fast Track. The applicant can be evaluated by a local doctoral level (PhD or PsyD) licensed psychologist or neuropsychologist with training in the condition. The applicant will also be required to provide the above-mentioned historical material to the psychologist or neuropsychologist in advance. If the examiner feels certification is appropriate, he completes an FAA form which is taken to the AME who can issue the medical certificate, if the airman is otherwise qualified. The AME will upload the supporting documents to the FAA, or the applicant can mail it in. If the applicant cannot be certified via the Fast Track, the exam must be deferred for evaluation through the traditional path.
One of the causes of FAA certification delays is difficulty recruiting FAA physicians. Most are retired military doctors. The FAA is authorized for 52. Currently they have approximately 40. Because of peculiarities in government pay rules, physicians from this recruiting pool can make approximately $50,000 more annually for similar jobs in other governmental agencies than with the FAA. In addition, the FAA physicians have mandatory overtime because of the backlogs. This is not attractive to many retiring military physicians and hampers recruitment efforts. It is a problem yet to be solved.
Happy flying!
EDITOR’S NOTE: Columnist William A. Blank is a physician in La Crosse, Wisconsin, and has been an Aviation Medical Examiner (AME) since 1978, and a Senior AME since 1985. Dr. Blank is a retired Ophthalmologist, but still gives some of the ophthalmology lectures at AME renewal seminars. Flying-wise, Dr. Blank holds an Airline Transport Pilot Certificate and has 6000 hours. He is a Certified Flight Instructor – Instrument (CFII) and has given over 1200 hours of aerobatic instruction. In addition, Dr. Blank was an airshow performer through the 2014 season and has held a Statement of Aerobatic Competency (SAC) since 1987. He was inducted into the Wisconsin Aviation Hall of Fame in 2021.
DISCLAIMER: The information contained in this column is the expressed opinion of the author only, and readers are advised to seek the advice of others, including their own AME, and refer to the Federal Aviation Regulations and FAA Aeronautical Information Manual for additional information and clarification.
