The Three Types of AMEs – Choosing Wisely

Information for AMEs – Choosing an AME

The choice of AME isn’t much of a problem for pilots without any medical issues. If you take no medications, mark “no” to all of the other questions, and have no concerning surgeries in your past, then it doesn’t matter which AME you go to. We have discussed this before. But once you start listing medications, marking “yes” to some of the medical condition questions or to the other questions, the situation becomes a bit more complex. 

Some medical conditions will prevent your AME from issuing your medical certificate at your exam.

Meanwhile, with the proper paperwork, many medical conditions can have a certificate issued at the exam, provided your AME knows what they are doing and has the time to do it! Some medical conditions that technically require a deferral can still be issued at the exam if:

1. You have excellent paperwork.
2. Your AME understands the process.
3. Your AME is willing to contact the FAA to discuss your case and request over-the-phone approval.

Are all AMEs capable of doing this?

Sadly, no. Like not every pilot you know is genuinely fantastic, the same holds for AMEs – not all are created equal. After years of working almost exclusively on complex cases, we have noticed that AMEs generally fall into one of three categories.

Information for AMEs –The Casual AME

Most AMEs in the country do very few exams. They may be in a rural location or perhaps just an area that doesn’t have a lot of flying. Maybe they got the qualification hoping to fill some slots on their schedule with non-insurance-paid patients. Perhaps they have a pilot friend who asked them to get the qualification. This AME is likely a primary care physician with a large patient load. 

This AME may be an excellent doctor, but you get good at things by doing them regularly. If they only do a minimum number of exams and attend the FAA-required refresher training every three years, how good of an AME are they when it comes to a complicated case? 

The FAA releases new guidelines 11 times a year.

If an AME isn’t intentionally keeping current on these changes, they may not even know the current certification standards or be unfamiliar with applying them. Between refresher courses, they can miss 33 policy changes.

It isn’t a big deal if most of their pilots have no issues. But if you have a problem and you expect this AME to be able to help you, they may not be up to the task.

If your AME is unfamiliar with your particular medical issue and the FAA requirements, they may defer your case to the FAA for disposition. However, for a condition that could have resulted in certification on the day of the exam, this represents an unnecessary delay of six months or more. We have seen this exact issue countless times.

Information for AMEs –The High Volume AME

Some AME practices only churn out exams. They don’t do any other medicine. They only do FAA exams. There are a handful of these AMEs around the country. We have met several of them, and they find it surprising we have time to do the consultation work we offer. Why is this?

High-volume AMEs may do three or four exams per hour for eight hours a day, five days a week.

This business model focuses on efficiency and volume. What do you think will happen if you bring in 20 pages of medical records showing you have two CACI conditions and an AASI? How long does it take to review that paperwork, compare it against the requirements, scan it, and upload it to the FAA system? You can bet it’s much longer than the 15-20 minutes your exam was scheduled for. Faced with this scenario, getting deferred is likely.

This high-volume AME doesn’t have the time to deal with the extra issues you brought to the exam, and its business model does not support giving you the additional time you need. Also, some high-volume AME practices that seem so appealing to a specific segment of pilots can cost you significant time and trouble later. Skipping the exam and urine test may sound expedient, but it won’t seem that way when the AME loses its qualification and you receive a letter from the FAA giving you 60 days to get a new exam. 

Information for AMEs – The Passionate AME

Somewhere in the middle, and what seems to be the smallest in number, is the passionate AME. This physician primarily focuses on aviation medicine. They tend to be aviation enthusiasts or may even be pilots themselves. Because of their passion, their focus is on aviation medicine—actual aviation medicine. They are not just cranking out high-volume exam numbers. 

These AMEs are likely members of the Civil Aviation Medical Association and/or the Aerospace Medical Association.

They keep up with the AME Guide’s regular changes, likely attend at least one training seminar annually, and structure their businesses to help pilots with medical issues navigate the certification process successfully. 

When you have a medical issue, and someone recommends you get a “consult with an AME,” this is the type of AME they mean, whether or not they know to say it. However, not all AMEs are the same. If you are a Wingman Med client, you might have heard, “You should be able to be issued at your exam with the right AME.” This is the type of AME we are referring to. We happen to have an in-person Wingman Med office as well. 

Information for AMEs – Expectations

Remember that no matter what AME you use, your exam fee typically pays for 20 minutes of their time to assess your health status and report to the FAA. Moreover, reviewing paperwork and physician notes, advising you on the FAA’s certification standards, and helping you meet those requirements takes over 20 minutes.

Furthermore, if you expect an AME to give you an unlimited amount of their time for no extra money, you will likely be disappointed.

Therefore, it probably doesn’t matter if you are young and healthy. When faced with a new medical issue, you should prepare for your certification exam well before your AME appointment. Above all, Whether you look for AME reviews online or decide that your regular doctor would be a good choice, selecting the right AME can heavily influence when you receive your medical certificate.