Aviation Medical Examiner (AME)

The Aviation Medical Examiner system is the FAA's mechanism for delegating routine medical certification to qualified physicians in the civil aviation community. Established under 14 CFR Part 183 (Representatives of the Administrator), §183.21 authorizes the FAA to designate licensed physicians as AMEs, empowering them to perform the physical examinations required for First, Second, and Third-Class medical certificates under 14 CFR Part 67. Without the AME network — which comprises several thousand physicians across the United States — the FAA's Civil Aerospace Medical Institute (CAMI) in Oklahoma City would be the sole issuance point for all aviation medical certificates, an operationally unworkable bottleneck.

AME designations are not automatically granted to any willing physician. Applicants must hold an unrestricted state medical license, complete FAA AME training (a multi-day course covering aviation physiology, the Part 67 standards, the MedXPress system, and disqualifying conditions), pass an FAA examination, and demonstrate proximity to an aviation community with sufficient demand to meet the minimum examination volume the FAA requires for designation maintenance. The FAA designates AMEs in two tiers: the basic AME designation authorizes issuance of Second and Third-Class certificates; the Senior AME (SAME) designation additionally authorizes issuance of First-Class certificates. SAMEs are typically physicians with specialized aviation medicine training or experience with Class 1 medical evaluation complexities.

The medical examination process is standardized through the AME Information Manual (AIM — distinct from the Aeronautical Information Manual) published by the FAA Office of Aerospace Medicine. Applicants complete the FAA MedXPress online application (FAA Form 8500-8) before the appointment, pre-populating their medical history, medications, and self-reported conditions. The AME reviews the MedXPress record during the exam, performs the physical examination per Part 67 standards, and either issues the certificate immediately (if all standards are clearly met), defers the application to the FAA Aerospace Medical Certification Division (AMCD) for further review (if a condition requires specialist evaluation), or denies the certificate. Conditions that are disqualifying unless specifically authorized include: epilepsy, diabetes requiring insulin or oral hypoglycemics (for first and second class), bipolar disorder, personality disorders with repeated overt acts, substance dependence, and several cardiovascular conditions per §§67.113, 67.213, and 67.313.

Deferred and previously denied applicants may pursue Special Issuance Authorization (SIA) under §67.401, also called a Special Issuance medical certificate or a Letter of Authorization (LOA). The AMCD reviews specialist evaluations, treatment records, and, for cardiac conditions, exercise tolerance tests and Holter monitoring data before granting or denying an SIA. An SIA holder must typically provide annual (sometimes more frequent) medical records to the AMCD to maintain the authorization — a recurring documentation burden that flight schools must track for affected instructors and students.

EASA's equivalent system is the Aero-Medical Center (AeMC) and the Aero-Medical Examiner (AeME), governed by Commission Regulation (EU) No 1178/2011, Annex IV (Part-MED). Under Part-MED, Class 1 medical certificates (required for CPL, ATPL, and multi-pilot operations) must be issued or renewed by an AeMC or a Class 1 AeME with AeMC oversight; Class 2 medical certificates (PPL and below) may be issued by any AeME. LAPL medical certificates may be issued by any general practitioner meeting the Part-MED requirements. Unlike the FAA's system, EASA requires a complete new examination at each AeMC/AeME visit (rather than the self-completed MedXPress plus AME review model), and the EASA Special Circumstances assessment process (Part-MED.B.095) differs from the FAA's Special Issuance pathway.

Flight schools in the United States must track medical certificate validity for every student and instructor to remain in compliance with 14 CFR Part 61 (§61.23) and Part 141 (§141.41(a)). Medical certificate classes expire on different schedules: a First-Class certificate for pilots under 40 expires 12 months after the month of examination; for pilots 40 and older it expires 6 months after the month of examination (for ATP privileges) or 12 months for second-class privileges. Second-Class certificates expire 12 months after the month of examination. Third-Class certificates expire 60 calendar months after the month of examination for holders under 40, and 24 calendar months for holders 40 and older. These multi-tier, age-dependent expiry rules create a diverse and non-uniform set of expiry dates across any school's population of pilots.

The AME's deferred or denied applications create a student interruption risk that schools must plan around. A student who sits a medical exam and is deferred — a process that can take several weeks to months while AMCD reviews specialist reports — cannot exercise pilot-in-command privileges during the deferral period. If the deferral coincides with a critical training phase (solo cross-country, checkride readiness), the school must hold training progression, reassign simulator resources, and communicate revised graduation timelines to the student. Schools that track medical status proactively — alerting students to schedule renewals well in advance — reduce the incidence of last-minute lapses and training interruptions.

Aviatize maintains a per-pilot medical profile that records certificate class, examination date, the issuing AME, the computed expiry date under the applicable age/class rule (§61.23(d)), and any Special Issuance conditions. Expiry calculations account for the age-split rules automatically: a student who turns 40 during their medical validity period receives an updated alert reflecting the shorter validity window that applies after the birthday. Instructors whose Class 1 or Class 2 certificate expires during scheduled flying are flagged and blocked from being assigned as PIC or acting instructor of record before the expiry date arrives.

For schools whose instructors hold EASA medical certificates alongside or instead of FAA certificates, Aviatize's medical-tracking supports both Part 67 (FAA) and Part-MED (EASA) class and expiry structures within the same platform. This is particularly relevant for combined ATO operations and U.S.-based schools with international instructor pools, where a single roster may contain pilots on Class 1, Class 2, Class 3, LAPL medical, and BasicMed — each with its own currency rule — all of which must be enforced consistently at booking time.