Cleared for takeoff
Alumni aviation medical examiners give pilots green light to fly
More than 87,000 aircraft are in the skies above America every day, including 28,000 commercial airliners and 27,000 private planes.
Despite this huge number, disasters are rare, thanks in part to four Medical College alumni counted among the ranks of Federal Aviation Administration-certified aviation medical examiners (AMEs) who help determine whether pilots and air traffic controllers are healthy enough to perform safely.
Roy V. Yeazel, MD ’61
Semi-retired general surgeon Roy V. Yeazel, MD ’61, of Madison, Wis., said he definitely feels a special responsibility when performing FAA-required flight physicals. “The reports I submit have lots of boxes,” he said, “but none asks, ‘Would you let your 10-year-old grandson fly with this pilot?’ Nevertheless, that’s one I always think about.”
Dr. Yeazel became an AME in the early 1970s after earning a pilot license himself. “We bought a Cessna 172, named it ‘George,’ and did a lot flying, including a trip to Alaska,” he said. “It made sense to expand my practice to include pilot certifications.”
He is one of 5,400 civilian AMEs in the United States, all trained by the FAA to perform exams on 640,000 pilots and 17,000 air traffic controllers. Another 500 AMEs certify members of the U.S. military or federal agencies, including NASA.
Most AMEs are engaged in family practices (56 percent) or internal medicine (19 percent). Others come from specialties such as general surgery (7 percent) and ophthalmology (3 percent). Only 4 percent practice aviation medicine full-time.
Official flight physicals date back to the Air Commerce Act, signed into law by President Calvin Coolidge in 1926. Administered by the U.S. Department of Commerce, it included procedures aimed at verifying the flight-worthiness of aircraft and pilots. The FAA assumed responsibility after its creation in 1958.
David V. Rousseau, MD ’65
San Diego AME David V. Rousseau, MD ’65, was drafted into the Navy after medical school and attended flight school in Pensacola, Fla. Later, he was stationed in Danang, Vietnam, where he served for a year as a flight surgeon.
“I didn’t pilot aircraft much, but I did spend some time as the navigator in the rear seat of an F4,” he said. “That experience kind of ruined me for flying small planes.”
He mustered out in the late 1960s, and after five years in the Reserves, left the armed services entirely to focus on his internal medicine practice. He missed aviation, however, so he rejoined the Reserves in 1981. Encouragement from other reservists and many commercial pilots motivated him to apply as an AME.
“It’s a rigidly patrolled process so it took a while,” Dr. Rousseau said, “but I finally got it in 1985.”
Retired as a captain from the Reserves since 1999, Dr. Rousseau still performs about 400-500 exams a year to help aviators secure an FAA medical certificate, called their “ticket” in airplane circles. Pilots must carry their ticket with them whenever they fly. An FAA representative might ask to see it at any time.
Mark G. Reuter, MD ’92, performs an exam in his Medford, Wis., office.
Mark G. Reuter, MD ’92, who practices family medicine in the northern Wisconsin city of Medford, likened his AME responsibility to counseling patients who have conditions that might affect their ability to drive safely. “We have to protect the patient first, but our responsibility also extends to the general public,” he said.
Although not a pilot himself, Dr. Reuter explored becoming FAA-certified when one local AME retired and another reduced his hours.
“I applied to meet the needs of pilots in my area,” he said.
He was accepted, trained for a week in Oklahoma City and began performing FAA physicals in 1999. Dr. Reuter said some of the training focused on phenomena that are unique to aerospace medicine such as the changes in oxygen content and air pressure that occur as altitude changes and how flying affects the way medications work.
“However,” he said, “AME physicals are similar to what I give my other patients.”
Sergio R. Bello, MD '88
AME certifications are maintained through continuing education seminars and online refresher courses.
Sergio R. Bello, MD ’88, a diagnostic cardiologist in San Francisco, followed in the footsteps of his own personal physician, who happens also to be an alumnus, Harry F. Colfer, MD ’43.
“Harry Colfer was my doctor from the time I was 12,” Dr. Bello said. “After I became a physician, he asked if I wanted to take over his practice when he retired.” Dr. Colfer was also an AME so Dr. Bello applied. “It wasn’t a slam-dunk but eventually I was approved,” he said.
Dr. Bello has performed medical exams since 1995 and does two or three monthly.
“Aviators are different from most people,” he said. “They tend to be model patients who exercise regularly, eat and drink moderately and want to stay well so they can fly. If a problem arises, they immediately ask what they can do to get healthy enough to fly.”
After completing an exam, AMEs may issue a medical certificate, deny the application or defer the decision to the FAA. Disqualifying conditions include angina pectoris, bipolar disorder, substance abuse or dependence and cancer.
“Some conditions that would have meant an airman or -woman couldn’t be certified are now treatable in a manner that is acceptable to the FAA,” Dr. Bello said. “For example, I had a young pilot with an arrhythmia. In the past, it would have been treated with drugs that would have meant a medical denial. Now we can eliminate it using other therapies, and he was certified.”
There are three types of FAA medical certificates: third-class for pilots who fly personal aircraft, second-class for commercial pilots who fly airplanes ranging from crop dusters to corporate jets, and first-class for passenger airline pilots. Dr. Rosseau and Dr. Yeazel are Senior AMEs who are certified to examine patients for all three FAA classes.
The biggest difference between the classes is how often examinations are required. Third-class applicants 40 and younger need to be examined every three years; those over 40, every two years. For second-class pilots, once exam per year is required, and first-class pilots need to have an exam every six months.
Medical requirements become more stringent with each level. For example, third class requires distance vision of 20/40 in each eye separately, with or without correction, but second class requires 20/20. An electrocardiogram must be submitted to the FAA for first-class applicants at 35 and annually beginning at age 40.
The AMEs said the hardest part of the job is telling an applicant that he or she is not capable of operating an aircraft safely. Reactions range from disappointment to anger.
“Pilots want to fly in the worst way and sometimes ignore a medical reality that makes an FAA certification out of the question,” Dr. Reuter said. “For example, one applicant didn’t say anything to me about his heart until I had him take off his shirt and noticed the bypass scar in the middle of his chest.”
All of the alumni AMEs said they enjoy treating pilots. “You get to hear their opinions on the different airlines they’ve worked for,” Dr. Yeazel said. “They tell me what planes they like and what’s happening in their personal lives. I’m quite happy to have them as friends as well as patients. They’re a great group of people.”
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