issues

One important distinction about BasicMed is that if the OP's goal is "a career in aviation" as indicated in his first post, and that career involves flying commercially, BasicMed won't work. Using BasicMed as an alternative to an FAA medical certificate, a pilot cannot fly for compensation or hire.
 
Thanks guys. A lot of valuable information here.
Since I’ve never been issued a FAA med cert before I can’t go basicmed right now.
And just to clarify, is the recommendation that I make an appointment for a consultation with an AME prior to the formal exam and application?
 
is the recommendation that I make an appointment for a consultation with an AME prior to the formal exam and application?
Yes, and just not yes, but HELL YES. Anytime there is question(s) that your medical certificate won't be immediately issued, schedule a consultation with the AME.

With the consultation, it is just that. And doctor patient privilege is attached as the AME is acting more "doctor-ish" than "examiner-ish". AKA he is working for you and not for the FAA.

The consultation, when done correctly, allows you to fill out all of the FAA forms, make an appointment with the AME, and do a "mock" exam. The entire intent is to allow the AME to review your medical history and documentation, conduct a brief physical exam, and then discuss with you his findings and (a) that he can issue you your certificate right now if you wished, or (b) why he cannot issue you before you leave. If the answer is (b), then find out why and what you should do to fix things so he can issue you in office.

Here is a cut and paste item I frequently post to help explain AME consultations.

------------------------------------------------------

  • Before setting your appointment with the AME, thoroughly review all of the questions regarding medical history, doctor visits, medications, and law enforcement encounters. Keep in mind that the preamble is "Have You Ever In Your Life...". These questions can be found by googling for the current FAA Form 8500-8, or starting on Page 24 of the MedXpress User's Guide
  • If any of these questions requires a yes answer, or you have had a bad run in with law enforcement, or you had taken medication for a psychiatric condition (including anxiety, depression, ADD/ADHD), do not proceed to the AME.
    • You may have a live hand grenade in your medical past.
    • And proceeding to the AME without being properly prepared is like pulling the pin.
  • For the item you answered yes to, start researching what it is that the FAA wants to know about you and these conditions, medications, doctor visits.
  • Only proceed to the AME once you have gathered 100% of any and all required documentation the FAA is going to want on these conditions, medications, doctor visits.

  • Only proceed to the AME once you know 100% (and then some) that the AME will issue your certificate in the office and not deny or defer you.
  • You want to avoid deferral and denial at all costs. These happen when the applicant is not properly prepared and "bombs" into the office not knowing that their history is going to cause problems.
  • Deferral means that the AME cannot issue in the office and must send your application to Oklahoma City (FAA Central) to be decided on. Expect a reply of some form (issue, denial, or need more info) in about 12-16 weeks.
  • Denial means that something about your history is going to keep you from your dream of flight.... forever.

  • If you have questions about your medical history or the process of the FAA approving your application,
    • call the AME to setup a consultative office visit.
    • You will be asked to pay his fee, but that's okay since you are taking up his time
    • You may be asked to fill out the online MedXpress in advance.
      • This is okay, however, after printing out the paper copy, grab scissors and remove the confirmation number that appears at the bottom of the form.
      • While in consultative mode, under no circumstance will you surrender this confirmation number
      • The confirmation number is needed to make the exam go "live". But going live means the AME can only issue, deny or defer. You are here to avoid denial and deferral.
    • If after completing the consultative visit, the AME says he can issue you right then and there, now you can surrender the confirmation number.
    • If after completing the consultative visit, the AME says your application would be deferred due to X, Y, and/or Z, discuss with him what it is you need to go obtain and bring back that will satisfy the FAA and allow the AME to issue your certificate.
If your situation is crazy messy or crazy difficult, do not proceed to the local AME. Seek out one of the very senior difficult case AME's such as Dr. Bruce Chien, www.aeromedicaldoc.com. Dr. Bruce (and AME's like him) are well known to manage the case before the FAA is told about it. And do it in a way so that when it is sent to the FAA, the chance of issuance is near 100%. If there is a whiff of denial, the file will not be sent in.
 
Another reason for a consultation when your medical history is complicated and thorny......

.... it is an opportunity to determine if this is the right guy/gal for the job.

Like any profession, there are the folk who are the right ones for you to go to, and many wrong ones. AME's are no different here.


Many AME's are just in it for the additional letters on their business card and won't do a whole lot to act as an advocate for their airmen. They will happily take your dollars, do the exam, and then send it up to FAA HQ knowing that there is a significant chance for deferral or denial. Sorta like throwing a glob of something against the wall and hoping it will stick. And then when the submission goes all pear shaped, they aren't too motivated to help.

Then there are those like Dr. Lou Fowler and Dr. Bruce Chien (both participants on PoA) who are totally there for their airmen. Not only acting as an advocate when the FAA starts waving warning flags and setting off warning bells, but also very willing to not send in a submission when it is incomplete or has a larger chance of being denied. They already know how badly jammed up the review process is, and won't submit any applications that will just add to the log jam.


So during the consultation, you get to determine in what category the AME you are meeting is in. If he is "just for the letters" type, then you might not want to return to his office. If you find someone like Dr. Lou or Dr. Bruce, even if you need to travel to them, then you have found the right guy/gal for you and your situation.
 
One important distinction about BasicMed is that if the OP's goal is "a career in aviation" as indicated in his first post, and that career involves flying commercially, BasicMed won't work. Using BasicMed as an alternative to an FAA medical certificate, a pilot cannot fly for compensation or hire.
You're correct that BasicMed wouldn't work for the long term, especially after he needs/has his commercial certificate and will be flying for hire and a Second Class.

But, during the runup phase to that point, BasicMed should work.
 
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What @azure is hinting at is that possessing a BasicMed certificate could be simpler for you in the long run should your symptoms be chronic.

Special Issuances for Third, Second, and First class medicals come with instructions on how frequently you must submit an updated status from your treating physician. For some SI's, this isn't too difficult or expensive. But for others, the testing required is expensive, and your health insurance may not cover the cost of the frequent testing.

For your Gastro Troubles, if a Special Issuance is required, you may be told to provide an update as frequently as every 12 months. Which means a doctors visit and having him write a status letter on your current state.

Under BasicMed, you are responsible for self certifying that your condition is under control and won't affect your performance as Pilot in Command. aka, you don't need to frequently submit items to the FAA.
Exactly. And yes, as you point out, the OP would need to have held an FAA medical certificate since July 2006 in order to be eligible to go BasicMed directly. Otherwise, he could go BasicMed after getting that first medical, even if it should prove to be a SI (depends on the dx, of course).
 
Doubtful my situation would be considered messy or difficult. As I hadn’t seen a doc until several visits to the GI earlier this year. I’ve never been treated with rx meds or required follow up visits. Reading here it does appear to be a real snag in the plans though to have a difficult AME. is there any referral networks to find a good ame in specific locations ?
 
is Are there any referral networks to find a good ame in specific locations ?
There are a few informal ones.... but they are more of a listing of what AME's are available versus the quality of the particular AME.

Best way to find one is

(1) Tell us where you are and hopefully a PoA member can suggest one who fits our definition of "good"

(2) Ask lots of pilots and instructors at the airport and flight schools near to you "Who is the AME in this area who is
(a) a Senior AME,
(b) Is good with challenging cases,
(c) willing to be my advocate should the FAA try to wrap me around an axle, and
(d) is willing to provide a consultation before doing a live exam"​
If after talking to 15-20 people, you start hearing the same name more than once, then that might be your guy/gal.​
 
@ChrisCC --- There are 2 concepts that I want to make sure you are aware of regarding flight medicals many of us support. (originally taught to us by Dr. Bruce Chien, @bbchien)

  1. Health First, Fly Later
  2. Own your medical

#1 means that you should take care of your health before becoming worried about flying. This includes flying as Pilot in Command if/when anything about your health is in question.

In other words, take care of yourself to remain healthy, or find out what is causing bad health, before you go get involved with a flight.

So for your case, visiting a doctor about your Gastro issues with the intent of finding out exactly what's going on and how to fix it is a top idea before you head to the AME's office. Remember the main advice of post# 43 was "Only proceed to the AME once you know 100% (and then some) that the AME will issue your certificate"

It also means do what is appropriate to always remain healthy. Lose excess weight, eat properly (good nutrition, exercise portion control), exercise regularly, and get good sleep. This is good advice for every human, but really comes into play when you want to fly airplanes and must deal with FAA medical.

#2 means that you take control over your health and the medical application process. While you often will seek out help and advice of others, do not let them "drive the bus". It is your medical, you need to be the "bus driver" and make sure it all gets done. And once issued, learn what is needed and execute the plan to always pass your flight medicals.
 
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