Should the air carriers commence to examine
and certify their own crews, a few senior AMEs
will be appreciably affected. It would be hoped
that the air carriers would consider the value
of such men in seeking out consultants to help
administer their certification responsibilities,

In considering the senior AME system as a
whole, there is ample evidence that the system
should continue along its present course. Fifty-
eight percent of the first-class certificate holders
are not employees of the air carriers. There is
also evidence that not all indicating employ-
ment with an air carrier are required either by
regulation or company policy to hold a currently
valid first-class medical certificate. One might
argue that a senior AME system is therefore not
needed to support the personal desires of these
unidentified individuals. There are several good
reasons to continue such a program, The class of
medical certificate held has to come to have
special meaning in the aviation industry. Em-
ployment policies, insurance considerations, etc.,
often involve evidence of medical qualification.
Some individuals have come to use the first-class
FAA examination as a focal point in establishing
their personal preventive health program. Such
side benefits are difficult to evaluate but should
not be overlooked. ”

Some crewmembers such as engineers are, by
Federal regulation, only required to hold a cur-
rently valid second-class medical certificate.
Should the airlines oversee the examination and
medical certification of all their crewmembers
requiring such certification, the senior AMEs
would no longer examine these airmen. Since
this study was designed to study first-class cer-
tificate holders, no comparable information was
obtained for holders of segond-class medical
certificates. The emphasis upon first-class cer-
tificate holders will be understood when it is
realized that only the 1928 designated senior

¥

AMEs can conduct examinations for these air-
men whereas any of the 6881 designated AMEs
can conduct second or third-class examinations.
Therefore, any appreciable impact from the pro-
posed regulatory changes wonld be expected to
be most obvious among the senior AMEs,

Ancillary proposals have also been made con-
cerning the cardiovascular evaluation and the
frequency of examination of the first-class cer-
tifieate holder and these considerations also
served to focus attention upon the senior AME
system,

IV. Conclusions.

Proposals have been made to modify FAA
medical regulations to allow airlines to use full-
time or consultant physicians designated by the
Federal Air Surgeon to examine and certificate
their own crewmembers. In considering the im-
pact. of such a proposal on industry and the
senior AME population, a more detailed study
of certain AME-airline pilot interrelationships
was undertaken. From previous studies, it was
known that relatively few of the first-class med-
ical certificate holders were actually required by
regulation to carry such certificates. It was
therefore estimated that a real need for senior
AMEs would continue to exist if such regula-
tions were implemented. This has now been
verified in that only 81,830 or 42 percent of the
first-class certificate holders are employed by
airlines. Should all 31,830 first-class certificate
holders employed by airlines be certified by the
designated airline physician, present senior
AMEs would still be examining the majority of
the first-class certificate holders. The identifica-
tion of the senior AMEs with the most experience
may be of use to industry as well as the FAA in
the surveillance of the airman medical certifica-
tion program,

REFERENCES

‘.
1, FAA Observes. 40th Anniversary of the AME pro-

gram at Civil “Aviation Medicine Luncheon. Aero-
space Medicine, 38:762, 1967.

2. Withers, H. W. and Dailey, J.T.: Reflections in a
Physician’s Eye—A Two-Year Look at the Air Traf-

fic Controller Health Program. Journal of Air
Trafic Controllers: September 1968.

3. Booze, C. F., Jr.: Usage of Combined Airmen Cer-
tification by Active Airmen; An Active Airman Pop-
ulation Estimate. AM Report 63-5, Office of Aviation
Medicine, Federal Aviation Administration, 1968.


company
ertificates.

first-class

Taste III.—First-Class Medical Certificates of Record, March

1968 By Activity of Examiner, By Currency of Certificate,

and by Employer

Medical Certificates Issued

Total Med. Certificates

*PEs Performed No. of Since Aug. 1967 (<7 months) of Record (<25 months)
by Senior
Each Examiner AMEs Employer Employer
Airline Other Total Airline Other Total

20 or more 644 23,646 17, 204 40,850 29,909 35, 873 65, 782
(89%) (94%) (87%)
Less than 20 1,284 1,442 3,846 5, 288 1,921 7,955 9,876
(11%) (18%)
TOTALS 1,928 25, 088 21,050 46,138 31,830 43, 828 75, 658

(54%) (46%)

(100%) (42%) (58%) (109%)

*Physical Examination

Sixty-eight airlines are coded for computer
purposes, These were ranked in several ways.
For example, the top 10 airlines by number of
airmen holding first-class medical certificates less
than seven months old were as follows:

United Airlines... 3850

Trans World Airlines 3222

American Airlines... 2633 Braniff Airways... 889
Eastern Airlines... 2604 Continental Airlines 620
Pan American World 2663 Western Airlines... 601
Airways

In tabulating the number of AMEs perform-
ing large numbers of first-class examinations for
a particular airline, it was noted that for most
airlines coded, four or fewer senior AMEs per-
formed the majority of the examinations for the

airline. For large rairlines, this did not hold
true:

AMEs performing
more than 25
class 1 exams for
employees of the

Maximum num-
ber of physical
examittations by

Airline airline one AME
1. United. 38 282
#2. TWA. 30 246
3. Americas . 26 166
4. Pan American. 23, 155
5. Eastern- 19 521
6. Delta. _ 15 151
7. Northwest______. 5 378

In identifying senior AMEs who performed
first-class examinations on large numbers of ac-
tive airmen who held certificates less than seven
months old, 108 AMEs had performed 25 or more
of the examinations for employees of a single
airline; 26 had performed 100 or more of the
examinations for employees of a single airline.
In identifying AMEs who had examined 200
or more first-class airmen (irrespective of the
time the certificates had been held), 67 senior
AMEs were noted. The maximum number cer-
tified by one examiner was 1710. As might be
expected, the greatest number certified by an in-
ternational AME occurred in Vietnam. 267 first-
class examinations were on record.

V. Discussion.

There are many factors that determine why an
airman seeks out a particular physician to con-
duct his medical examination for FAA certifica-
tion. Among these are availability, convenience,
cost and reputation of the examining physician.
While the relative weights of these factors are
unknown, it is recognized that definite selection
takes .place. Thirty-three percent of the desig-
nated senior AMEs examined 87 percent of the
first-class certificate holders of record, The ma-
jority of the pilots of the smaller scheduled air
carriers were examined by fewer than five phy-
sicians. While more examiners were involved
with pilots of larger air carriers, even here rela-
tively few examiners saw the majority of such
pilots. One individual had examined 521 pilots
from a single air carrier.



i

T. Repert No. 2. Government Accession No. 3. Recipient's Catalog No.

FAA-AM-71-38

TECHNICAL REPORT STANDARD TITLE PAGE

4. Title ond Subtiile: 5. Report Date

. Ti
SENOR AVIATION MEDICAL EXAMINERS CONDUCTING Senteaber 19
FAA FIRST-CLASS MEDICAL EXAMINATIONS aeepeemest a

7. Author's) 8. Performing Organization Report No.
Gordon K. Norwood, M.D.

9. Performing Organization Nome and Address 10. Work Unit No.

Office of Aviation Medicine

Federal Aviation Administration Tl. Contract ov Gront No.

800 Independence Avenue, S.W.

Washington, D.C. 20591 T3. Type of Report ond Period Covered
12. Sponsoring Agency Name ond Address

Office of Aviation Medicine OAM Report

Federal Aviation Administration

800 Independence Avenue, S.W. 14. Sponsoring Agency Code

Washington, D.C. 20591

15. Supplementary Notes

16. Abstract

Airline medical departments have provided a system of preventive health
maintenance for their crews that has economically effected rehabilitation

of experienced crewmembers who otherwise would have lost their medical
licenses and thereby their livelihood. In recognition of this fact, the FAA
has proposed to designate full-time or consultant physicians of certain air
carriers in order that they might examine and certify their own crewmembers.
The impact of this proposal on the presently designated senior aviation medical
examiners is considered. Computer data relating to the activity of these
designees indicate that relatively few would be significantly involved. Those
not serving as consultants to an airline would still be examining over 50

t percent of the first-class certificate holders.

¥ .
17. Key Words 18. Distribution Statement

| Examination (Aeromedical) Availability is unlimited. Document may

| Pilots (First-class) be released to the National Technical

r Statistical analysis (senior aviation | Information Service, Springfield,
aviation medical examiners) Virginia 22151, for sale to the public.
19. Security Classif. (of this report) 20. Security Classil. (of this page) 21. No. of Pages | 22, Price
Unclassified Unclassified 4 $3.00

Form DOT F 1700.7 te-69)



—_

SENIOR AVIATION MEDICAL EXAMINERS CONDUCTING FAA
FIRST-CLASS MEDICAL EXAMINATIONS

I, Introduction.

The designated aviation medical examiner
(AME) system of the Federal Aviation Admin-
istration had its origin in 1927 under Dr. Louis
H. Bauer, the first Medical Director or Chief,
Aeronautics Bureau, Department of Commerce.
It is of historical interest that of the 144 phy-
sicians designated in 1927, 12 were still active at
the 40th Anniversary of the program.)

The medical examiners of commercial pilots
have always been so designated. There have
been periods when examiners of private and stu-
dent pilots were not. After World War II, the
physician shortage was so acute that any phy-
sician was allowed to examine for the FAA. Un-
fortunately, the term physician was defined by
some states to include anyone in the healing arts
and as a consequence, reports of examination
were received from examiners with little or no
formal medical training.

In 1960 the designated AME system was re-
established to cover examiners of all civil air-
men required by Federal Regulations to hold
valid FAA medical certificates, Since 1966,
many designated AMEs have also become in-
volved in providing for the examination of FAA
air traffic controllers.?

With the establishment of airline medical de-
partments, a system of preventive health main-
tenance for crew personnel has developed over
the years. Modern methods of program evalua-
tion have indicated that these departments have
been able to economically effect rehabilitation of
highly skilled and experienced crewmembers
that woud have otherwise lost their only means
of gainful employment. In recognition of the
present capabilities of such airline medical de-
partments, the FAA has proposed that air car-
riers medically examine and certify their own
crews by means of full-time medical personnel or
medical cosultants. Those senior aviation med-
ical examiners not so employed could continue

to examine first-class certificate holders other than
those employed as air carrier crewmembers. Pre-
paratory to this proposal, it was decided to de-
termine the impact of such regulatory change
upon the senior AMEs now designated.

In 2 previous study of October 1967,? it was
estimated that 17,750 of 623,534 active airmen
were airline transport pilots requiring, by Fed-
eral Regulation, currently valid first-class med-
ical certificates. A. first-class medical certificate
issued on the first day of the month would be
valid for the remainder of that month plus six
more months (or a maximum of seven months).
In October 1967, only 42,656 of the 72,155 first-
class certificates held by active airmen were less
than seven months old. The 42,656 represented
not only all active airline transport pilots but
also some 24,900 others who chose to hold first-
class FAA medical certificates. Of the 72,155,
about 18,600 were over seven months but less
than 13 months old and thereby valid for pri-
vate and commercial purposes other than as air-
line transport pilots. Of the 72,155 first-class
certificates, 10,919 were greater than 13 months
but less than 25 months old (valid for student
and private pilot purposes only).

Taste 1.——Active FAA First-Class Medical Certificate
Holders as of October 1, 1967

Number Percentage
First-class total. 72,155 100
Less than 7 months old 42,656 59
Over 7, less than 13 months old. 18, 580 26
Over 13, less than 25 months old-. 10, 919 15

II. Statement of Purpose.

Preliminary figures seemed to indicate that
relatively few of the first-class certificate holders
would be involved under the proposal to have air
carriers oversee the medical examination and cer-



Sample Computer Printout

Greater than 7 mo,

Greater than 13

Dr. Doe, John Less than 7 mo. less than 13 mo. less than 25 mo. Total
EAL 1 i} 0 1
UAL 25 3 } 0 28
Other 24 4 i 39

tification of their own crews. However, it was
anticipated that more detailed information might
be desired by the industry and AME popula-
tion—information that would better define cer-
tain senior AME-airline transport pilot inter-
relationships.

IL. Procedure.

In March 1968, the FAA computer tapes con-
taining medical certification information were
scanned to survey the currently certified pilot
population and to determine which senior AMEs
were examining first-class certificate holders. In-
dividual senior AMEs were listed when they had
performed 20 or more of the valid first-class
examinations of record. All others were pooled
for tabulation purposes. Under each senior
AME’s name, codes were listed to indicate the
airlines which employed the pilots examined.
Under each airline or employer code, the pilots
were distributed to indicate how long their first-
class medical certificates had been issued.

From the sample printout, it is seen that Dr.
Doe has performed FAA examinations for first-
class medical certificat holders of two airlines
(Eastern and United) and that a maximum of
26 were for airline transport pilots. Three
were possibly for other crewmembers (com-
mercial pilots, engineers, navigators, ete.).  ,

Should the two airlines certify their own crew-
members, as many as 29 of the 68 first-class cer-
tificate holders Dr. Doe examined (43%) would
no Ignger seek certification from him,

The AeromedicalyEducation Branch of the
FAA Civil Aeromedical Institute provided basic
statistics as to the number of designated avia-
tion medical examiners at the end of March
1968,

‘Taste II—Population of Designated Aviation Medical
Examiners, March 1968

Senior Class 2
Category of Examiner (Class1) and3 —‘Total
Examiners Examiners

Civil, USA. 1,722 4,281 6, 003
Civil, Foreign. 206 8 214
Military. 0 664 664

1,928 4,953 6, 881

IV. Results.

Of all active airmen as of March 1968, 644
senior AMEs had performed 20 or more exam-
inations for first-class certificate holders. These
644 senior AMEs had collectively performed
65,782 or 87 percent of the 75,658 first-class ex-
aminations of record. They also performed
29,909 or 94 percent of the 31,830 examinations
of first-class certificate holders who reported that
they worked for an airline.

From Table III it can also be noted that while
the present and proposed regulations require only
certain airline crewmembers to hold a currently
valid first-class medical certificate, many other
individuals elect to hold first-class medical cer-
tificates. The 31,830 who work for the airlines
represent only 42 percent of the total first-class
population. Of the 31,830 working for airilnes
25,088 held first-class certificates less than seven
months old. This reflects the fact that not all
first-class medical certificate holders working for
airlines are required by regulation or company
policy to maintain current first-class certificates.
It also appears that nearly 50 percent of the
pilots holding first-class certificates but not em-
ployed by airlines tend to renew their first-class
certificates every six to seven months.

Ta

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