Time for the exam itself, the doctor looks over my application and immediately stops. He has me add a comment that the Claritan and Flonase are non sedating. I thought that was obvious, but he says the FAA is very strict about these things. He continues "The Wellbutrin is definitely going to be a problem. I will have to defer your application to the FAA..." Vaguely recalling some horror story on the AOPA website regarding the massive backlogs and long delays, I immediately explain that I take it for smoking cessation not depression, and I would be more than willing to cease taking it immediately to avoid a problem with my application. He responds that he still has to include it on the application and defer to the FAA, but reassures me that he has obtained certificates for patients with far more serious medical issues than mine (triple bypass's, cancer, etc). "Some of the serious cases take up to 6 months, but if you get a note from your doctor indicating that you take Wellbutrin for smoking cessation, and will stop immediately, it shouldn't take more than a couple of months". A couple of months! I will be ready to solo in a couple of weeks if the weather cooperates. At this point I am obsessed with flying, and the notion of not being able to pursue my goal for two to six months is unfathomable. I suggest that I not complete the examination, discuss it with my doctor and instructor and come back again after I sort the whole thing out. A clever scheme, but the AME replies that he must send my completed form to the FAA whether I complete the exam or not.
Oh well. I crossed the point of no return. We continue with the examination, and everything goes smoothly. My far vision is 20/20 and my near vision is only fractionally worse. My blood pressure is acceptable but a little high for someone my age (probably because I am about to blow an o-ring over my impending Kafkaesque encounter with the FAA Aeorspace Medical Certification Division). As the exam continues, the AME and I switch to small talk. It turns out the we are both avid sailors, a group that is almost as exclusive as pilots (the jury is still out on which is more difficult: learning to fly or learning to sailf). He has to cut a fellow sailor some slack! After the exam, the AME proposes that I get the letter from my physician that we discussed, and he send it with my application to Oklahoma City. He insists that he can get my certificate in two weeks if the examiner approves it. I'm skeptical to say the least, but I promptly call the doctor who prescribed the medication. As the person who inspired me to become a pilot, he understands exactly how important this is to me and his letter arrives on the AME's fax machine before the receptionist finishes processing my credit card.
I get home, and I am in a foul mood. The cat wants food. I yell at the cat (he knows that he doesn't get fed until 5:00 and its only 2:00). A few minutes later, my friend calls me, apologizes for not realizing that the Wellbutrin might present a problem on the FAA application and suggests that I contact AOPA to see if they can offer any advice on expediting the process. He also suggest that I take up flying gliders in the mean time since it does not require a medical certificate. I go to AOPA's web site and read the ugly truth about the situation with medical certificates. Now I'm really depressed, but I call anyways. When I explain the situation to the AOPA certification expert and indicate that I am concerned, she replies without hesitation "and you should be concerned. Wellbutrin results in automatic denial. They will issue your certificate only after you have been off the medication for 90 days." She continues to explain that the chances that the OKC examiner will waive the 90 days are slim. On the brighter side she explains that my application won't have to be thrown into the black hole in Oklahoma City as there are expediters who can speed things up.. Three months appears to be the magic number. Now I truly need the antidepressants.
Time to break the bad news to my instructor. He immediately suggests that I reduce my lessons to once a week to minimize my expense without regressing to much while I wait. Could be worse. He continues with war stories about medicals and smoking. He is on a personal crusade to both eradicate smoking and eliminate the inefficiencies in the FAA's Medical Certification Process. At some point my call waiting blinks in. I don't recognize the number on caller ID, but I suspect that it is my AME. I tell my instructor that I will call him soon to schedule my next weekly lesson, and pickup the incoming call. It is my AME: "We handled this exactly as it should be handled. The explanation from your doctor was exactly what we needed. The medical examiner approved your application and you will have your certificate in the mail next week!" Needless to say, I can hardly contain myself. I thanked him profusely (he'll get a nice gift from me this Christmas), and called my instructor to tell him the good news. Much ado about nothing? Maybe, but my "problem" was relatively simple, my AME took the time to go to bat for me.
My advice. First, if you think that you want to be a pilot, get your medical certificate as soon as possible. Don't wait until the eleventh hour. If you don't mind considering it part of the upfront costs (mine was $130, but I did not shop around and paid the big city penalty), get the certificate before you start your training. Obviously, if you have a certificate that is going to expire, renew it 3 months early, 6 months if you know that there is going to be an issue. Second, read the FAR, look at the AOPA web site, and check the list of medications and conditions that the FAA frowns upon. If you have any questions, contact your personal doctor before seeing the AME, and have him provide detailed documentation of your condition and an exculpatory letter explaining why it will not affect your ability to be a pilot. If you are taking a medication that the FAA does not allow, ask if you can stop taking it or switch to a different medication. Finally, many people suggest that you avoid checking or including anything that would raise any issues with the AME or FAA. I always feel that honesty is the best policy, but many of the FAA's medical rules are draconian and do nothing to enhance the safety of aviation. That said, they require the medical certification for a reason, and no passenger would be happy if the pilot had a seizure at 35000 feet. It is definitely a judgment call. If you are not sure whether your condition or medication poses a danger, consult a doctor other than your AME and ask if your condition would effect your ability to fly a plane before omitting it from your application. Honesty worked for me...barely.
My opinion. The AME's are all well trained, competent doctors and many of them are pilots as well. Even if they are not pilots, as AME's they certainly should have a solid understanding of the physical and mental capabilities required of a pilot. The FAA must allow AME's to exercise their judgment as physicians and issue certificates in cases where a medication or condition presents no hindrance to a person's ability to be a pilot. Clearly the FAA can establish guidelines as to when an AME must defer an application to ensure that questionable cases are investigated thoroughly. The current system reminds me of mandatory minimum sentences for criminals where judges are not allowed to differentiate between the major drug trafficker and the curious teenager. Ignore the mitigating circumstances, 25 to life for everyone. If the FAA would let the AME's act as doctors, not just data gathering devices, they might just eliminate the notorious backlog from which they currently suffer.
Gene's Aside:
I know of one pilot who spends a minimum of $7,000 per medical to satisfy the requirements of Dr. Silberman's empire.
Case 72
Bureaucratosis Spreads (The Second Medical)
When I took my medical exam I was given the standard simple medical questionnaire. The questionnaire asked if I had taken any prescription drugs in the past. I honestly answered that I had previously taken
antidepressants for mild depression (dysthymia). I am not currently taking any medication (for about 4 or 5 years). The FAA quickly rejected my medical certificate. I'm now looking at paying $120 an hour to a psychologist to evaluate my mental condition. This is probably going to cost me $3000. I can't help but feel bitter about this whole thing. The costs of the these medical tests alone will more than double the total cost of my flying lessons.
Is there some appeal I go through to limit the scope of this medical exam? If not, then can anyone recommend a psychologist in the San Francisco Bay Area willing to charge less than $120 an hour for this
service?
The FAA Aeromedical Certification Division wants the following in order to reconsider my medical certificate:
a. A current psychological test evaluation:
1. Wisconsin Card Sorting Test
2. The Trail Making Test
3. The Paced Auditory Serial Addition Test (PASAT)
b. A report by a qualified clinical psychologist.
The report should include:
1. The complete Wechslet Adult Intelligence Scale (WAIS-R)
2. The Minnesorta Multiphasic Personality Inventory
c. The report must also three or more of the following tests:
1. Cognitive function screening test such as Category Test,
Wechsler Memory Scale, California Verbal Learning, or Rey Auditory
Verbal Learning
2. Projective test such as Rorschach or Sentence Completion
3. Personality inventory such as NEO-R,
Personality Assessment Inventory,
Millon Clinical Multiaxial Inventory (MCMI)
4. Symptom screening test such as Beck or Hamilton or depression or
MAST for alcoholism.
Any words of advice? Does anyone have any experience with a similar situation?
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