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AME Physicians

The Aviation Medical Examiner is the most important professional in the airman's medical certification. As an agency specializing in behavioral medicine, Aviation Psychology works closely with AME's to provide you, the physician, with what you need to certificate the pilots with whom you work.

CFR (FAR) Parts 67.107 (67.207 and 67.307) provide the "Mental Standards" for airmen. This is the area where we can be of most help to you in evaluating a pilot's fitness for certification. In addition to the psychiatric symptoms associated with emotional and behavioral conditions, related incidents of brain injury, Human Immunodeficiency Virus (HIV), Driving Under the Influence (DUI) and problematic behaviors may be under review in your examination of a pilot.

Even under the new BasicMed program associated with Third Class Medical Reform, these conditions require evaluation through the AME (or, in the case of BasicMed, the family doctor). We are glad to consult with you regarding your airman patient who may have any condition covered under the standards (see below).
The FAA's Guide for Medical Examiners states: As of 2017, the standards are as follows:

§67.107 Mental. (First, Second and Third Class have identical standards)

Mental standards for a first-class airman medical certificate are:

(a) No established medical history or clinical diagnosis of any of the following:
  • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts.
  • A psychosis. As used in this section, "psychosis" refers to a mental disorder in which:
    • (i) The individual has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition; or
    • (ii) The individual may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition.
  • A bipolar disorder.

    (4) Substance dependence, except where there is established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section-

    • (i) "Substance" includes: Alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and
    • (ii) "Substance dependence" means a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by-
    • (A) Increased tolerance;
      • (B) Manifestation of withdrawal symptoms;
        • (C) Impaired control of use; or
        • (D) Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.
(b) No substance abuse within the preceding 2 years defined as:
  • (1) Use of a substance in a situation in which that use was physically hazardous, if there has been at any other time an instance of the use of a substance also in a situation in which that use was physically hazardous;
  • (2) A verified positive drug test result, an alcohol test result of 0.04 or greater alcohol concentration, or a refusal to submit to a drug or alcohol test required by the U.S. Department of Transportation or an agency of the U.S. Department of Transportation; or
  • (3) Misuse of a substance that the Federal Air Surgeon, based on case history and appropriate, qualified medical judgment relating to the substance involved, finds-
    • (i) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
    • (ii) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
(c) No other personality disorder, neurosis, or other mental condition that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds-
  • (1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
  • (2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
[Doc. No. 27940, 61 FR 11256, Mar. 19, 1996, as amended by Amdt. 67-19, 71 FR 35764, June 21, 2006]