As an AME, who do you reach out to for assistance with Special Issuance cases?

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"Flying a plane is no different from riding a bicycle. Its just a lot harder to put baseball cards in the spokes."

— Captain Rex Kramer, in the movie Airplane.

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CAMA sends point paper to Senate Committee as PBR-II bill is marked up this week
A point paper and recommendations from CAMA was forwarded to the Senate Commerce, Science and Transportation Committee to weigh in on negotiations of the Pilots Bill of Rights II bill currently being marked up for possible movement to the Senate floor in the very near future. The Pilot's Bill of Rights II (S. 571) calls for private pilots who fly aircraft of certain specifications be allowed to fly without any medical surveillance other than the ability to quality for an unrestricted driver's license in the airman's respective state.
The paper encouraged expanding the use of Conditions AMEs Can Issue (CACIs) as a first step to improving turnaround time. Allowing designated Aviation Medical Examiners (AMEs) the ability to use a checklist approach to ensure an airman is meeting pre-designated medical criteria currently helps to expedite a variety of cases that previously required medical waivers to be reviewed by the FAA.
CAMA also proposed establishing Centers of Specialized Aeromedical Excellence that would allow for medical centers or clinics that meet certain criteria to be designated by the FAA to assist the agency in assessing and reviewing cases involving pilots with complex medical conditions. Centers, particularly those with an educational mission and/or training programs in Aerospace and Aviation Medicine could be designated by the FAA to serve as specialized centers to evaluate multiple cases that would be presented to FAA medical reviewers for aeromedical certification decisions after all supporting data were collected and collated. Subspecialty experts could be pre-scheduled to provide their opinions and discuss current medical literature applicable to making a medical certification decision as needed. Designating centers also would serve to assist the FAA in preparing cases for presentation to a reviewer panel at no cost to the taxpayers or pilots (other than traveling to a regional center of excellence for testing and aeromedical reviews which would not be required but would be at the pilot’s discretion), and allow pilots to seek care at medical institutions with specialized expertise in aviation physiology and environmental factors unique to aviation in order to expedite medical certification review.
CAMA provided the following recommendations or points:
  • Opposed the legislation (S.571) as written currently but is open to compromise language that preserves a system of periodic preventive surveillance assessments, particularly for pilots with complex medical conditions;
  • Recommended that the legislation be amended to include designation of Centers of Specialized Aeromedical Excellence to assist the FAA in processing applications associated with pilots who have been diagnosed with complex medical conditions;
  • Encouraged the FAA to further expand use of CACIs for a variety of medical conditions, and decentralize the process of medical decision-making for medical conditions for which specific criteria can be followed by the AME;
  • Urged Senate members to include language in the bill that would compel the FAA to work with civil aviation safety organizations to determine what medical conditions require special surveillance as part of a compromise proposal;
  • Suggested that if frequency of medical certification is altered, that evaluations occur with AMEs or providers that can demonstrate specific training or knowledge of the aviation environment;
  • Supported efforts to improve education to pilots on the importance of medical fitness as a critical component of aviation safety. 

"We would rather be running toward a solution rather than away from a problem," said CAMA President Clayton T. Cowl, MD, a senior Aviation Medical Examiner at Mayo Clinic in Rochester, Minnesota. "The reason for the legislation in the first place was to reduce regulatory burden on pilots. What has sustained it as a continuing discussion issue has more to do with delays in medical certification than solely in cost or regulatory burden of the medical exam itself. We are looking for a way to ease the burden of establishing medical fitness for duty for general aviation pilots but without jeopardizing public safety."
CAMA led a consortium group of aviation interest groups in October just prior to its annual meeting. A white paper is being drafted that will be presented to FAA aeromedical leadership providing suggestions for addressing significant delays in processing certain types of medical conditions. Plans are underway to set up a meeting in Washington DC at the Federal Air Surgeon's Office early next year.
Energy from annual meeting to be harnessed to offer more service to membership

Focusing more value to membership has been identified as one goal for the coming year, according to discussion at the latest CAMA Board fo Directors meeting. Although membership has grown slightly in the past three years, only approximately 12 percent of AMEs are full members of CAMA. The FAA has reported that the average age of AMEs across the nation has climbed to 60.8 years, suggesting a critical shortage of examiners with strong aeromedical knowledge may be imminent.


CAMA will be working on offering for members that include more resources for assiting with complex cases, creating a stronger culture of serving pilots who need help navigating FAA aeromedical certification, and proactively reaching out to the FAA to decrease turn around times of reviewing cases requiring Special Issuance authorization as well as expanding CACIs (Conditions AMEs Can Issue).


The CAMA Board also pledged to continue to offer state-of-the-art educational meetings that feature FAA renewal certification for examiners.



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