Elimination of the third class medical—What I posted on the aeromedical Email list

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I have been a Senior AME for over thirty year and have been controversial but I have never had to endured as much distain from many of my fellow AMEs for supporting the elimination of the third class medical--even to the point of being hesitant to post this opinion on the list.

First, I think it is important to recognize a distinct difference between a third class medical and the second and first class ones.  When we get into someone’s automobile, we are assuming a certain amount of risk.  When we get into a Greyhound bus, we are assuming that the driver has passed various certifications like a commercial driver’s license (CDL) and a CDL medical

When one gets into an aircraft of a pilot who is flying Part 91, there is an assumption of risk by the passenger just like the automobile.  No one is suggesting we eliminate second and first class medicals for commercial operations.

During the two to five years between third class medical exams, every pilot self certifies that he is safe to fly.  Forget that all pilots are supposed report any change in condition that would adversely affect their medical--this just not happen.  Have these pilots done a good job with this interval self-certification?  The statistics show the answer is a resounding "yes."

What do we do as AMEs?  We certify most people and make the rest go through the special issuance process of which most pilots are eventually--after much time and expense--given their medicals. The number who never get their medical (or medical back) is incredible low.

Now some may say that many pilots who would not qualify do not apply because of fear of failure. That may be true but what do these pilots do?  Many fly "light sport", gliders, or balloons. Since the medical related accident statistics for these groups essentially are the same as the third class medical population, again the question is “what are we doing?”

We have watched the FAA loosen medical certification of the past 30 years without any significant consequences.  The certification of insulin dependent diabetics, those with a cardiac history, and many other conditions are now routinely granted SI's without any ill told impact on aviation safety. (Show me the IDDM pilot who tests their blood every hour in the aircraft.)  The FAA has been dragged kicking and screaming to certify more and more previous un-certifiable pilots with various medical conditions.  Where are the statistics which show this has been a problem?

We have to also realize that we need to reduce as many barriers to flying as possible or we will eventually not have any third class general aviation pilots to certify.  The recent depression has sent GA into what may be an unrecoverable dull-drum.  Even with the recovery, the high price of fuel is a major hindrance to flying and is unlikely to ever drop.  Reducing the cost and hassle of having to obtain a medical and particularly the special issuance medical will eliminate significant barriers.

I understand that a few AMEs make their living from doing flight medicals.  However, this small group will still be busy with second and first class exams.

The truth is that the far majority pilots do not want to take risks.  Those that are reckless will fly regardless of any medical issues by falsifying their medical history and/or flying with conditions they know they should not be. As AMEs, we do not impact these shortsighted pilots with a third class medical.  We may have more impact by giving quality lectures and writing accurate articles for the aviation community so pilots can use good aeromedical information to continue their self-certification before any flight whether they hold a third class medical in their pocket or not.

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Comment by Michael Millman on September 17, 2014 at 7:58pm

I very much appreciate Dr. Blue's analysis, and agree. There are hurdles and restrictions in many professions / activities that were thought to provide benefit and safety, but were based on beliefs and not facts. This is another example where the data just doesn't support the value of a third class medical. 

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