BasicMed is a program developed by the Federal Aviation Administration (FAA) in response to the FAA Extension Safety Security Act of 2016 (FESSA) that exempts certain pilots from holding an FAA-issued medical certificate in order to fly certain small general aviation aircraft. It has been available since May 1, 2017. The program allows any state-licensed physician to examine those pilots operating aircraft under this new rule. If you are a physician interested in serving in this capacity, read on and follow the links below to learn about BasicMed and how to conduct these examinations.
Which pilots does BasicMed apply to?
This BasicMed rule applies to pilots flying certain small aircraft under specific restrictions. They must be flying general aviation aircraft having a capacity of 6 or fewer seats and have previously held a valid FAA medical certificate. It does not apply to commercial pilots or airline transport pilots who fly passengers or cargo aircraft for hire, who must still get their medical certificate from a designated FAA Aviation Medical Examiner (AME).
How does BasicMed work?
A BasicMed pilot must hold a valid driver’s license and have held a valid FAA medical certificate issued at any time after July 14th, 2006. If the individual you are examining has never held an FAA medical certificate, they must apply for one through an FAA Aviation Medical Examiner (AME). Also, their most recent medical certificate may not have been suspended, denied or revoked, or in the case of a special issuance (SI) medical certificate, it may not have been withdrawn. A SI is a “waiver” granted by the FAA in the event that an aviator does not meet published medical standards, but the FAA has determined that it is safe for them to fly with their medical condition. The applicant will arrive at your office having completed the “individual information” portion of the FAA’s Comprehensive Medical Exam Checklist (CMEC). This assessment will capture the applicant’s personal information and their medical history. It is not the responsibility of the examining physician to ensure that the pilot is being truthful in attesting that they meet the BasicMed requirements. The physician must only ensure that the affirmations on the CMEC have been completed. As the examining physician, it will be your responsibility to exercise medical discretion to address any medical conditions identified and to exercise medical discretion in determining whether any medical tests are warranted as part of the comprehensive medical exam. Provided you are satisfied that the applicant does not present any medical evidence that they are unsafe for flight, you can sign and date the Physician Attestation Statement.
The FAA provides a good website outlining BasicMed requirements at FAA BasicMed website.
The Aircraft Owner’s and Pilot’s Association (AOPA) has developed an Fit to Fly Selector Tool you and your pilot can use to determine a pilot’s eligibility for BasicMed.
You are encouraged to review FAA Advisory Circular 68-1A, which contains detailed information about BasicMed, before you begin performing these examinations at
AOPA also has a “Fit to Fly Physician’s Guide” and a “BasicMed Pilot & Physician Guide”:
How do I do a BasicMed exam?
The FAA has provided a checklist that pilots and state-licensed physicians must use to complete the BasicMed examination called a Comprehensive Medical Examination Checklist (CMEC). At the start of the exam, you will ensure that the pilot has completed Part 2 of the checklist and will review their responses. You will then perform a standard history and physical exam, reviewing all current prescription and non-prescription medications, which you will record in Part 3. The website below lists medications that are not authorized for flight by FAA AMEs.
While you are not bound to follow this list as a BasicMed examiner, it is a good starting point, as is the FAA Guide for Aviation Medical Examiners.
Use clinical judgement to determine if additional testing is warranted (lab work, EKG, etc.). Once you have determined that the pilot is fit for flight, sign the Attestation Statement and return it to the pilot. These examinations must be completed every 48 months. Additional information can be found in the Instructions for completing FAA Form 8700.2.
If the pilot has developed certain mental health, cardiac, or neurologic conditions for which they do not currently have a special issuance (SI), they must have been evaluated for SI by the FAA before they may exercise pilot duties to fly under BasicMed. List of disqualifying medical conditions and medical condition requiring Special Issuance.
In addition to a medical examination every 48 months, BasicMed requires pilots to complete an aeromedical education course every 24 months. There are two courses available, one from the AOPA and the other from the Mayo Clinic.
You can audit either the Mayo Clinic or AOPA course without being a pilot if you want to review the information yourself.
FAQ:
What if I don’t think the pilot should fly?
Good question! Your first approach should be to work with the airman, but do not sign the Attestation Statement. Request additional testing or consults as needed, and manage their medical condition until you do feel it is safe for them to fly. Explain to the airman what steps you are taking, why you do not feel it is currently safe, and what parameters they will need to reach in order for them to be cleared to fly. If you do not feel they can ever fly safely, then do not sign the Attestation Statement.
What skills do pilots need when flying?
Pilots need to understand technical information, have good spatial awareness, good communication skills, and have the ability to think quickly and make decisions in difficult situations. They must be able to reach for and manipulate controls including overhead panels in some aircraft. You should take these things into consideration during your exam.
What if the airman is taking medication?
It is important to ensure that your patient is not taking medications that will cause drowsiness, confusion, cognitive effects, or dizziness. You can review the list of medications authorized and disallowed by the FAA below, though you are not bound by that list.
What if I have questions?
You can refer to the AME Guide link above. You can also consult with colleagues, including those who are either AMEs or Aerospace Medicine Specialists, though if you consult with an FAA AME, they are answering questions strictly on their own and are not representing the FAA when they do so. Because the FAA Office of Aerospace Medicine does not have oversight responsibility over BasicMed, it cannot provide answers to physicians who perform BasicMed exams, nor can the FAA provide you with any information from the airman’s medical file without written consent, the sole exception being to affirm the status of the airman’s most recent medical certificate. However, the FAA has developed a comprehensive FAQ list.
The airman I examined has a serious medical condition, so I didn’t sign the form, but I suspect he/she is flying. What do I do?
The BasicMed system relies on the integrity of the airmen. Your options are 1) talk to the airman, 2) file an anonymous tip on the FAA hotline, or 3) do nothing. You are under no legal obligation to act, though you may feel a moral obligation, especially when there is risk to others.
I am a Physician Assistant/Nurse Practitioner. Can I perform a BasicMed examination?
No. BasicMed requires that the examining individual be a state-licensed physician.
What is an FAA Aviation Medical Examiner? It sounds interesting.
You can find additional information about this on the FAA’s website. FAA AMEs provide medical examinations to all classes of pilots and help to ensure safety in the skies. Receiving an AME designation can provide a change of pace within your current medical practice or can even lead to an entirely different career in the aviation medicine field. To be clear, you are not required to be an FAA AME in order to perform a BasicMed exam. For more information on what AMEs are and how to become one, visit: