Getting Started

If there are any medical concerns, like the fact that you take insulin, I strongly recommend getting a medical certificate before you begin lessons. There are two reasons for this… First, if you are unable to obtain a medical certificate, you won’t be able to fly solo, and you won’t be able to obtain a private pilot certificate. Second, before you can fly solo, you must have a valid medical certificate. Once you begin training, you don’t want to be held up waiting for medical approval when it’s time for you to solo.

So, locate an Aviation Medical Examiner (AME) in your area. The FAA web site will have all AME’s in your area, so start there. Before you decide on an AME, ask local pilots in your area which AME they use and why. An AME doesn’t have to be a pilot, by the way. Often, it’s just a matter of personal taste and location as to which AME you select. If you are medical capable of obtaining a medical certificate, it shouldn’t make any difference as to which AME you choose. In fact, with insulin dependency, as well as with a number of other conditions, your application WILL be initially rejected by the FAA. This initial application is only the first step. You will have to provide other documentation later before you end up with a valid certificate. It may take months to get through all the hurdles. In my case, it was 10 months after my initial application, and a couple of additional documents, before I had that certificate.

Again, I’m focusing on insulin dependency here, but you will need to see your endocrinologist every 3 months and have HbA1C values at each of those visits. So, if you haven’t been doing this already, start doing so. You will need a year’s worth of HbA1C quarterly data. Your endocrinologist will have to provide exactly what the FAA is requesting in his correspondence that you will be submitting on a regular basis, namely his evaluation of your control, his comments on your blood glucose levels at each visit, your hypoglycemia awareness, etc. If any of this is left out, the FAA will deny your application until it is supplied.

You will also need an annual eye exam from an ophthalmologist. A letter from your ophthalmologist will need to describe your visual clarity (you must have at least 20/40 in each eye, corrected or not), and any other issues with your eyes (such as retinopathy, etc.) and whether or not other issues affect your visual clarity.

Depending on your age and medical issues, the FAA may require a treadmill stress test every 5 years. Go ahead and have this done in order to submit this when they ask. The FAA requires copies of the test charts, not just a doctors evaluation of them.If you take insulin, you are not allowed to take any other hypoglycemic agents. This means you won’t be able to take oral medications to reduce insulin resistance. The FAA will NOT tell you that you must stop. They do NOT give medical advice. And, if your doctor feels that you need other medications, your health is more important that obtaining a pilot license. But, if you are taking other oral medications to reduce insulin resistance, and your doctor feels that it isn’t necessary for good control, you may wish to talk to your doctor about medication changes. Otherwise, the FAA will deny your medical certificate.

The FAA maintains a changing list of allowed and disallowed medications. You won’t find such a list on the FAA web site. You will find such a list on the AOPA web site, provided you are a member of the AOPA (another good reason to join AOPA). You should always know what medications you are considering are allowed and which are banned. Often, there are alternatives your doctor might prescribe. Again, the FAA does NOT provide medical advise. That’s between you and your physician.

Antidepressants are never allowed by the FAA, even if not taken for depression. UPDATE: Certain SSRI antidepressants are now allowed.  Certain medications can’t be taken within a certain time of flying. Any medication that may have an affect on your ability to clearly think or act will not be allowed.

The FAA does not publish a list of “approved” medications for pilots.  If you are an AOPA member, you can check the currently allowed and disallowed medications from their site in the members only section.  You can also check Aviation Medical Advisory Service or Pilot Medical Solutions.

There are specifically disqualifying medical conditions the FAA lists that will prevent you from initially obtaining a medical certificate to fly.  This doesn’t mean you still can’t get a medical certificate.  It means additional steps, approval, and reviews must be conducted, at the FAA’s discretion, in order to obtain a special issuance medical certificate.  The conditions are:

• Angina pectoris
• Bipolar disorder
• Cardiac valve replacement
• Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant
• Diabetes mellitus requiring insulin or other hypoglycemic medication
• Disturbance of consciousness without satisfactory medical explanation of the cause
• Epilepsy
• Heart replacement
• Myocardial infarction
• Permanent cardiac pacemaker
• Personality disorder that is severe enough to have repeatedly manifested itself by overt acts
• Psychosis
• Substance abuse and dependence
• Transient loss of control of nervous system function(s) without satisfactory medical explanation of cause.