AMEs

[sunday driver]

Well I am having real problems.
1. My long-time AME - a fine chap - was 'audited' by the CAA a couple of years ago, and is no longer listed.
2. The chap who did my next medical - seemed OK - had retired when I came to renew this year.
3. So, I am looking for my 3rd AME in as many years.

The Problem
I am hunting for someone a reasonable distance from Andover, but those I have tried to contact have either closed their list to new applicants (clearly a good sign), or don't answer emails (clearly not a good sign).

Is there a diminishing supply of AMEs?
Is it just me?
Does everyone have to drive for miles to get a class 2 medical these days?
Thoughts? Suggestions?

SD :sad:

[Capt Kremmen]

Do you really need a Class 2 ? What certification do you normally fly ? EASA, LAA Permit, CAA Permit ? What licence category ?


IF it is outside EASA then a CAA Medical Declaration might suit.

[alex90]

Quite a few AMEs around the south of London have recently retired, including my AME, I hear that there are a couple of practices that are still currently running that are also considering closing within the next few years.

Are they diminishing, in my eyes yes, but perhaps all the AMEs just work part time out of the big centre at Gatwick!

I keep telling my other half (who is a doctor), to consider becoming an AME, but although she loves flying with me, she has no real interest in the aviation industry which is a barrier to become an AME (not really sure why - although an interest is definitely a good thing, they don't do much more than a set of required tests which surely could be done by any competent doctor with the mandatory training that the CAA provides). It looks as though you either need to have a Pilot's Licence (£10,000 +), or do a 1 year full time course at KCL (which costs £27,750).

Perhaps these barriers are somewhat too strenuous to attract new, younger doctors to the AME field.

(or perhaps they all buggered off to Australia to get a fair wage & fair timetable!)

[A le Ron]

Quite a few AMEs around the south of London have recently retired, including my AME, I hear that there are a couple of practices that are still currently running that are also considering closing within the next few years.

Are they diminishing, in my eyes yes, but perhaps all the AMEs just work part time out of the big centre at Gatwick!

I keep telling my other half (who is a doctor), to consider becoming an AME, but although she loves flying with me, she has no real interest in the aviation industry which is a barrier to become an AME (not really sure why - although an interest is definitely a good thing, they don't do much more than a set of required tests which surely could be done by any competent doctor with the mandatory training that the CAA provides). It looks as though you either need to have a Pilot's Licence (£10,000 +), or do a 1 year full time course at KCL (which costs £27,750).

Perhaps these barriers are somewhat too strenuous to attract new, younger doctors to the AME field.

(or perhaps they all buggered off to Australia to get a fair wage & fair timetable!)
The CAA applies certain criteria, including being on the specialist register, having a pilot's licence, and having attended the courses on aviation medicine at King's. The latter is proving problematic at the moment (the courses are once a year; the course for this month has just been cancelled). Added to this, there are a number of older AMEs retiring, and much dissatisfaction with the changes at the CAA leading to others giving up their aeromedical practice in favour of less stressful areas. It is also true that some AMEs have abreacted to the new CAA audit process. So as far a source I know, the reduction in the number of AMEs is very real, but hopefully the pendulum will eventually swing the other way. I am aware of examples of all of these issues in my local area (Yorkshire) where I have practised as an AME for several years now.

[abgd]

If I were a younger doctor 1) I wouldn't be able to post anonymously because the GMC disapproves* and 2) I would be worrying that with moves such as self-declarations afoot and the diminishing number of ppls, the supply of work might dry up.

Dabbling in aviation medicine doesn't look like an attractive option; the amount of work required not just to qualify as an AME but also to stay on the register (having one's premises inspected etc...) seems quite significant. You'd have to be doing a lot of work per year to make it worthwhile.

1/100 PPLs will die flying, often taking other people with them. Medical issues _are_ implicated fairly frequently, so I would anticipate an unpleasant degree of scrutiny from time to time.

This is just my impression from reading the requirements. If any AMEs would like to tell me otherwise, I'd be interested. However I suspect that we'll move towards there being a smaller number of more active AMEs - which may be no bad thing.

* This was very controversial and felt by many doctors to be an unwarranted intrusion on one's private life.

[wiggy]

Dabbling in aviation medicine doesn't look like an attractive option; the amount of work required not just to qualify as an AME but also to stay on the register (having one's premises inspected etc...) seems quite significant. You'd have to be doing a lot of work per year to make it worthwhile.



That seems to be the story more and more of us are hearing as our AMEs retire.

[460]

"1/100 PPLs will die flying, often taking other people with them."

I would be grateful for the source of that information, abgd.
Thank you.

[flyingorthopod]

I had thought about sething up as an AME to do class 2 medicals, but the admin and cost* obstacles really mean it wouldn't be worthwhile. I'do do it even if it only made a small income but I think it would cost me money instead. And I wouldn't need to do any extra training really.

Pity as I could do with a way to pay for more flying!

*insurance, premises etc. My phone autocorrected costs to "costrich".

[flybymike]

1/100 PPLs will die flying, often taking other people with them. Medical issues _are_ implicated fairly frequently,

What an extraordinary claim. One wonders how the CAA dared to allow self declarations, how the NPPL survived so long using self declarations, and how the FAA ever permitted "driver's licence" medicals.

[360BakTrak]

Fly up to Gloucester to do it; based on-airfield with online booking, and a top chap!

Gloster Aviation Medicals Ltd | Aviation Medical Services (http://www.glosteraviationmedicals.co.uk/)

[Talkdownman]

Fly up to Gloucester to do it; based on-airfield with online booking, and a top chap!
Doctor Foster?

[old,not bold]

1/100 PPLs will die flying,Like others who commented on that, I am always bemused by people who fling utterly absurd "statistics" into a discussion without a second's thought along the lines of "hang on, that can't be right". That was my initial reaction to seeing the assertion. It took googull about 1/10 of a second to bring up a table of EASA and UK National licence holders (https://www.caa.co.uk/uploadedFiles/CAA/Content/Standard_Content/Data_and_analysis/Datasets/Licence_holders_by_age_and_sex_by_year/Pilot%20licence%20holders%20by%20age%20and%20sex%202015.pdf) broken down by age and sex (sorry, couldn't resist) and another 30 seconds to work out that if the assertion were true, we would be reading about an average of somewhere between 2 and 3 PPL/NPPL etc holders dying while flying every week, assuming that nearly all PPL holders hold both UK national and EASA licences (see the note at the bottom of the table.)

So I too "......would be grateful for the source of that information, abgd.

Thank you."

[tmmorris]

Is Wantage too far from Andover? If not PM me and I'll send details of my chap.

[abgd]

Like others who commented on that, I am always bemused by people who fling utterly absurd "statistics" into a discussion without a second's thought along the lines of "hang on, that can't be right". That was my initial reaction to seeing the assertion. It took googull about 1/10 of a second to bring up a table of EASA and UK National licence holders (https://www.caa.co.uk/uploadedFiles/CAA/Content/Standard_Content/Data_and_analysis/Datasets/Licence_holders_by_age_and_sex_by_year/Pilot%20licence%20holders%20by%20age%20and%20sex%202015.pdf) broken down by age and sex (sorry, couldn't resist) and another 30 seconds to work out that if the assertion were true, we would be reading about an average of somewhere between 2 and 3 PPL/NPPL etc holders dying while flying every week, assuming that nearly all PPL holders hold both UK national and EASA licences (see the note at the bottom of the table.)If 3 ppl holders died every week, that would be 156 a year and more than 1% per year. I never claimed that 1% would die in a year. I claimed that around 1% will die flying i.e. over the course of their flying careers. You're trying to calculate the incidence of death-by-aviation amongst private pilots, which admittedly would be a more sensible thing to do in this instance.

The truth of the matter is that I don't remember where I first found/derived the 1% statistic. I would agree that it's suspect in that there's probably not enough information in the public domain to get more than a decent approximation. However, it doesn't seem outlandish to me. The statement could also be more precisely specified - does '1% of ppls' mean 1% of people who qualify over a given period of time - which will include a lot of inexperienced pilots - or does it mean 1% of people who hold a ppl at a given point in time - which will contain a higher proportion of long-term pilots who have built up a significant number of hours.

Have a look at CAP667, page 30. 158 pilots were involved in fatal accidents over a 10 year period, at the end of which there were 25592 pilots. That's 0.6% fatal accidents per pilot. Of course some of the people killed will not have been the pilots. On the other hand, more than one person is killed in an average fatal crash, and that '+1' person is reasonably likely to be a pilot. I am well aware of the fact that the number of pilots has waxed and waned over the years. I'm also aware that many pilots won't fly for the 16 years necessary to rack up a 1% risk. On the other hand, many will fly for much longer.

Another way of looking at it - aircraft are involved in fatal accidents somewhere between 1/10,000 hours for permit types and 1/43,000 hours for certified types (page 34). 100 hours in a permit aircraft - 1% of 10,000 - isn't that difficult to accrue. Fewer people will get to the 430 hours required to run a 1% risk of being involved in a fatal accident in a certified aircraft. That said, the pilots in the 37 year-old+ age categories were racking up 34-49 hours a year so it isn't unreasonable to imagine that a high proportion of these long-term PPLs would reach or exceed that numbers of hours over the course of their flying careers ('career' meant in the non-commercial sense).

So, as a citeable statistic, mea culpa, I'll try and remember where it came from but I can't quite recall that at the moment. As a decent back-of-the-envelope figure I stand by it (which is what 1/100 is, as oppose to 1/89 or 1/122).

What I would fear is that if an AME has enough pilots on his or her books to make being an AME worthwhile, the chances are that a few of them will be killed in flying accidents over the course of the AMEs career. I think my AME saw about 170 pilots a year - I don't know if that counts as a lot or a little.

Flybymike: the question your statements relate to is 'how many accidents would have been prevented by the requirement to get a medical from an AME?'. If the answer is 'hardly any' then you can make a good argument against requiring a medical. It's an argument I have some sympathy for, with the caveat that I don't know enough to hold any firm opinions in either direction.

'What proportion of accidents are partially or wholly due to medical causes?' is a different question. This paper suggested about 4.7%: Role of medical factors in 1000 fatal aviation accidents: case note study BMJ 1997;314:1592.

As a prospective AME, the question to ask would be different again: 'if a pilot has a fatal accident, how much grief will the investigation cause me, even if it's ultimately not found to be due to medical causes?' As an example, only a small proportion of fatal accidents are generally thought to be suicide, but what proportion of all accidents might have been due to suicide? Will my notes be medicolegally watertight? Or if there's a discrepancy between the GP records (e.g. early signs of heart failure) and the AME records (no early signs of heart failure) will this result in aggressive cross-examining whether or not it's directly relevant? Pilots and their passengers are often wealthy and I'd expect a reasonable chance of high-grade acrimony after untimely deaths. I have no idea whether or not this is frequently the case.

[Sleeve Wing]

Wow, abdg, I’d guess you have got to be an accountant ! So much information……..
That’s the trouble with everything to do with flying these days; excess analysis that bears little relation to what we actually do.
Bring back the good old days when we had no radios and your licence could be used as a passport ! ;)

[astir 8]

My AME is giving it up shortly - too much hassle, not worth it.

Very sad and it'll be a problem finding another around here:(

[Whopity]

The diminishing number of AMEs is largely the result of the incompetence of the CAA management who presumed to dump all their responsibilities onto the AMEs whilst closing down the CAA Medical Dept to save money.

My AME, who I have know for 40 years, said a few years ago that he had no intention of stopping. At the last Medical he said "I have had enough, I don't know who to recommend because many more are quitting for the same reason".

[abgd]

I wonder how things are working out for professional pilots in need of a class-1?

[Curlytips]

For airline pilots, fees are reclaimable, so since CAA shut its medical centre, 3 AME practices covering London area have "merged" and increased rates considerably - so much so that they definitely won't disappear any time soon.

Unfortunately they also increased the cost of a Class 2 by more than 50%, so I've had to find a new local guy at a reasonable rate, rather than take the long drive to expensive Gatwick.......

[Hornet33]

I wonder how things are working out for professional pilots in need of a class-1?
There are some very good practitioners around including Peter Orten at Stansted.

[First_Principal]

@abgd If I were a younger doctor 1) I wouldn't be able to post anonymously because the GMC disapproves*Wow, '1984' anyone!

https://en.wikipedia.org/wiki/Thought_Police

I say the GMC should be made to read Eric's book, perhaps Aldous Huxley, and finally JS Mill...

FP.

[sunday driver]

Thanks for the replies and suggestions.

Capt Kremmen - I fly EASA, though if the AME trend continues I may need to reconsider.

360BakTrak - thanks for the Gloucester suggestion

tmmorris - thanks for the Wantage suggestion

I have gained an email reply from a reasonably adjacent AME.
Hasn't yet solidified into a specific appointment time - slightly unsettling, though I guess there are those who have a life beyond email.

We'll see how it goes.

SD

[Lordflasheart]

Curly - For airline pilots, fees are reclaimable, My :cool: AME heard that BA has told its pilots that they will soon only get “free” medicals if they use the company docs, but if they insist on using independent AMEs, the fees will no longer be refunded. Apparently the BA AMEs are cheaper. I think that means cheaper for BA – I didn’t get the impression it was a subtle advert for all and sundry non-BA folk to try booking their aviation medicals at the BA Medical Dept.

Not sure I would want to get my licence medical at the Company Store .:suspect:

[Curlytips]

But still the original problem was caused by CAA closing it's doors at the medical centre. Nice for BA to be able to save cash, but no help to Class 2 users who will certainly pay more in the future. Just part of ongoing PFI (private flying inflation), I guess.......

[MungoP]

I was in the same position as you a couple of years ago. My long term AME had retired, been looking after me for 35 years. I had been flying more recently on N reg a/c (FAA).. Needing to find another AME I tried Gloster Aviation Medicals at Gloucester/Staverton. He picked up on a small issue with my right eye.. something I'd been flying with for my entire career.. No only did he refuse my medical, he faxed off his results to the FAA HQ at Oklahoma.. I was then told I would have to attend the FAA medic center at OK.. maybe take a flight test etc etc.. a few thousand $$$$$. Unless you're in perfect shape I'd give Gloster Aviation medic. a very wide berth.