Mayo Clinic Clear Approach: Recent Episodes
Greg Vanichkachorn MD, MPH
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As the holiday season approaches, one gift to pilots is the AME Guide available from the FAA on line as an insider resource to aviators preparing for their flight physicals. Think of preparation for a flight physical as a pre-flight inspection of yourself. Medical conditions never seem to strike at convenient times, so having an online, free, and accessible guide to understanding what tests and materials might be required by your AME is a true gift in the process of navigating FAA medical certification.
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On this episode, we review glaucoma, one of the most common causes of visual acuity loss in older adults and gradually affects visual field of pilots if not detected early. That early detection is a key factor in preventing its effects. What about aeromedical certification implications? Is there CACI criteria available for glaucoma? Is a pilot able to hold a medical certificate with this condition?
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On this episode, we access a world expert on complex cardiac arrhythmias that can result in sudden cardiac death. Can a pilot resuscitated on the flight deck or in the field actually get back to flight duty? What trends are being seen in the FAA cardiology panel when it comes to consideration of these conditions? Why is it important to perform detailed research and provide data to the FAA to help shape future aeromedical decision making?
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On this episode, we interview Dr. Wigdan Farah, a pulmonologist in Mayo Clinic's Division of Pulmonary & Critical Care Medicine to discuss several respiratory conditions seen commonly in pilots seeking medical certification -- then review aeromedical implications and requirements.
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On this episode, we ask a few questions of an aviation attorney as it pertains to aeromedical certification. How worried do pilots need to be about falsification on on a medical application -- intended or unintended? What is the liability for using BasicMed as an alternative to aeromedical certification? What are the most common cases for which pilots contact an aviation attorney?
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On this episode, we review any potential changes in flight physical reviews on the basis of the government shutdown. In addition, with the outstanding weather this fall in the upper Midwest, we review ultraviolet radiation effects as it pertains to skin cancer and how that can affect aeromedical certification.
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On this episode, we discuss items learned at the Civil Aviation Medical Association meeting (CAMA) in Spokane, Washington along with a few updates from the FAA communicated on the recent AME Grand Rounds held virtually this past week.
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A certain portion of pilots develop low platelet counts, otherwise known as thrombocytopenia. On this episode, we look at how platelets work in the body, what happens if there are not enough platelets, and why the FAA even cares. Having a good plan in place with your AME to deal with this condition is important when considering aeromedical certification.
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Atrial fibrillation is one of the most common forms of heart arrhythmia that require Special Issuance Authorization from the FAA. On this episode, we review what testing is required and how difficult the challenge is to obtain a medical waiver for the condition.
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Falls, crashes, and other events resulting in head trauma are never planned but can have significant consequences for a pilot's ability to maintain a medical certificate. On this episode, we review the various levels of severity of head trauma as defined by the FAA and navigate direct paths to aeromedical certification.
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On this episode, we visit with an FAA-trained neuropsychologist -- an expert in the field of testing cognitive ability -- often required as part of medical certification in pilots with conditions such as depression, ADHD, prior drug or alcohol disorders, and past head trauma. We ask what to do, and what not to do as part of these testing sessions, often cloaked in anonymity.
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Many times in the process of obtaining an aviation medical certificate, pilots come across acronyms and terms typically unfamiliar to most people. On this episode, we decipher some of those terms so you can impress friends and family at the hangar or pilot domicile.
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On this episode, the podcast returns Mitch and Clay from extended vacations to review highlights from one of the largest aviation events in the country held in Oshkosh, Wisconsin -- along with outlining the framework for an upcoming AME refresher seminar to be held by the FAA Education Division on the Mayo Clinic campus.
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Ever wonder what an AME feels like when they have to undergo the scrutiny of a flight physical themselves? On this episode, we reflect on life from the "other side of the gurney" and how to best prepare for undergoing a flight physical before showing up.
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Hepatitis C is a viral infection of the liver that often involves no specific symptoms -- until it is too late. On this episode, we cover a pathway to FAA medical certification in pilots who contract this sneaky virus.
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On this episode, we visit with soon-to-be retired Executive Director of the Aerospace Medical Association, Jeff Sventek. His insights from more than 30 years in the United States Air Force along with 15 additional years guiding the leading specialty organization for Aerospace Medicine culminate with the annual Scientific Meeting scheduled in Atlanta the first week of June. We will get a sneak peak of the meeting and ask about his vision for the future of the specialty.
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On this episode, we discuss a pilot who was charged with making false statements on the FAA medical application form and what implications that might have including possible jail time or fines. How does one balance the need to be complete with that of unnecessary worry about missing a non-relevant medical visit?
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On this episode, we review the recently announced FAA strategy for hiring more air traffic controllers -- all while addressing the first pollen burst of the year and how pilots can navigate using antihistamines and other medications without jeopardizing their medical certificate.
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At the latest AME Grand Rounds, medical examiners heard updates from the FAA regarding a recent listening session in which a variety of aviation-related organizations provided insight into how the FAA's medical divisions could improve -- and they're listening. On this episode, we review the updates from the latest information session provided to AMEs by the agency, plus meet one of the Mayo Clinic fellows in training within the Aerospace Medicine program.
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Although a very common condition, the presence of glucose intolerance or what the FAA calls "pre-diabetes" can result in medical certification -- and in some cases, does not even require Special Issuance Authorization. What are the newer drugs allowed and what is required to obtain or keep your medical certificate?
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The Human Intervention and Motivational Study, also known as the HIMS Program is an occupational substance abuse treatment program dedicated to helping all pilots return to the cockpit or flight deck. HIMS-trained AMEs, neuropsychologists, and psychiatrists in conjunction with employers, union representatives, and other support organizations work together to evaluate and support pilots with substance disorders or dependence, or other mental health conditions. On this episode, we discuss the program as well as lessons learned from the recent Advanced HIMS Seminar held in Louisville, Kentucky.
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Episodes of syncope or loss of consciousness can result from something as simple as a brief fainting episode -- up to the level of a severe head injury. How it's documented and the testing required for FAA purposes can be critical. On this episode, we discuss the aeromedical implications of syncope and stand down times depending on the various severity of head injuries as well as a less common condition known as transient global amnesia (TGA). What testing is required and what information will the pilot with a loss of consciousness need to track down to have a successful journey towards flying again?
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On this episode we review the technology of coronary artery CT scanning and CT angiography. Although used as an effective screening tool for certain individuals, is this imaging something that pilots should pursue? What happens if an elevated coronary calcium score is identified? Will a pilot still be able to retain their medical certificate, and how much additional testing might be required?
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The FAA medical application, Form 8500-8, is completed electronically through the electronic platform called MedXPress. Are you ready for your next flight physical? What potential pitfalls are there with filling out the application form and how can you prevent those? We cover some of the most common applicant questions as well as places on the form that pilots can potentially get in trouble.
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On this episode, we review aeromedical certification consequences of passing kidney stones. Major issue or just a "small pebble" in the shoe of a long aviation career? Plus, we break down the new Air Force One Boeing 747 plagued by delays and cost overruns.
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On this episode we cover some of the topics discussed at the recent FAA aviation medical examiner grand rounds such as more information on color vision screening and CACI qualification for "low T," and we meet the newest addition to the Mayo Clinic aeromedical team.
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From stories of a pilot getting knocked out by a wild horse while walking along a beach to discussing the details of aeromedical certification with bladder cancer, this episode has a little bit of everything.
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On this episode, we discuss bundle branch block and what is required if a heart transplant is required for severe cardiac disease. What is bundle branch block? Is it a deal breaker? And is it even possible to get a medical if a pilot experiences a condition that requires a heart transplant?
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On this episode, we discuss what pilots need to be prepared for after undergoing heart valve repair or replacement. How long is the stand down time? What tests are needed? What should the cardiologists say in their note in order to avoid sabotaging the chances for a medical certificate?
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On this episode, we look at a common condition unfortunately experienced by many pilots -- whether flying recreationally or for a living -- coronary artery disease. What tests are needed and how can a pilot be adequately prepared through the process of obtaining a Special Issuance Authorization? Do you really need to get a coronary angiogram after a stent is placed? What type of stress test do I need? Are there any tricks to being ready and what is the earliest a pilot can see their AME to get a new medical?
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It's not just the crazy weather headaches to tackle, but some pilots deal with chronic and sometimes severe headaches that can affect aeromedical certification. On this episode, we discuss what medications are allowed by the FAA, which are not, and how best to report chronic headaches during the flight physical.
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Last month, the FAA announced changes in screening for color vision deficiency. On this episode we discuss what pilots will be directly affected and address some of the common questions being asked right now by our patients and aviation medical examiners across the country. What tests will be allowed? What happens if my AME doesn't have one of the new approved computer-based color vision screening tests? What happens if I have a color vision waiver now with a Class III medical and want to move up to a Class I or Class II certificate?
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Mayo Clinic's Section of Transportation Medicine was joined recently by U.S. Air Force flight surgeon and FAA Senior AME Dr. Sheyna Gifford. On this episode of the podcast, she discusses her philosophies and approaches to a successful flight physical -- and the importance of professionalism in pursuing an aviation career.
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On this episode, we review changes coming to color vision screening for pilots after January 1, 2025, plus chat with Mayo Clinic optometrist Dr. Muriel Schornack to learn more about everything eyes -- from glaucoma suspects to aviators with cool glasses.
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This week the FAA announced significant changes in screening for color vision deficiency, and also declared a change in how the agency will interface with pilots in the future -- expect more denial letters coming in the mail after the first of the year.
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On this episode we take a look at the current updates on Basic Med announced this past week by the FAA, and also look at a new "fast track" process for adjustment disorder that may allow pilots originally having to go through an extended mental health evaluation be rapidly certified by their aviation medical examiner.
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Hemochromatosis is an iron storage disease that affects not only the liver, but also the heart, kidneys, and central nervous system. Although not the most common condition, it is often associated with a genetic abnormality -- and those with the gene are typically unaware of it until middle-age. The key is in screening for it -- before it becomes a significant medical problem. What about pilots who have hemochromatosis? Can they be certified? What is the process? This episode covers the details of this condition and the potential aeromedical pitfalls.
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Male hypogonadism, otherwise known as "low T" is a common diagnosis received by adult males, including those who operate aircraft. Many medical providers who prescribe testosterone supplements do not "speak airplane," making aeromedical certification challenging in certain cases. What does it take to obtain or maintain a medical certificate when prescribed supplemental testosterone? We discuss the details.
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Ever wonder what can be annoying to your aviation medical examiner? On this episode, we pick a few favorites and jokingly review the top "pet peeves" on the list.
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Although a relatively rare type of cancer, testicular carcinoma affects thousands of individuals each year. On this episode, we discuss what it is and what is required for aeromedical certification.
Although breast cancer can be devastating for any individual being diagnosed with the disease, the aeromedical certification process has come full circle and allowed for pilots to obtain their medical certificates relatively easily with appropriate preparation and documentation of clinical stability.
On this episode, we discuss a couple of conditions not commonly seen in pilots but which can make a difference in terms of aeromedical certification. We look at pectus excavatum, otherwise known as "funnel chest," and how pilots with speech impediments can still qualify for their FAA medical certificate.
LADA, or latent autoimmune diabetes of adults, is often misdiagnosed and is sometimes called "diabetes 1.5." On this episode, we'll review what LADA is, what to look for, and how it affects aeromedical certification.
Pacemakers are amazing devices that can help regulate heart rhythms, synchronize arrhythmias, and can be career saving for certain pilots. On this episode, we discuss certification requirements for aviators who will need Special Issuance Authorization for pacemakers. A little preparation goes a long way.
Psoriasis is a chronic and incurable condition involving the skin that is sometime associated with arthritis and other autoimmune conditions. There are a variety of treatments for this disease and we discuss aeromedical implications to minimize delays in certification.
In the process of conducting dozens of flight physicals, there are questions that periodically come up when filling out the medical application form. On this episode, we review some of those head-scratching anecdotes and how to efficiently complete the process.
On this episode, we review aeromedical certification requirements for a relatively uncommon disease called hemochromatosis -- a condition that involves elevated iron levels in the blood that can result in liver failure and may affect multiple other organs. Screened and taken care of early, it is completely controllable but left unchecked, can result in significant problems. We review the treatment and what is required of pilots with this condition.
In this episode, we go single pilot and cover one of the most common valvular heart issues -- mitral valve regurgitation. For stable established cases of mild severity, a pilot might not even need Special Issuance Authorization. CACI qualification is possible, and if appropriate testing is obtained ahead of the time of the flight physical, aeromedical certification is a streamlined, painless process.
Drones, love 'em or hate 'em, are here to stay. The FAA announced groundbreaking approvals this week for commercial drone operations of delivery packages involving unmanned aircraft outside the sight line of drone operators -- paving the way for packages to be delivered remotely to your doorstep using drones operated by pilots miles away. With these changes come issues and a litany of considerations -- from safety to airspace congestion to cooperation of competing firms sharing the same airspace.
Kidney stones are estimated to affect one in 10 individuals and are a common source of aeromedical certification questions from pilots. On this episode we also discuss what these stones are, how they are produced, and how they are diagnosed and treated. Then we cover how to prepare when it comes time to reporting a kidney stone on your FAA medical application.
On this episode, we reflect on EAA's AirVenture 2024, Boeing's forecast for the future of personnel needs in the field of aviation, and CACI qualification criteria for chronic Hepatitis C.
One of the most common medical conditions encountered by pilots is elevated blood pressure. On this episode we discuss what is allowed for maximum blood pressure levels, what medications are approved, and the options available to pilots who find themselves dealing with hypertension.
After a brief vacation hiatus, Mitch and Clay are back at the podcast microphone to share aeromedical insights. Recently introduced FAA modifications to "uncomplicated" anxiety and depression requirements are discussed along with other pertinent topics.
Most of us take for granted the bean-shaped organs located along our flanks that are responsible for filtering the blood and maintaining fluid balance in the body. But what happens when things go wrong with the beans? How will this affect aeromedical certification for pilots? This episode covers current requirements for obtaining and maintaining your medical certificate for individuals with kidney issues.
Several announcements this week to FAA aviation medical examiners by the agency will significantly decrease the burden on pilots with certain uncomplicated mental health conditions, eliminate the need for exercise stress tests for renewal of Special Issuance Authorization for pilots with coronary artery disease -- and other streamlining efforts are on the horizon.
The presence of a tremor has, in the past, delayed efforts of pilots to become medically certified. Use of CACI criteria now streamlines the process. In this episode, we review what is required and touch base on the new FAA reauthorization bill that was signed into law last week.
Pilots often forget to report arthritis or musculoskeletal injuries on their FAA medical application. On this episode, we walk.....er, tiptoe....through the process of reporting these common conditions and what is allowed by the FAA to maintain your flight physical.
The Aerospace Medical Association (ASMA) is the largest gathering of aviation and aerospace experts in the country with its recent annual meeting concluding in Chicago this week. We discuss some of the highlights and then review recent FAA updates regarding use of certain medications for weight loss.
Asthma is a common condition in the general population and is often worse during allergy seasons in the spring and fall. Is being diagnosed with asthma a significant barrier to obtaining a medical certificate? We discuss stages of asthma severity and how FAA medical certification may be affected.
Atrial fibrillation is the most prevalent treated heart arrhythmia. We meet with a cardiology expert to discuss assessment, treatment, and new trends in taking care of the condition -- and then review your pathway to aeromedical certification.
The thyroid is often considered the "black box" gland -- not only to patients and pilots, but also to their providers. In this episode, an expert in thyroid disease helps navigate common thyroid conditions, and we discuss the resulting aeromedical implications. Can a pilot still get a medical with thyroid problems, and, if so, what limitations will there be on the certificate?
On this episode we review current events -- from three new antidepressant medications announced by the FAA as allowable for aeromedical certification to a recent report released by the Aviation Rulemaking Committee (ARC) regarding advances in mental health disclosure and certification.
Diabetes is a condition that not only can affect your health, but also your FAA aeromedical certification. On this episode we interview an expert in diabetes who is also a pilot to learn more about detection, treatment, and ultimately, how to preserve your medical certificate.
Operation of remote unmanned aircraft, otherwise known as drone operation, has become the fastest growing segment of aviation in the country. What does it take to become a drone pilot and do you have to have a medical certificate to fly one?
One of the most common issues affecting pilots is that of visual acuity. On this episode, a Mayo Clinic optometrist covers the most common eye issues facing pilots. Are those aviator shades worth it? Should pilots be worried about cataracts or glaucoma, and what about monovision correction or LASIK? Listen to find out....
Although almost everyone experiences ups and downs of mood and attitude, some pilots encounter mental health conditions that require detailed assessments and testing in order to qualify for their medical certificate. In this episode, we visit with Mayo Clinic psychiatrist Dr. Greg Couser to better understand what goes into these detailed evaluations and how aviators can best prepare for the process.
On this episode we dust off things in the hangar, get ready for the prime of flying season, and discuss hot air ballooning ups and downs -- from what's required in an annual inspection to the angst of "aeronauts" having to obtain a Class II medical certificate.
Obstructive sleep apnea and other sleep-related disorders are some of the most common conditions requiring Special Issuance Authorization clearance from the FAA. On this episode, we hear from a sleep disorders expert followed by discussion on aeromedical implications.
In between carpet upgrades to the perch of the Aerospace Medicine practice on the 18th floor of the Gonda Building, we take some time to review a number of abbreviations that are used commonly in the aeromedical certification world -- but may not be familiar to pilots.
The age for mandatory retirement for commercial airline pilots flying under Part 121 was raised to 65 years in 2007. A recent pitch to increase the age limit to 67 was voted down recently by the Senate Commerce Committee. What implications will this have on the pilot shortage, and what's the answer?
It's second nature to pre-flight with a checklist, but what about "pre-flight checklisting" yourself? On this episode we meet one of our talented nurses dedicated to helping pilots through the process of applying for a medical certificate and passing through this part of the journey unscathed.
On this episode, we pay tribute to our colleague Dr. Greg Vanichkachorn who was the master of ceremonies for the Clear Approach podcast but departed the "nest" for a better view at Delta Airlines. We launch our new format, and discuss being aware of colleagues and friends with mood issues that could lead to the unthinkable. NOTE: Potential sensitive topic of depression and suicidal ideation is discussed.
In this episode, we review a surprisingly troubling condition for many unsuspecting pilots, ADHD.
Get comfy for my adventure/horror story about EAA Airventure 2023. Then we go over the newest medication approved by the FAA for the treatment of depression.
Im back after suffering a loss. After sharing my experience, I give some helpful hints for reducing the pain of Jet Lag. And then, Im off to EAA!
Its Podcast Reboot 3.0. And for this episode, we go over pain thats with you but behind you: back pain.
My pain is your pleasure in this week's episode. And I share some amazing new information from the FAA regarding medical certification for pilots on anxiety and depression medications.
Im back from vacation! In this episode I review three frequent questions we get from pilots. And I share a fun time on a Boeing 727.
Pilots have a higher risk of skin cancer. I review what you need to know and what happens if you develop skin cancer as a pilot. Also, we review some medical news, including some interesting eye drops that correct near vision.
There are new updates from the FAA regarding depression and CBD. Yup, you heard me right! Join me to learn what you need to know about cannabidiol and minor depression.
Like a Cessna 150 with its 8th owner, we are back up and running! Updates from Dr. Van on the flying life and we go over all the really important details you need to know about color vision and testing.
In this first episode for 2022, we go over the danger of steroids for pilots. Then we make sure you are in the know about masks.
In this episode, I review the dangerous side effects of Viagra and similar medications. Then, I give some important advice on what to do if you have an unfortunate lapse in judgment and get pulled over for driving after drinking.
In this episode, we introduce the “medication moment” segment by tackling Kava Kava. Someone way more eloquent than me tells you how not to self destruct your medical certification process. And I share a story about hot starts and hazardous attitudes.
Today, we go over the basic facts that pilots should know about the COVID-19 delta variant. And I make the most of being grounded.
Yes, I am alive! Welcome to the reboot of the podcast. I have been completely crushed with patient care and post COVID work, and I haven’t had much time to sleep let alone record another episode. But alas, thanks to labor laws, I have some more time now, and we are back! In today’s episode, … Continue reading Under Pressure: Glaucoma →
In this episode I go over what pilots need to know about treating allergies safely. Also, I do a brief overview of my new job in the Human Intervention Motivation Study with the FAA. To help, here are some key links to support your learning: Allergy Medicine Guidelines by the FAA The HIMS Program
In this update, we go over some of the newest information for pilots that have had a COVID-19 infection.
In today’s episode, we go over some of the newest information about a topic that hopefully won’t put you to sleep: obstructive sleep apnea. And then we chat with Dr. Susan Northrup, the Federal Air Surgeon for the Federal Aviation Administration.
For this episode we cover the entire atmosphere, and then some! I go over kidney stones and what it means for flying and the FAA. And then we talk to commercial space flight specialist Dr. Michael Harrison about the next frontier and his research about an underappreciated danger in general aviation.
On this episode, I talk about the fun of getting the COVID vaccine, we discuss needle phobia, and finally Dr. Emily Stratton takes us up high to review high altitude medical conditions and treatment.
On this Thanksgiving special edition of the podcast, we review the crucial details pilots need to know about the non-FDA approved COVID vaccines. And then, we talk prevention in a way I hope you will never forget.
After a long COVID induced hiatus, I bring you episode 4! This episode is all about diabetes. Dr. Clayton Cowl gives an overview of the condition. Then, Andrew Schmertz, CEO of Hopscotch Air, shares his adventures in being in the sky with insulin.
In this episode, we will review some new updates from the FAA regarding diabetes and SFAR 118. We also go over the top 10 things you can do to make your next aviation medical exam a piece of cake. And finally, an American Airlines pilot shares his story about prostate cancer and returning to flying.
In episode 2 we discuss what pilots need to know about post covid syndrome, or long haul COVID. Then, I interview a Delta 777 pilot that died mid flight and came back.
Welcome to the first episode of the Mayo Clinic Clear Approach Podcast! In this episode, you can learn about our new podcast and your host. We will talk about hernias and why they matter to pilots. Of course, we will discuss some new developments about COVID-19. And finally, I’ll share a personal story about medical … Continue reading COVID, Hernia’s, and SSRI’s →