How to get medical clearance

J

Jimmy H.

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As I am exiting high school (age 18), I am very interested in becoming a professional pilot. I am thankful to have found this forum, and am hoping for some sincere advice about how to proceed. There are possible roadblocks to my medical clearance as I discuss below, so I wanted to describe my situation, providing the relevant important information, to see what my future could hold, and what advice I could get to help me best shape that future.

Summary: I have High Functioning Autism and Inattentive ADHD. I also had a diagnosis of Generalized Anxiety Disorder as a child, and this is no longer a struggle. I had an episode of depression (age 16) where I wanted help and was hospitalized voluntarily. I was never medicated for depression, but have been medicated for ADHD at low level doses.

Details: Currently, I am in all advanced classes with a mix of A's and B's, and have a very good ACT score. I am undeclared for my major as I am entering college in the fall (at age 18), but my college has an undergraduate degree for commercial pilots that I am strongly considering. I was on an IEP for about two years starting in elementary school due to autism/ADHD, but I met all of my academic goals quickly and so I no longer qualified for an IEP by middle school. Therefore, I have been on a Section 504 Plan which basically grants extended time which I rarely use.

I have been on VERY low doses of one ADHD medication, and I (and my prescribing doctor) believe I will function very well without them when I stop taking them. (I had good grades before any ADHD medications were given but they helped me a little bit, mostly as a child.) I have a driver's license with no issues, and I have been active in sports and music throughout high school. My social skills are strong for somebody with Autism.

Two years ago I struggled with depression for a short period of time and was hospitalized voluntarily. I wanted to go, and I recognized that I needed to get help. Since then, I have done really well with therapy and I NEVER took any SSRI's or any other medication for depression. I was a minor at this time, and everything is definitely better.

Given my history above: What should I know before pursuing a pilot's license? Any of your sincere advice is truly appreciated.
 
Obviously - and you know this because you're smartly asking for help and advice - you have some challenges. The best thing you can do at this point, BEFORE you start flying lessons, is to engage someone like Dr. Bruce Chien (www.aeromedicaldoc.com) or Dr. Lou Fowler (https://www.louisbfowlerjrmd.com/services/aviation-medicine) and have them walk you through the process of getting your medical certification. Others more knowledgeable than me will likely chime in, but it sounds like (if it's doable) it won't be easy or cheap. If you go down the path with Drs. Chien or Fowler, follow their advice TO THE LETTER. If it's at all possible, they would be your best chance for a good outcome, given your history.
 
Your episodes of depression/anxiety requiring hospitalization and the use of a ADHD medication are most problematic. To improve your chances, a medically supervised discontinuation of that medication is advised ... if possible, and after being successful in this endeavor you would be in a position to apply. You will likely have psychiatric and neuropsychological hoops to jump thru.
 
Jimmy H. said:
Given my history above: What should I know before pursuing a pilot's license? Any of your sincere advice is truly appreciated.
Click to expand...

Dr Fowler's advice to work with your doctor(s) to discontinue medication is the first step. You can get started on that now.

From an expectation standpoint - you have been officially diagnosed with conditions the FAA is concerned about. Unringing that bell is possible, especially if there was a wrong diagnosis.

The resolution will be testing via HIMS (Human Intervention Motivation Study) testing. To be honest, the HIMS testing is expensive, I've heard costs around $5000 several years ago. It will take time and in the end it's possible that you don't pass.

Start with a consult with Dr Fowler, Dr Chien or a HIMS AME near you - you're not doing an exam, you want to talk about your condition. The consult is a paid engagement with an AME where they will help you understand what will be required. Be completely open with them, it's much better that they know everything that is out there. Then you'll start through the testing and make sure you get results that pass. After you have those tests in hand, then you'll do an official FAA medical exam. Once your medical exam starts, there are deadlines involved with responses to the FAA and it's very likely they will be impossible to meet due to scheduling constraints.

Best of luck. You're in a good position.
 
The FAA divides the firmament of psychiatry into “one offs” and into recurrent disease. NB if you have more than one episode, you have recurrent disease that has recurred.

Then there is disease that has not yet recurred but there is good reason to expect that it will.
The reason this is important is FAA denies 100% of recurrent disease, unmonitored and untreated.”

So, you need to first get an expert on your care team- a board certified psychiatrist. Nobody knows what your really have until you have one-off these guys on your team....

The route if you have recurrent disease is the SSRI pathway but there are some in history exclusions to taking that path. It is expensive and there are no guarantees, but there are currently 760 airmen on this issuance. It has costly recurrent requirements, too.
 
Only thing I can say is a diagnosis of Autism isn't a game over (depending on how you were diagnosed, your follow-ups, and anything/everything in your medical records). Somehow I got slapped with it (Trigger-happy doctors; I'm very extroverted so who knows how the diagnosis came about) and my AME and Neuropsychologist were able to prove that the diagnosis wasn't completely valid according to I think DSM standards. I didn't have to get a psychiatric eval and only needed a neuropsychological eval. Then again the depression may throw you for a loop. Your AME will know what to do. Trust them.
 
This sounds mean, but it’s just reality and sadly it’s true for me also for different reasons, but I don’t think being a pilot is an appropriate profession for you. That doesn’t mean you shouldn’t try to get your certificate anyway, but I would certainly position myself with another career option.
 
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