AME HIMS AME & Special Issuance Processes — Questions and Answers
Question 1: What does 'HIMS' stand for in the context of FAA Aviation Medical Certification, and what is the primary function of a HIMS AME?
- Human Integrated Medical System; manages electronic health records for airmen
- Human Intervention Motivation Study; HIMS AMEs are specially trained to evaluate airmen with substance use disorders and manage their return to flight (Correct answer)
- High-Intensity Medical Screening; a more thorough version of standard AME evaluation
- Horizontal Incapacitation Management System; a protocol for managing in-flight medical events
Correct answer: Human Intervention Motivation Study; HIMS AMEs are specially trained to evaluate airmen with substance use disorders and manage their return to flight
HIMS (Human Intervention Motivation Study) AMEs are specially certified to evaluate airmen recovering from substance use disorders, coordinate with treatment providers, and manage the complex FAA authorization process for return to flight.
The Human Intervention Motivation Study was an FAA research program established to address substance use disorders in aviation. HIMS AMEs are AMEs with specialized training in substance use evaluation who are authorized to manage the FAA certification process for airmen with alcohol and drug use disorders. Their role includes coordinating comprehensive evaluation (AUDIT, SASSI, liver function tests, psychological assessment), working with qualified HIMS psychiatrists and counselors, monitoring sobriety documentation, and managing the AASI re-issuance process once Authorization is established.
Question 2: What is the minimum sobriety period typically required before the FAA will consider an initial Special Issuance Authorization for an airman with alcohol use disorder?
- 6 months of documented sobriety
- 1 year of documented sobriety and AA or treatment participation (Correct answer)
- 2 years of documented sobriety with complete HIMS evaluation package
- 30 days of inpatient rehabilitation
Correct answer: 1 year of documented sobriety and AA or treatment participation
The FAA generally requires a minimum of 1 year of documented sobriety, active participation in a recovery program, and a complete HIMS evaluation package for initial Special Issuance Authorization consideration.
The general threshold for initial HIMS Authorization consideration has been approximately 1 year of documented, verifiable sobriety combined with active participation in an established recovery program such as AA or equivalent; completion of a HIMS evaluation package (SASSI, AUDIT, MMPI-2 or similar, liver function testing, physician attestation); no history of relapse during the monitored period; and a favorable prognosis from a HIMS psychiatrist. The process typically begins with inpatient or intensive outpatient rehabilitation documentation followed by structured monitoring.
Question 3: Under the AASI (AME-Assisted Special Issuance) program, what is the primary difference between an AASI re-issuance and a standard certificate issuance?
- AASI certificates are valid for only 6 months regardless of condition
- AASI allows an AME to re-issue a certificate to an applicant with an established FAA Authorization without sending the case to AMCD each renewal, provided the applicant continues to meet specified criteria (Correct answer)
- AASI requires a HIMS AME for all certificate classes
- AASI is only available for Third-Class certificates
Correct answer: AASI allows an AME to re-issue a certificate to an applicant with an established FAA Authorization without sending the case to AMCD each renewal, provided the applicant continues to meet specified criteria
AASI streamlines recertification for applicants with established Authorizations by allowing qualified AMEs to re-issue certificates without AMCD review at each renewal, reducing administrative burden while maintaining specified monitoring criteria.
The AASI program was designed to reduce administrative burden on both the AMCD and airmen with established conditions requiring Authorization. Once the Federal Air Surgeon has issued an initial Authorization for a specific condition and established the criteria for re-issuance, the FAA may authorize qualified AMEs to re-issue at subsequent exams without sending the file to Oklahoma City - provided the AME confirms that the applicant continues to meet the Authorization's criteria. This allows routine renewals for stable conditions to occur at the AME's office, with AMCD involvement reserved for cases where criteria are not met or the condition changes.
Question 4: What documents must the AME review before proceeding with AASI re-issuance for an airman with a history of coronary artery bypass graft (CABG) surgery?
- Only the completed Form 8500-8 with normal physical exam
- The Authorization letter specifying required documents, which typically include: current stress test results, echocardiogram, cardiology status report, and medication list (Correct answer)
- A letter from the airman's cardiologist stating the airman is 'fit to fly'
- The original surgical report from the CABG procedure
Correct answer: The Authorization letter specifying required documents, which typically include: current stress test results, echocardiogram, cardiology status report, and medication list
AASI re-issuance requires the AME to review the specific documents outlined in the airman's Authorization letter - typically including current cardiac testing results, specialist reports, and medication documentation - before issuing.
Each AASI Authorization letter is individualized and specifies the precise documentation required for re-issuance. For CABG, typical requirements include a current cardiac stress test, a current echocardiogram, a current cardiology status report, a complete medication list confirming no disqualifying medications, and a completed physical exam by the AME. The AME must review and confirm all specified documents meet the Authorization's criteria before issuing. If any required document is missing, outdated, or shows the airman no longer meets criteria, the AME must defer to AMCD rather than issue under AASI.
Question 5: Under the SSRI Authorization pathway, which of the following SSRIs is NOT on the FAA's approved list for aeromedical certification?
- Sertraline (Zoloft)
- Paroxetine (Paxil) (Correct answer)
- Fluoxetine (Prozac)
- Escitalopram (Lexapro)
Correct answer: Paroxetine (Paxil)
Paroxetine (Paxil) is not on the FAA's approved SSRI list for aeromedical certification, primarily due to its greater anticholinergic effects, discontinuation syndrome, and CNS side effect profile compared to the four approved SSRIs.
The FAA's approved SSRI list includes sertraline, fluoxetine, citalopram, and escitalopram. Paroxetine was excluded due to its more prominent anticholinergic side effects, severe discontinuation syndrome due to short half-life and high receptor affinity, and modestly higher rate of CNS adverse effects in studies. Pilots on paroxetine who wish to seek certification must typically transition to an approved SSRI under psychiatric supervision before pursuing the SSRI Authorization pathway.
Question 6: What is the purpose of the FAA's BasicMed program, and how does it relate to the standard FAA medical certification process?
- BasicMed replaces all classes of FAA medical certificate for certificated pilots
- BasicMed allows certain private and recreational pilots to fly specific aircraft without an FAA medical certificate, using a recent medical examination by any licensed physician and an online course, subject to specific operational limitations (Correct answer)
- BasicMed is a simplified AME training program for new examiners
- BasicMed is an FAA program for issuing medical certificates to student pilots only
Correct answer: BasicMed allows certain private and recreational pilots to fly specific aircraft without an FAA medical certificate, using a recent medical examination by any licensed physician and an online course, subject to specific operational limitations
BasicMed allows eligible private pilots to fly without an FAA-issued medical certificate, using a comprehensive medical exam by any licensed physician and an AOPA online course, with specified aircraft and operational restrictions.
BasicMed was implemented in 2017 as an alternative pathway for eligible pilots. To qualify, a pilot must hold or have held a valid medical certificate after July 14, 2006; undergo a medical examination by any state-licensed physician using CMEC at least every 48 months; and complete an FAA-accepted online medical course every 24 months. Operational limitations include aircraft with max 6 seats, max gross weight at or below 6,000 lbs, no more than 6 passengers, no operations above FL180, and airspeed not exceeding 250 KIAS. BasicMed does NOT apply to commercial or ATP operations, which still require FAA-issued medical certificates.
AME HIMS AME & Special Issuance Processes
What does 'HIMS' stand for in the context of FAA Aviation Medical Certification, and what is the primary function of a HIMS AME?