I am a senior aviation medical examiner for the FAA.  Part of my duties is to provide pilot with medical consultations so that despite medical issues, they can continue to be certified his meeting the requirements for duty. I am a specialist in diagnostic cardiology and use the tools of trade to facilitate special issuance for these pilots.  Doing so often means the difference between continuing one’s career and livelihood or beginning a forced disability or retirement. I routinely help pilots navigate the administrative hurdles necessary to regain medical certification.   Over the years pilots being examined for FAA certification have chosen me as their primary physician 80% of the time.  They do this because they know that my skills allow me to diagnose earlier and began treatment when needed. I am also keenly aware that regaining ones medical certification after cardiac event wires an intimate knowledge of the process.  I am often able to recertify a pilot after exactly six months which is the minimum required under FAA guidelines. As an example of this, the following letter illustrates a routine case of pilot who suffered a myocardial infarction and cardiac stents.  I routinely provide the cardiac  evaluations including stress testing so that a comprehensive report can be submitted to the FAA. The following letter is taken directly from the records of the pilot who successfully resume his career he currently maintains excellent health. Courtney Scott, DO Manager, Aeromedical Certification Division PO Box 26080 Oklahoma City, OK 73126 Re:  Capt Smith DOB: 05-22-55 Dear Dr. Scott, I performed the cardiovascular exam as per protocol for the first request for Authorization for Special Issuance of a First Class Medical Certificate.
This airman has a history of MI in March 2013 followed by successful PTCA and stenting of the distal circumflex artery on March 28 using a Resolute drug eluting stent.  He made an excellent recovery and underwent nuclear exercise stress testing on August 29 with normal exercise capacity (Bruce stage 4, 10 minutes) and normal scans.  This airman also had transthoracic echocardiography done on the same date, which showed normal wall motion and LVEF. Furthermore, after these tests were done and reported as normal, this pilot underwent another cardiac catheterization which showed normal flow through the stent and excellent perfusion to all areas of the myocardium. I am pleased to report that his health continues to be good, free of cardiovascular symptoms of chest discomfort, shortness of breath, palpitations, dizziness, or side effects from his medications.  He is currently taking Lisinopril 20 mg per day,  Dexilant  60 mg per day, Crestor 10 mg per day, Plavix 75 mg per day and ASA 81 mg per day. His metoprolol was discontinued after the normal stress test and catherization.  He has no side-effects from these medications.  He does not use tobacco, family history is negative for CVD, and his weight has come down from 232 to 225 lbs.  He runs a couple of miles daily. This airman has normal blood pressure 120/80 in each arm on 3 separate visits, and physical exam shows: HEENT-  Anicteric, PERLA, EOMI, Fundi nl Neck- supple, JVD neg , no bruits Lungs- clear to A & P, well healed midline CABG scar COR- RSR no murmurs, gallops or rubs, PMI is not displaced Abd- soft, no organomegaly, no CVAT Ext- no clubbing cyanosis or edema Neuro- A & O X 3, Cr Nerves II-XII intact, Motor intact EKG- Normal Sinus at 65 per minute, normal axis and intervals, no acute ST-T wave changes, no change from recent EKGs Labs showing fasting glucose of 102, total cholesterol of 145, triglycerides of 76, and LDL of 86. I am enclosing a copy of all the pertinent medical records including the old and recent catherization reports, stress test, and blood work. He will be followed closely by me in the office every 90 days and report any symptoms immediately.  I would like to emphasize my support for this pilot’s efforts and comfort with Special Issuance of a First Class Medical Certificate. Sincerely, Raymond S. Basri, MD, FACP Senior Aviation Medical Examiner The result of this letter was the successful return of a career commercial airline pilot to full duty exactly six months after his myocardial infarction.  This pilot was extremely happy that his career would continue and his health restored.