President’s Corner 1st Quarter Issue 2026
Lessons in Recovery Applied Broadly – Steady Progress and Twelve Steps
The privilege of working with pilots in recovery from substance use disorders through the HIMS program has been one of the most rewarding experiences in my career. Certainly, there have been many challenges working with pilots in the depth of their disease and in early recovery, but these have been very meaningful learning experiences. The deep satisfaction of seeing pilots enjoying the promises and rewards of their good recovery and the hard work they do each day to achieve this is indescribable. This program truly saves lives, careers, and families in addition to enhancing aviation safety and operational efficiency.
A theme I hear from these pilots every day is “Progress, Not Perfection.” Steady and continuous improvement is the path to sobriety, serenity, and success. The FAA is following a similar strategy in its efforts to improve the medical certification system, although not explicitly. Like the Twelve Steps, let me highlight twelve areas of progress.
- Dr. Northrup has instituted her “pre-flight your medical exam” campaign of education. We use a checklist for everything else we do in aviation, so why not do the same with our medical as we do with our annual inspections or before take-off checklists? This has resulted in a huge reduction in deferred medical certificates awaiting processing at the FAA.
- MedXPress now has an online guide for first-time applicants to help them understand how to navigate the application with links to key references in completing the form.
- Pilots using MedXPress can now search for information on conditions they may have acquired since their last medical application with links within the Guide to AMEs for the protocols and documentation they need to provide for the AME to process their exam quickly.
- The Office of Aerospace Medicine hosts monthly AME Grand Rounds, offering free CME credits to more than five hundred attending AMEs. The grand rounds are presented by FAA aerospace medicine physicians providing certification policy updates to AMEs have the most current information.
- The Guide to AMEs is now updated on the last Wednesday of each month. Notifications are available not only to AMEs but also to the public, and is searchable.
- The Guide to AMEs now has checklists for both pilots and providers to use in determining if a pilot is eligible for medical certification and what documentation is required to support that determination.
- The list of Conditions AMEs Can Issue (CACIs) has significantly expanded and continues to grow each month. This helps prevent delays in medical applications and ensures pilots can maintain a valid medical certificate without unnecessary hold-ups.
- The FAA has announced that its “One Guide” of internal policies and protocols will gradually be made public, starting with an initial release of the neurology section.
- The Aeromedical Certification Division in OKC has dedicated additional physician and legal Instrument Examiner resources to substantially reduce the review times for medical applications that have been deferred by AMEs. The review time is now under one month for most deferred applications if information is complete.
- At FAA HQ in Washington DC, the review time for HIMS (substance abuse and dependence) cases is now at the one-month mark while other psychological conditions are being reviewed in several months, mostly due to the high influx of young aspiring pilots with a history of ADHD. Both of these timelines are drastically improved from just one year ago.
- The Federal Air Surgeon continues to promote the “Three Es”; Educate, Early Intervention, and Evolving Standards, by engaging with aviation groups nationwide through in-person visits, videos, and various print and social media platforms. Her commitment to transparency is yielding positive results, with more pilots being certified and fewer waiting for medical certification decisions.
- The FAA Reauthorization Act of 2024 and the 411/413 Task Group continue their work, with Task Groups meeting multiple times each month. Task Group leaders meet monthly with Dr. Northrup and me to provide updates on the progress of the 70+ pilots and physicians involved, for inclusion in our reports to Congress.
Like the recovery community that works collaboratively with mutual support and accountability, the FAA is mirroring these highly successful principles for steady progress, aiming for perfection while realizing that the ever-evolving world of aerospace medicine demands daily work and rigorous honesty in the search for areas to improve.
Be well,
Quay
N321QS
