Updated September 2026 to reflect current FAA guidance on AME authority, Senior AMEs, HIMS AMEs, and how to find an examiner.
Any Aviation Medical Examiner (AME) can handle a routine exam for a healthy pilot, so for many people the closest examiner with an open appointment is fine. Your choice matters more in three situations: you need a first-class medical certificate, you have a medical condition the FAA reviews, or your history means the FAA requires drug or alcohol monitoring. This guide explains what AMEs can and can't do, which kind of AME you need, and how to find one.
An AME is a physician, either an MD or a DO, whom the FAA has designated to perform airman medical exams. AMEs are private physicians, not FAA employees. At your exam, the AME has the authority to issue, defer, or deny your medical certificate based on the medical standards in 14 CFR part 67. The FAA can still review that decision. A certificate an AME issues can be reversed by the FAA within 60 days of the exam, or within 60 days after the FAA receives additional information it asked you for. AMEs may not examine themselves or issue a certificate to themselves or an immediate family member.
There are two levels of AME, and the difference is not just experience. Under FAA Order 8000.95D, only Senior AMEs have the authority to perform first-class exams. Other AMEs perform second- and third-class exams. To be designated a Senior AME, a physician must keep meeting the requirements for AME service and have an acceptable record performing second- and third-class exams for at least three years. Senior AMEs must also have ECG equipment and be able to send ECGs to the FAA as part of first-class exams. If you need a first-class medical, confirm that the examiner is a Senior AME before you book.
First-class applicants need an ECG at the first exam after their 35th birthday and then every year after turning 40. An ECG counts if it is dated no earlier than 60 days before the application it goes with. ECGs are not routinely required for second- or third-class certificates.
How long your certificate lasts depends on the privileges you use and your age on the date of the exam (14 CFR 61.23(d)). Every period runs through the end of the month of the exam, plus a set number of calendar months. For first-class privileges, that's 12 months if you're under 40, or 6 months if you're 40 or older. For second-class privileges, it's 12 months at any age. For third-class privileges, it's 60 months if you're under 40, or 24 months if you're 40 or older. When a higher-class period ends, the same certificate still works for lower-class privileges until those periods run out. For example, a first-class certificate issued at age 45 covers first-class privileges for 6 months, second-class for 12 months, and third-class for 24 months.
Some medical conditions are disqualifying under part 67 unless the FAA grants an Authorization for Special Issuance. An AME cannot grant an initial Special Issuance. For a first-time case, the AME defers and sends your documentation to the FAA, and an FAA physician makes the decision. After the FAA grants an Authorization, many conditions qualify for AME Assisted Special Issuance (AASI), which lets your AME reissue your certificate at later exams if you bring the reports your Authorization letter lists. For certain other conditions, the AME can issue at the exam if you meet the criteria in the FAA's Certification Worksheets, often called CACI conditions. In both cases, what makes same-day issuance possible is bringing the right documents.
A HIMS AME is an AME with Human Intervention Motivation Study training. The FAA describes HIMS AMEs as trained in evaluating airmen for substance- or alcohol-related conditions or other mental conditions, and says they can provide sponsorship and monitoring when the FAA requires it for medical certification. HIMS AMEs must complete FAA-required training to appear on the FAA's HIMS AME list and must keep up with recurrent training.
You need a HIMS AME when the FAA requires monitoring. The FAA's guidance says that airmen with a regulatory diagnosis of alcohol dependence or abuse may need evaluation and monitoring before they can get a medical certificate, and that airmen who need monitoring should work with a HIMS AME. Not every alcohol-related event leads there.
The FAA's DUI/DWI/Alcohol Incidents disposition table (updated June 2024) tells AMEs how to handle alcohol events. If the FAA has already reviewed your event and given you a letter saying monitoring is not required, bring the letter, and your AME can issue after confirming there have been no new events. For a single event 5 or more years ago with a blood alcohol content (BAC) below 0.15, the AME can issue if the exam and interview show no current or past evidence of substance abuse or dependence. The AME records the event and sends your personal statement to the FAA. For a single event less than 5 years ago, or a single event with a BAC of 0.15 or higher or an unknown or refused test, the AME completes an Alcohol Event Status Report and sends it to the FAA for review. Two or more events in your lifetime, or a history of dependence or substance use disorder, means the AME defers and the FAA reviews your case. If the AME can't get and review the required reports within 14 days of the exam, the AME must defer. The FAA has a separate disposition table for past or present drug use.
Pilots taking an antidepressant also work with a HIMS AME. The FAA's SSRI program was renamed the Antidepressant Protocol on April 24, 2024, when it expanded beyond SSRIs, and the FAA's airman information sheet for initial certification tells pilots to select and work with a HIMS AME. Our Antidepressant Policy guide covers that process in detail.
The official place to find an AME is the FAA Designee Locator at https://designee.faa.gov/designeeLocator, which the FAA describes as an up-to-date listing of AMEs. The FAA also publishes a list of HIMS AMEs on its Find an Aviation Medical Examiner page. The FAA itself suggests asking pilot advocacy groups or local flight schools for recommendations, and pilots who have been through the process can tell you which examiners know your condition.
ClearedMed's AME Directory at clearedmed.com/ame-directory lists 1,789 AMEs, including 247 HIMS AMEs, and is refreshed monthly from the FAA Designee Locator. You can search by name, city, state, or distance from your location, and filter for HIMS AMEs. Because designations can change between refreshes, confirm an examiner's current status in the FAA Designee Locator before your appointment.
When you call an AME's office, a few questions help. Does the AME perform first-class exams? Has the AME handled cases like yours, and what records should you bring? What does the exam cost? The FAA does not set AME fees. It recommends that examiners charge the usual and customary fee for similar services in their area, so prices vary and it's worth asking up front.
Every exam starts with an application in MedXPress (FAA Form 8500-8). Your application stays active for 60 days, and your exam has to happen within that window, so contact an AME soon after you submit. Bring your confirmation number to the exam. Answer every question completely and honestly, including every condition, medication, and healthcare visit the form asks about. Falsifying the form can cost you your certificates and carries criminal penalties. If you aren't sure how the FAA will view something, report it anyway, and ask the AME's office what records to bring.
Documents are what keep a case moving. Before your exam, look up your conditions in the FAA's Guide for Aviation Medical Examiners, which is written for physicians but useful for pilots and their doctors. For some conditions, the FAA wants a current, detailed Clinical Progress Note from a visit with your treating physician no more than 90 days before your exam. A patient portal After Visit Summary is usually not enough. With the right records, your AME may be able to issue at the exam. Without them, certification may be delayed.
After the exam, the AME must send it to the FAA electronically within 14 days. If your exam is deferred, the FAA's Aerospace Medical Certification Division or a Regional Flight Surgeon makes the decision and may ask you for more information.
For a routine exam, any AME will do. If you need a first-class certificate, pick a Senior AME. If the FAA requires monitoring, or you take an antidepressant, pick a HIMS AME. Whatever your situation, disclose everything, bring complete records, and confirm the examiner's status in the FAA Designee Locator before your appointment.