Choosing an Aviation Medical Examiner might seem like a trivial decision. After all, any AME can conduct an FAA medical exam, and the exam itself follows a standard protocol. For a pilot with a clean medical history and no complicating conditions, the choice of AME is largely a matter of convenience — pick whichever examiner is closest or has the earliest available appointment. But for pilots with medical conditions that require Special Issuance, HIMS evaluation, or any level of FAA review beyond routine certification, the choice of AME can be the single most important factor in determining how smoothly your certification process goes.
The right AME can help you prepare a complete documentation package on the first submission, avoid unnecessary deferrals, and navigate the FAA's bureaucratic process efficiently. The wrong AME — one who is unfamiliar with your specific condition or the relevant FAA disposition pathway — can lead to incomplete submissions, preventable deferrals, months of delay, and in some cases, inadvertent creation of problems that didn't need to exist. This guide will help you understand what AMEs do, when your choice matters most, how to evaluate potential examiners, and how to use available tools to find the best AME for your situation.
What Exactly Is an AME?
An Aviation Medical Examiner is a physician — MD or DO — who holds a designation from the FAA to conduct aviation medical examinations. AMEs are not FAA employees; they are private physicians who have applied for and received FAA designation. They maintain their own medical practices and perform FAA exams as one component of their work. Some AMEs conduct dozens of FAA exams per month; others might do only a handful per year.
The FAA designates AMEs at two levels. A regular AME can conduct examinations for all certificate classes (first, second, and third) but may have less experience with complex cases. A Senior AME has demonstrated additional experience and proficiency in aviation medicine. Senior AMEs have typically been designated for several years, conduct a higher volume of exams, and have more experience navigating the FAA's Special Issuance and review processes. The Senior AME designation is not just a title — it reflects a track record of competence and volume in aviation medical certification.
There is also a specialized category of AME that matters enormously for certain pilots: the HIMS AME. HIMS stands for Human Intervention Motivation Study, and HIMS AMEs have received specialized training in substance abuse and dependence evaluation within the aviation context. If you have any history of substance use, DUI/DWI convictions, or alcohol- or drug-related incidents, a HIMS AME is not optional — the FAA requires that your evaluation be conducted by a HIMS-trained examiner. HIMS AMEs also tend to be highly experienced with other complex psychiatric and neurological cases, making them valuable resources beyond just substance-related evaluations.
When Does Your Choice of AME Matter Most?
For routine medical exams — a healthy pilot with no medical conditions, no medications, and no history items that require disclosure — any competent AME will do. The exam is standardized, and the outcome is predictable.
Your choice of AME becomes critically important in these situations: when you have a condition requiring Special Issuance (such as cardiac events, diabetes requiring insulin, SSRI use, or ADHD history); when you need a HIMS evaluation for substance use history; when you have a condition on the CACI list and want same-day issuance rather than a deferral; when you have a complex medical history with multiple conditions; when you've been previously deferred or denied and are reapplying; and when you're a student pilot encountering the FAA medical system for the first time with a known medical condition. In all of these scenarios, an experienced AME who knows the specific requirements for your condition can make the difference between a smooth process and a frustrating ordeal.
How to Evaluate an AME
Volume matters. AMEs who conduct a high volume of exams see more cases, encounter more conditions, and develop better working relationships with the FAA Aerospace Medical Certification Division (AMCD) in Oklahoma City. A high-volume AME is more likely to know exactly what documentation the FAA will want for your specific condition, reducing the chance of a deferral for incomplete information. While there's no public database of exam volume, you can often get a sense by asking the AME's office how many FAA exams they conduct per month.
Condition-specific experience is even more important than overall volume. An AME who has guided dozens of pilots through the SSRI Special Issuance process will know the documentation requirements cold — which CogScreen administrators to recommend, what the psychiatrist letter needs to include, how to organize the package for fastest processing. Ask the AME's office directly: "How many cases like mine have you handled?" Don't be shy about this. A good AME will welcome the question, and their answer will tell you a lot.
Senior AME designation is a meaningful signal. While not every Senior AME is better than every regular AME, the designation indicates experience and a sustained commitment to aviation medicine. If you're choosing between two AMEs and one is a Senior AME, that's a reasonable tiebreaker in favor of the Senior designation — especially for complex cases.
The local pilot community is one of the best resources for AME recommendations. Local flight schools, flying clubs, AOPA chapters, and online pilot forums (such as AOPA's forums and various aviation subreddits) are excellent places to ask for AME recommendations. Pilots who have navigated complex medical certification processes are often generous with their experiences and referrals. Ask specifically about AMEs who have experience with your particular condition.
Using the FAA Designee Locator
The FAA maintains an official database of all designated Aviation Medical Examiners, accessible through the FAA Designee Locator at designee.faa.gov. This tool allows you to search for AMEs by location, name, and designation type. You can filter specifically for Aviation Medical Examiners and further narrow results to Senior AMEs.
The FAA Designee Locator provides basic information including the AME's name, office address, phone number, and designation level. It does not provide information about the AME's specialty experience, exam volume, or patient reviews. Think of it as the starting point for your search, not the complete picture.
To use the locator effectively: start by searching for AMEs within a reasonable radius of your location. Don't limit yourself too tightly — it may be worth driving an extra hour to see an AME with specific experience in your condition rather than choosing the closest one by default. Note which examiners hold Senior AME designation. Then take the list of candidates and do additional research — call their offices, check for reviews from other pilots, and ask your local flying community.
Using the ClearedMed AME Directory
The ClearedMed AME Directory at clearedmed.com/ame-directory provides an enhanced search experience built on top of FAA data. In addition to basic location-based search, the ClearedMed directory offers proximity search — enter your location or use your current position to find AMEs sorted by distance. You can also filter for HIMS-designated AMEs, which is essential if you need a substance-related evaluation and don't want to manually cross-reference HIMS designations against the general AME list.
The directory includes all FAA-designated AMEs and is regularly updated from FAA source data. Use it as a complement to the official FAA Designee Locator — start with ClearedMed for convenient searching and filtering, then verify details with the FAA's official tool if needed.
When You Need a HIMS AME
If you have any history involving alcohol, drugs, DUI/DWI convictions, or substance-related incidents, you will need a HIMS AME. This is not a recommendation — it is an FAA requirement. A HIMS AME has completed specialized training in addiction medicine as it relates to aviation and is qualified to conduct the comprehensive evaluation that the FAA requires for substance-related Special Issuances.
HIMS AMEs do several things differently from regular AMEs. They conduct a more detailed substance use history, coordinate with HIMS-designated psychiatrists and psychologists, understand the specific documentation and monitoring requirements for substance-related cases, and have established relationships with the FAA's HIMS program administrators. Trying to navigate a substance-related medical certification with a non-HIMS AME is like trying to file a complex tax return with a generalist bookkeeper — technically possible but far more likely to result in errors and delays.
Not every area has a HIMS AME nearby, and you may need to travel. The ClearedMed AME Directory allows you to filter specifically for HIMS AMEs, making it easier to locate the nearest one. Some HIMS AMEs also offer initial consultations by phone or video before the in-person examination, which can help you prepare and determine whether you're ready to proceed with the formal evaluation.
Practical Tips for Your AME Visit
Bring everything. The most common cause of deferrals is incomplete documentation. For every medical condition you're disclosing, bring the relevant records: treatment notes, lab results, specialist letters, imaging reports, medication lists with dosages and dates, and any prior FAA correspondence. Organize your documents in a clear, labeled folder. Your AME will appreciate the preparation, and a complete package on day one can save weeks or months.
Consider a pre-exam consultation. Many AMEs offer a brief consultation — sometimes by phone — before you schedule the formal exam. This is especially valuable for complex cases. The AME can review your medical history, tell you exactly what documentation you'll need, and advise you on whether you're ready to proceed or if additional preparation would be beneficial. Some AMEs charge a fee for consultations; others include it as part of their service. Either way, the investment is worthwhile for complex cases.
Do not submit MedXPress (Form 8500-8) before talking to your AME. Once you submit MedXPress, the clock starts ticking. The FAA expects you to complete your exam within a specific window. If you submit the form and then discover you don't have the right documentation, you may end up in a deferral that could have been avoided with better preparation. Many experienced AMEs prefer to review your situation before you submit MedXPress so they can guide you on exactly what to disclose and what documentation to bring.
Think of your AME as a partner, not just an examiner. The best AME relationships are collaborative. Your AME is your advocate in the certification process — they want you to succeed. Be completely honest about your medical history, follow their guidance on documentation, and maintain open communication throughout the process. Pilots who try to hide conditions, minimize symptoms, or withhold information from their AME are making a serious mistake. Your AME can only help you if they have the full picture.
The Bottom Line
For a routine medical exam with no complications, any AME will serve you well. But if your case involves a Special Issuance, HIMS evaluation, CACI pathway, or any complexity beyond a standard exam, your choice of AME can save you months of delays and thousands of dollars in unnecessary testing. Take the time to research your options, ask the right questions, use the tools available to you, and choose an examiner whose experience matches your needs. The right AME doesn't just conduct an exam — they guide you through a process, and that guidance is invaluable.