- Follow your usual diet and exercise program. Do nothing extreme just before the exam.
- Avoid excesses. If you already are a smoker and drink a lot of coffee, then back off a little. Sudden withdrawal may cause "abnormals."
- Do no strenuous exercise for 24 hours prior to the exam. If you regularly exercise a lot, taper off a little. Any strenuous exercise just before an exam can throw off blood and urine tests.
- Be well rested. Ensure that you get a good night's sleep for several nights prior to the exam.
- Be well hydrated. Even though some companies will require you to fast, you must still drink plenty of fluids.
- Avoid noise for two or three days prior to the exam, including on the plane ride to the company physical. Wear ear plugs.
- Avoid alcohol for two to three days prior to the exam.
- Follow the company instructions to the letter. If the airline prescribes a specific diet, follow it.
- "Think positive." If you know what your health is and are doing everything that you can do, approach the exam with a positive, relaxed attitude. Let go and present your best.
- Have an extensive advance medical evaluation. Do this on your own. If at all possible, consult a senior AME. If none is readily available, go to your own physician and say that you want an "executive-type physical," a complete exam with blood tests, EKG, chest X-ray, etc. Explain to him or her that you will be taking a comprehensive pre-placement medical at a company you would like to work for and that it is essential for you to know whether or not you have any condition that might be considered unacceptable. Anything that is found to be even slightly out of limits must be explained by further testing. For example, a murmur may be judged by a physician to be insignificant However, the doctor needs to do other tests, such as an echo cardiogram, a treadmill, etc., to document that this murmur is indeed an insignificant matter.
Having a medical examination is one thing; having it reviewed by an aviation physician is another. It is imperative that any testing which you undergo on your own be evaluated and judged by a physician familiar with aviation standards. Many FAA AMEs and most military flight surgeons can do this for you.
Having such a medical evaluation on your own probably is the most important step in preparing yourself for the company physical.
Finally, have realistic expectations. If you know that a company is popular and has lots of applicants, and you know as well that your vision is 20/200 or that you have a strong family history of diabetes or have an abnormal EKG, you should also accept that your chances of being hired are remote. It is better to concentrate your efforts on companies with less restrictive standards. This strategy can work to your advantage. If you have realistic expectations, you can tell the smaller company that you will not be using it as a stepping stone to the major carrier because you realize your medical condition is non-competitive, although not medically significant The company then knows that you are willing to remain as a long-term employee, and that's what it is seeking -career employees.
Another source, of course, is friends. If you have a friend who belongs to an ALPA local or who flies for an airline, he or she may be able to pass on the name of a good senior AME.
Most AMEs perform FAA physicals as a supplement to their practice. The majority of AMEs are general or family practitioners; others may be internists, ophthalmologists, or ear, nose and throat specialists.
This advice was prepared with the help of Bruce Jackson, M.D., a Navy Reserve flight surgeon and a senior AME with a practice in Berkeley and Oakland, Calif., and Richard O. Reinhart, M.D., USAF flight surgeon and senior AME practicing in Minneapolis, Minn., who are among a handful of physicians nationwide who limit their practice primarily to aviation medicine.
Dr. Reinhart had advice for pilots who are afraid (or know) that they have medical problems. While understanding the temptation to search for an "easy" examiner, he pointed out that any seeming gains are likely to prove illusory: Major and national airline health standards are stricter than the FAA's, so getting a Class I medical certificate is no guarantee of an airline flying job. Dr. Reinhart counseled against imperiling long-term health for the illusion of career advancement now.
ALPA's Captain Stone pointed out that the FAA knows which doctors give the easiest exams. "They watch those records very closely," he said.
Dr. Reinhart suggested that what worried pilots really need is an AME with a reputation for helping pilots.
Pilots can ask doctors beforehand what they would do if they found evidence of a serious condition, such as a heart murmur. The response should be that the examiner would work with the pilot on his problem.
