Ever since the FAA broke its own disqualification rules for taking a approved drug, whether prescribed or not, that has not been on the market for 2 yrs AND loosening the EKG standards as far as Im concerned it is nothing but a sham.
So dont be too upset if your examiner has you out the door in 15 mins. be thankful.
FAA Special Issuance can be a real bastard – as many European based pilots have found.
Based on observation of my 79 year old friend’s process after substantial heart issues, it looks to me to be lengthy (a year in his case) but not unreasonable. However that is with an experienced FAA AME who knows how to work the system.
Happily his experienced AME had time to help him because he wasn’t performing brain surgery and EKGs to get people through their very special routine PPL medicals 
My friend is now flying on BasicMed, for four more years without further medicals as long as he has no recurrence. He waited until the Special Issuance needed renewal before going on BasicMed (signed off by the same AME) so it is effectively 5 years between exams. We’ll see if he still wants to fly at 84 but he’s still very good now.
FAA Special Issuance can be a real bastard – as many European based pilots have found.
The problem is much worse because most Europe based FAA AMEs do not want to touch Special Issuance medicals, saying they can’t be bothered with the extra work. And if you need to move to SI, the AME will tell you he doesn’t want to service you anymore. Some of the AMEs whose names are regularly recommended here are firmly in that category…
The FAA is also really picky on some conditions which would be relatively OK under Part-Med, so this is the opposite of what is often said.
once you have failed your US medical (e.g. Class 3) with an AME, the BasicMed option is closed to you
Not quite, you have to make it through the process to get one special issuance 3rd Class, then you can go on BasicMed with no differentiation from anybody else on BasicMed. After that you don’t have to renew the special issuance 3rd Class again.
The same is true for somebody who does not fail a 3rd Class but who is diagnosed with one of the very limited number of listed BasicMed disqualifying items. You have to get one special issuance 3rd class before resuming BasicMed.
I used to joke that the class III physical was a test to see if I was still warm. Then came requirements for special issuance for diabetes 2, … and it became a real headache. I had to produce reports from my GP, cardiologist with an annual stress test, sleep doctor, diabetic eye exam and this had to be repeated annually. Then a specialist AME had to prepare a package about a half inch thick to be sent off to Oklahoma City, 90 days prior to expiration and I had to make multiple inquiries to get a new one year Class III. I still had to have the AME also do a Class III physical every two years. It was a total PIA, expensive, and stressful and sometimes my medical would lapse for a month each year. My cardiologist only did the annual stress test because the FAA required it, not because it was medically necessary. He now recommends one every five years unless I were to experience symptoms.
I don’t think a private pilot should require any sort of physical as we required to self determine when we don’t feel well and whether or not it is safe to fly. I don’t think the Class III medical or Basic Med requirement adds to safety.
The other key difference is that once you have failed your US medical (e.g. Class 3) with an AME, the BasicMed option is closed to you.
I don’t know about the French UK no-medical route but the UK PMD no-medical route is available even if you have failed the AME medical.
There is an important difference.
Here is a link to the Basic Med Instructions Form
For Basic Med, the FAA requires the pilot to do the online course every two years and the doctor report every 4 years. My insurance company is the real regulator, since I turned 75, they require me to take the course every year and get the doctor report every year, so I do it at my regularly scheduled annual physical. I have the form filled out at my annual physical by my GP. Insurance pays for the physical, so it is free to me.My interaction with the actual doctor took 17 seconds
So my 3rd Class medicals were very exacting given that they were about 53 times longer than that 
I didn’t actually meet the doctor during my BasicMed exam last year, a PA (physicians assistant, typically requires master degree) did the exam, presented the data to the MD elsewhere in the building and returned with the signed forms. The doctor is required to certify the exam, nothing says who has to perform it. And given that the doctor in this case was treating urgent care patients (sick or injured Mexicans mostly) that was no problem for me at all. I get excellent medical care elsewhere, medical certification of healthy individuals for private flying is a charade and the system operates pragmatically to comply with the law.
Blood work is 90% of a real health check, not the Stone Age aviation stuff.
Airborne_Again wrote:
That’s fascinating… Over the years I’ve had a couple of different AMEs for my class 2 and for all of them it took about one hour to cover everything even when there were no issues.
I have have had medicals for over 20 years here in Europe, covering both FAA and EASA licenses. Always 45 to 60 minutes and very thorough. The guy I have used for the last few years, Dr Nomy Ahmed in N London, is very professional, and I consider the exam as a useful general health check too.
I did have reason to do a medical in the US once, some years ago in Florida, near a busy GA airport. As I sat in the waiting room I could see how this "AME conveyor belt’ was operating so decided to time it. My interaction with the actual doctor took 17 seconds “you look to be in good health”. “yep, I am feeling fine”. “good, let me sign those forms, my assistant will take your payment”. Obviously an extreme example, and very funny too.
So what exactly happens at that exam? Over here you’re supposed to leave a urine sample which it tested. Your vision is tested (both acuity, near and peripheral vision). The AME listens to your lungs and heart, checks reflexes etc. There is also run through of a questionnaire. No way this could be done in 15 or even 30 minutes if you actually do everything.
All of that minus the urine sample, which I believe is supposed to be done for a 3rd Class but was never actually done in my experience with three different AMEs. The application including questionnaire must be done and filed online before you show up, and you give the AME the file number. The run through of the questionnaire takes 30 seconds if all the answers are ‘no’. The eye check is cursory, to determine that you need corrective lenses or not (near and far) and can at minimum manage 20/40 corrected (near and far). The AME does not attempt to be your optometrist. No EKG is ever required for a 3rd Class. It’s no problem in 15 minutes and I’ve noticed in my experience that no one wants it to be more.
@gallois, the description of FAA BasicMed in the link you reference is inaccurate. BasicMed is in effect and applicability much like 3rd Class if you fly anything smaller than a Cessna 340. The application and exam is almost identical except it can be done by any physician and no medical data is filed with the FAA. Only the date and physicians name is in the FAA file and the way that info is collected is by a cursory biennial online ‘training’ session done at home that requires you to supply that data – the physician has no contact with FAA. The medical difference is that there is a very short list of significant conditions that make you ineligible for BasicMed. Outside of those if the doctor and you agree that you are healthy enough to fly, you pass – there are no elaborate FAA criteria for every condition and no special issuance process, board evaluation etc. You can also go to another physician if you can’t come to terms with the one you’ve selected. Once you’ve passed, the exam lasts four years versus two years for a 3rd Class that’s done on anybody over 40 years old.
It would be great if private pilot medical exams would go away completely in the US as they have for pilots of N-registered LSAs, medical certification for private pilots is acknowledged as nonsense by almost everybody, but BasicMed is what we have so far and it’s not awful. The 3rd Class is not bad either if you have no significant reportable conditions or relevant medical history, with only irrelevant or routine doctor visits to report.
