AdamFrisch wrote:
They can’t take the farm or the Cub
Maoraigh wrote:
walked 10 miles along a rough coast path
Two things to aspire to 
If you can become an FAA AME also then you can make a lot more money
I have no idea of the process but I have been told (well, by FAA AMEs) that it is a dead man’s shoes thing.
Dwelving deeper into the topic of AMEs, I found out that there are AMEs class I and class II, the former required for class I medicals and the latter sufficient for class II. Becoming a class II AME in Germany apparently only requires a 60 hours course in addition to the completion of medical specialty training (but apparently any specialty suffices!).
So what I read about was the specialisation as offered by my local medical association, this takes 18 months. The LBA (our CAA) does not require this kind of training, but instead having completed the respective courses offered by them.
This means I can become an AME quite quickly apparently, once having completed my training as anaesthetist (which will be at the end of 2019). Good to know…
Fenland_Flyer wrote:
Please pardon my ignorance but what is the differenece between an anaesthetist and an anaesthesiologist?
Thanks
There is no difference really. Anaesthesiologist is just a slightly fancier way of saying anaesthetist. The suffix -logos is ancient Greek (English: -logy) and basically means “the (academic) teaching of X”. We mostly refer to ourselves as “Anästhesist” or “Narkosearzt”, which is the German word. Nobody in Germany refers to themselves as “Anästhesiologe” except in situations where academic snobbery is called for (usually when talking to other doctors with an attitude).
Please pardon my ignorance but what is the differenece between an anaesthetist and an anaesthesiologist?
Thanks
I’d love to be an AME on the side, but the prerequisite training would for me require a major detour from my current specialist training as an anaesthesiologist. I have to look further into this, but 18 months of full time training separate from my current job seem to be the minimum to become an AME, possibly in addition to 4 years of training in internal medicine!
It would be very dependent on the doctor in question what can be billed to an insurance and what not.
in the case of cardio problems, they will refer you to a specialist who has accreditation with the competent authority. In such a case, it may be advisable to make the guy your treating doctor if he is capable as well as pro-patient rather than one of those who try to ground as many folks as possible in their practice. (I had an AME like that, he almost got me to stop flying, the AME I have now is super an I would trust him as my personal doc as well, which btw is what some of his clients do).
In the case where he is the treating doc, he can do a lot of testing needed to prove to the CAA that you are fit to fly again as part of the treatment and simply share the documentation with the CAA when the time comes, in this case only the stuff they would not do will have to be payed by the patient himself, including the paperwork for the CAA. In the other case, it is likely that all tests and procedures will be done twice and the full cost ends up with you.
BTW, you as a doc, mabe you could eventually become one of those AME’s who as a pilot yourself can be one where pilots will go to because they know you will be diligent but will also help them if there is a problem, in as so far as to tell them what needs to be done to keep/regain their medical and possibly actively support them during this. I wish there were a lot more of them.
Peter wrote:
To get an aviation medical back, you have long extra protocols such as exercise ECG, nuclear perfusion scan (2-yearly for FAA, initial for UK CAA) and this costs a few k. To regain a Class 1 or 2 under FAA you need a repeat angiogram (!!) and this costs a good few k in Europe and 2x that in the USA. These tests have to be paid for privately. A normal person would not need any of this, if they are free of angina, etc. Drive 1 week after a stent, 6 weeks after a bypass.
Reading this I don’t think Germany differs that much from the UK. An exercise ECG could probably be obtained through normal health insurance here, but a nuclear perfusion scan probably not as there doesn’t seem to be a medical indication for it. Angiogramms are done quite often in Germany because we are densely covered with the required machinery and every hospital with a cardiology unit wants one because it’s one of the few procedures where hospitals get a nice income from public insured patients.
It would be great if we got a German cardiologist on here who could give us more insight. An AME will usually not perform all these diagnostics unless he also is a cardiologist or radiologist himself, but AFAIK only specialist in internal medicine and work medicine can become An ex here.
The follow-up diagnostics such as coronary angiography or myocardial CT scans would also be covered by health insurance in most cases, since this disease not only endangers one’s medical but more importantly one’s life.
Maybe this is where Germany differs from the UK but here you get stented or bypassed and sent home, and there is not even a follow-up consultation. They do send you to a “cardio rehab class” where you stand around lifting your feet off the floor (hard work for some people even before they had work done) and generally telling everybody they are glad to go back to eating their fry-ups
To get an aviation medical back, you have long extra protocols such as exercise ECG, nuclear perfusion scan (2-yearly for FAA, initial for UK CAA) and this costs a few k. To regain a Class 1 or 2 under FAA you need a repeat angiogram (!!) and this costs a good few k in Europe and 2x that in the USA. These tests have to be paid for privately. A normal person would not need any of this, if they are free of angina, etc. Drive 1 week after a stent, 6 weeks after a bypass.
Airline pilots, those that I have known, have their Class 1 insured for some large amount (250k in one case) but that is for a permanent loss of it, and that is not common; even after a bypass you get it back after 6 months (with a multi pilot restriction, AIUI). They may have additional insurance…
Peter wrote:
AFAIK very few people have insurance covering this sort of thing. Germans pay (via salary deductions) towards a fairly comprehensive cover but it would be amazing if it covered the cost of regaining aviation medicals.
No, the cost of aviation medicals is indeed not covered by German health insurance (neither public nor private, but I guess you can get some add-on insurance for this as a professional pilot).
However:
Peter wrote:
According to one AME, most people who lose their medical lose it due to heart disease (bunged-up heart arteries mostly) or cancer.The former can usually be fixed but you usually have to spend 4 figures to get your medical back. There are CAA protocols which have to be followed. The FAA has a better protocol than EASA in this area. It can also be fixed with a diet but it will probably take you years to get your medical back so pilots have little choice but to go for surgery.
If we stay with the example of coronary heart disease (“bunged-up heart arteries” in the layman’s terms ) then it is perhaps easier to understand what I meant. CHD is a life-threatening condition per se. It can either manifest as
Diagnosis and treatment of coronary heart disease is most definately completely covered by health insurance. If an operation is necessary (coronary bypass, multiple acronyms are used such as ACVB or ACB or CAB) then it is also completely covered by health insurance (would otherwise indeed cost several k€, up to 10k or so). The follow-up diagnostics such as coronary angiography or myocardial CT scans would also be covered by health insurance in most cases, since this disease not only endangers one’s medical but more importantly one’s life.
The only case I can see where this actually costs a pilot extra money is if their AME says they need an operation when their normal cardiologists say they don’t. Then it get’s interesting. Unfortunately the criteria defined by the CAAs or the AMEs are somewhat opaque for me as a physician. Normally you can simply look up the guidelines to diagnosis and treatment of any disease as published by the respective specialists organisation, but the aeromedical organisation doesn’t seem to publish these.
