If you’ve ever sat for an FAA medical exam, you may have heard your Aviation Medical Examiner (AME) mention “the guidance” or "the Guide", referencing the FAA Guide for Aviation Medical Examiners. 

So what is the Guide?

Effectively, the Guide is the AME's playbook for when to certify or defer. It provides a structured decision tree for common conditions, including when they may be cleared for issuance, require deferral, or what further information must be gathered for the FAA Aerospace Medical Certification Division (the FAA big dawgs). 

It's the FAA-published official resource that tells medical examiners how to evaluate pilots for FAA medical certification. 

Inside the Guide, you'll find basic operating info (how to conduct exams, equipment standards, exam frequencies) and, more importantly, detailed 'disease protocols' that may lay out what to expect for a medical issue relevant to you (this is the juicy part). *

*side note, our personal favorite part about the AME Guide is that it is updated multiple times per year (we love that the FAA grows with the times)

Why should aviators care?

The power of the AME Guide — at least from your perspective — is how it helps you walk into your exam informed and prepared. Here’s what knowing about it can do for you:

• Fewer Surprises
  If you’ve had a medical issue, the AME Guide may lay out exactly what to expect or what to bring to your exam.

• Faster Certification
  Knowing what documentation is needed ahead of time (especially for Special Issuance renewals or CACI cases) can expedite your certification.

• Transparency
  The Guide ensures your AME is following FAA policy — so you don’t have to wonder if the outcome is fair.

• Self-Advocacy
  We hate to admit it, but AMEs aren’t omniscient — and yes, we make mistakes. The more you know, the more empowered you are to advocate for yourself.

Final Thoughts

At HIMS AME of Houston, we use the FAA AME Guide every day — not to gatekeep, but to help you navigate the system with clarity and confidence. Whether you're a student pilot applying for your first Class 3, or a seasoned ATP managing a Special Issuance, the guide helps keep things grounded in process, not guesswork.

Have questions about your medical history or whether something is certifiable? That’s what we’re here for.

As Always, 

Smooth skies and steady pulses,

— HIMS AME of Houston

Disclaimer

This blog post is intended for general informational purposes only and does not constitute as medical advice, diagnosis, or treatment. It is not a substitute for consulting with your healthcare provider for case-specific assessment. Always seek the advice of your physician for any concerns or questions regarding medical conditions. Following the suggestions in this post does not guarantee a specific medical outcome or certification outcome. HIMS AME of Houston is not a representative of the Federal Aviation Administration.