General Systemic Medical Issues

Item 48: Guideance for the Pilot Medical Exam

Apr 2014

Guidance is compiled and interpreted by professional pilots and physicians at from the 2014 AME Guide, FAA and FDA web data ( &, instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).

Code of Federal Regulations (Legal Extracts)

FAA Examination Techniques - Item 48. General Systemic

A protocol for examinations applicable to Item 48 is not provided because the necessary
history-taking, observation, and other examination techniques used in examining other systems have already revealed much of what can be known about the status of the applicant's endocrine and other systems. For example, the examination of the skin alone can reveal important signs of thyroid dysfunction, Addison's disease, Cushing's disease, and several other endocrine disorders. The eye may reflect a thyroid disorder (exophthalmos) or diabetes (retinopathy).

When the Examiner reaches Item 48 in the course of the examination of an applicant, it is recommended that the Examiner take a moment to review and determine if key procedures have been performed in conjunction with examinations made under other items, and to determine the relevance of any positive or abnormal findings.

FAA Considerations - Item 48. General Systemic

The following lists the most common conditions of aeromedical significance, and course of action that should be taken by the examiner as defined by the protocol and disposition in the table. Medical certificates must not be issued to an applicant with medical conditions that require deferral, or for any condition not listed that may result in sudden or subtle incapacitation without consulting the AMCD or the Regional Flight Surgeon. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.

Related Pages:

This page discussed the General Systemic section of the Fight Physical Examination required of pilots.

Reminder: use to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now