Flight surgeon
Encyclopedia
A flight surgeon is a military medical officer assigned to duties in the clinical field variously known as aviation medicine
, aerospace medicine, or flight medicine. (Although the term "flight surgery" is considered improper by purists, it may occasionally be encountered.)
Flight surgeons are medical doctors, either MD
s or DO
s who are primarily responsible for the medical evaluation, certification and treatment of aviation
personnel — e.g., pilots
, USN and USMC Naval Flight Officer
s, USAF navigators/Combat Systems Officers, astronaut
s, air traffic controller
s, UAV operators and other aircrew
members. They perform routine, periodic medical examinations ("flight physicals") of these personnel. In the U.S military, flight surgeons are trained to fill general public health
and occupational and preventive medicine
roles, and are only infrequently "surgeons" in an operating theater sense. Flight surgeons are typically on flight status (i.e., they log flight hours), but are not required to be rated or licensed pilots. They may be called upon to provide medical consultation as members of an investigation board into a military or NASA
aviation or spaceflight mishap. Occasionally, they may serve to provide in-flight care to patients being evacuated via aeromedical evacuation, either fixed wing or rotary wing.
The civilian equivalent of the flight surgeon is the Aviation Medical Examiner
(AME). Though some civilian AMEs have training similar to that of military flight surgeons (and some are either retired military flight surgeons or actively serving flight surgeons in a military Reserve Component), many are less extensively trained.
and the Aerial League of America — to manage problems of medical screening and standards for U.S. military aviators.
The term is especially associated with Col. (later Brig. Gen.) Theodore C. Lyster
(the first Chief Surgeon, Aviation Section, U.S. Signal Corps, U.S. Army), and with Maj. Isaac H. Jones. These two officers proposed the organization of a “Care of the Flier” unit in June 1918.
The original intent was for the military and the Surgeon General to understand what was causing the high flight mishap rate. Shortly after the appointment of the first flight surgeons, research and experience led to a dramatic improvement in aircrew health as well as a significant raising of the entry medical standards for all aircrew. The early flight surgeons found that the Army's practice of assigning officers to flight duty who were not physically qualified for infantry or cavalry duty was improper. Because of the G-forces, risk of spatial disorientation
, and risk of hypoxia
encountered in the aviation environment, among other challenges, early flight surgeons found that aviation personnel must be scrupulously healthy and well trained in the basics of aerospace physiology.
The role of flight surgeons continued to mature and expand as the U.S. faced World War II. The 1941 movie Dive Bomber
, although focused on Naval Aviation
, highlighted the role of the flight surgeon just prior to the attack on Pearl Harbor
, and demonstrated how solving the problems of hypoxia Strict racial segregation in the U.S. Army required the development of separate black flight surgeons to support the operations and training of the Tuskegee Airmen
in 1941.
Flight surgeon training varies depending on the branch of service:
In the U.S. Air Force, most flight surgeons have received initial training in the form of the Aerospace Medicine Primary (AMP) course, an eight week training program that involves aeromedical topics as well as aircrew and survival training.
Some flight surgeons ultimately move on to the Residency in Aerospace Medicine (RAM), a three year program involving a Master of Public Health, a year of aerospace medical training, and a year of either occupational or preventive medical training. Graduates of the RAM are eligible to be double-boarded in Aerospace Medicine and either Occupational or Preventive Medicine, and are generally assigned to supervise other flight surgeons or medical units. The RAM also involves Medical Officer Flight Familiarization Training (MOFFT), during which the flight surgeon receives abbreviated ground school and some basic pilot training. Consequently, a RAM has some actual piloting experience and some training toward initial qualification, although the rating of pilot is not awarded.
In the U.S. Navy, initial flight surgeon training is significantly longer and involves a version of MOFFT, so that all Navy flight surgeons have some formal pilot training. Naval Flight Surgeons may also attend a three year RAM training program that is distinct from the Air Force program. A small number of Naval Flight Surgeons are also "dual-designated" as Naval Aviator
s, having either been former unrestricted line officer pilots who attend medical school and transfer to the Navy's Medical Corps, or previously designated Naval Flight Surgeons selected to attend flight training as Student Naval Aviators. These officers are awarded Naval Aviator insignia, but remain in the Medical Corps as "dual designator" officers, qualified as both a Naval Aviator and a Naval Flight Surgeon. Such officers are often assigned as research pilots.
The U.S. Army, which has more Flight Surgeons than the U.S. Air Force, has a combined training program. Most Army Flight Surgeons graduate from a basic course of 6 weeks taught at the US Army School of Aviation Medicine at Fort Rucker
, Alabama and are then assigned to their units. After some experience in the field, Army physicians are then eligible to participate in a RAM program as described above-- In the past, most Army RAMs have participated in the USAF program, but currently most take part in the USN program, while a few study in the only US civilian RAM program, at Wright State University. RAM training is the equivalent of other specialty residency training in the US, and a graduate of the program can take board certification tests and is then considered a fully-fledged specialist.
The training requirements in other nations than the US are different -- for example, in the United Kingdom, Aviation Medicine is considered a sub-specialty of Occupational Medicine rather than a fully separate specialty. Thus, Royal Air Force
, Royal Navy
and British Army
specialists in Aviation Medicine are usually required to be specialists in Occupational Medicine before undertaking the specialised training in Aviation Medicine.
During World War II
, the head of the Army Air Forces, General of the Army
'Hap' Arnold, directed all flight surgeons in the U.S. Army Air Forces to fly regularly with their patients in order to better understand the aviation environment. Consequently, in the U.S. military, flight surgeons are rated aircrew
members who receive flight pay and who are required to fly a certain number of hours monthly.
Aviation medicine
Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or persons involved in spaceflight...
, aerospace medicine, or flight medicine. (Although the term "flight surgery" is considered improper by purists, it may occasionally be encountered.)
Flight surgeons are medical doctors, either MD
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
s or DO
Doctor of Osteopathic Medicine
Doctor of Osteopathic Medicine is a professional doctoral degree for physicians in the United States. Holders of the MD degree, Doctor of Medicine, have the same rights, privileges and responsibilities as osteopathic physicians in the United States.The American Osteopathic Association’s Commission...
s who are primarily responsible for the medical evaluation, certification and treatment of aviation
Aviation
Aviation is the design, development, production, operation, and use of aircraft, especially heavier-than-air aircraft. Aviation is derived from avis, the Latin word for bird.-History:...
personnel — e.g., pilots
Aviator
An aviator is a person who flies an aircraft. The first recorded use of the term was in 1887, as a variation of 'aviation', from the Latin avis , coined in 1863 by G. de la Landelle in Aviation Ou Navigation Aérienne...
, USN and USMC Naval Flight Officer
Naval Flight Officer
A Naval Flight Officer is an aeronautically designated commissioned officer in the United States Navy or United States Marine Corps that specializes in airborne weapons and sensor systems. NFOs are not pilots per se, but they may perform many "co-pilot" functions, depending on the type of aircraft...
s, USAF navigators/Combat Systems Officers, astronaut
Astronaut
An astronaut or cosmonaut is a person trained by a human spaceflight program to command, pilot, or serve as a crew member of a spacecraft....
s, air traffic controller
Air traffic controller
Air traffic controllers are the people who expedite and maintain a safe and orderly flow of air traffic in the global air traffic control system. The position of the air traffic controller is one that requires highly specialized skills...
s, UAV operators and other aircrew
Aircrew
Aircrew are the personnel who operate an aircraft while in flight. The composition of the crew depends on the type of aircraft as well as the purpose of the flight.-Civilian:*Aviator** Pilot-in-command** First officer** Second officer** Third officer...
members. They perform routine, periodic medical examinations ("flight physicals") of these personnel. In the U.S military, flight surgeons are trained to fill general public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
and occupational and preventive medicine
Preventive medicine
Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...
roles, and are only infrequently "surgeons" in an operating theater sense. Flight surgeons are typically on flight status (i.e., they log flight hours), but are not required to be rated or licensed pilots. They may be called upon to provide medical consultation as members of an investigation board into a military or NASA
NASA
The National Aeronautics and Space Administration is the agency of the United States government that is responsible for the nation's civilian space program and for aeronautics and aerospace research...
aviation or spaceflight mishap. Occasionally, they may serve to provide in-flight care to patients being evacuated via aeromedical evacuation, either fixed wing or rotary wing.
The civilian equivalent of the flight surgeon is the Aviation Medical Examiner
Aviation Medical Examiner
In the United States and other countries, an Aviation Medical Examiner is a physician designated by the local aviation authority and given the authority to perform flight physical examinations and issue aviation medical certificates...
(AME). Though some civilian AMEs have training similar to that of military flight surgeons (and some are either retired military flight surgeons or actively serving flight surgeons in a military Reserve Component), many are less extensively trained.
History
The term “flight surgeon” originated in the early months of 1918 when the U.S. Air Medical Service of the U.S. Army collaborated with two civilian aviation organizations — the Aero Club of AmericaAero Club of America
The Aero Club of America was a social club formed in 1905 by Charles Glidden and others to promote aviation in America. It was the parent organization of numerous state chapters, the first being the Aero Club of New England. It thrived until 1923, when it transformed into the National Aeronautic...
and the Aerial League of America — to manage problems of medical screening and standards for U.S. military aviators.
The term is especially associated with Col. (later Brig. Gen.) Theodore C. Lyster
Theodore C. Lyster
Brigadier General Theodore C. Lyster, M.D. was a United States Army physician and aviation medicine pioneer....
(the first Chief Surgeon, Aviation Section, U.S. Signal Corps, U.S. Army), and with Maj. Isaac H. Jones. These two officers proposed the organization of a “Care of the Flier” unit in June 1918.
The original intent was for the military and the Surgeon General to understand what was causing the high flight mishap rate. Shortly after the appointment of the first flight surgeons, research and experience led to a dramatic improvement in aircrew health as well as a significant raising of the entry medical standards for all aircrew. The early flight surgeons found that the Army's practice of assigning officers to flight duty who were not physically qualified for infantry or cavalry duty was improper. Because of the G-forces, risk of spatial disorientation
Spatial disorientation
Spatial disorientation is the inability to correctly interpret aircraft attitude, altitude or airspeed, in relation to the Earth or point of reference. Spatial disorientation is a condition in which an aircraft pilot's perception of direction does not agree with reality...
, and risk of hypoxia
Hypoxia (medical)
Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise...
encountered in the aviation environment, among other challenges, early flight surgeons found that aviation personnel must be scrupulously healthy and well trained in the basics of aerospace physiology.
The role of flight surgeons continued to mature and expand as the U.S. faced World War II. The 1941 movie Dive Bomber
Dive Bomber (film)
Dive Bomber is a 1941 American propaganda film directed by Michael Curtiz. It is notable for both its Technicolor photography of pre-World War II United States Navy aircraft and as a historical document of the US in 1941, including the aircraft carrier USS Enterprise, one of the best known World...
, although focused on Naval Aviation
Naval aviation
Naval aviation is the application of manned military air power by navies, including ships that embark fixed-wing aircraft or helicopters. In contrast, maritime aviation is the operation of aircraft in a maritime role under the command of non-naval forces such as the former RAF Coastal Command or a...
, highlighted the role of the flight surgeon just prior to the attack on Pearl Harbor
Attack on Pearl Harbor
The attack on Pearl Harbor was a surprise military strike conducted by the Imperial Japanese Navy against the United States naval base at Pearl Harbor, Hawaii, on the morning of December 7, 1941...
, and demonstrated how solving the problems of hypoxia Strict racial segregation in the U.S. Army required the development of separate black flight surgeons to support the operations and training of the Tuskegee Airmen
Tuskegee Airmen
The Tuskegee Airmen is the popular name of a group of African American pilots who fought in World War II. Formally, they were the 332nd Fighter Group and the 477th Bombardment Group of the U.S. Army Air Corps....
in 1941.
Training
This position requires additional specialized training. It was created as distinct from other medical professionals in the armed forces because of the special, and often higher, minimum standards of fitness and physical requirements required by the extremely high responsibility positions of aviators and ancillary personnel. For example, some routine treatments, such as certain antihistamines, when administered to aviation personnel, are cause for temporary grounding (loss of flying privileges) until the therapy and its effects are completed. Further, the whole "mindset" of aviation/flight medicine practitioners is different from that of non-aviation physicians. Most medical problems on the ground are "an abnormal response to a normal environment", while in aviation the clinician must consider the "normal response to an abnormal environment".In the U.S. Air Force, most flight surgeons have received initial training in the form of the Aerospace Medicine Primary (AMP) course, an eight week training program that involves aeromedical topics as well as aircrew and survival training.
Some flight surgeons ultimately move on to the Residency in Aerospace Medicine (RAM), a three year program involving a Master of Public Health, a year of aerospace medical training, and a year of either occupational or preventive medical training. Graduates of the RAM are eligible to be double-boarded in Aerospace Medicine and either Occupational or Preventive Medicine, and are generally assigned to supervise other flight surgeons or medical units. The RAM also involves Medical Officer Flight Familiarization Training (MOFFT), during which the flight surgeon receives abbreviated ground school and some basic pilot training. Consequently, a RAM has some actual piloting experience and some training toward initial qualification, although the rating of pilot is not awarded.
In the U.S. Navy, initial flight surgeon training is significantly longer and involves a version of MOFFT, so that all Navy flight surgeons have some formal pilot training. Naval Flight Surgeons may also attend a three year RAM training program that is distinct from the Air Force program. A small number of Naval Flight Surgeons are also "dual-designated" as Naval Aviator
Naval Aviator
A United States Naval Aviator is a qualified pilot in the United States Navy, Marine Corps or Coast Guard.-Naming Conventions:Most Naval Aviators are Unrestricted Line Officers; however, a small number of Limited Duty Officers and Chief Warrant Officers are also trained as Naval Aviators.Until 1981...
s, having either been former unrestricted line officer pilots who attend medical school and transfer to the Navy's Medical Corps, or previously designated Naval Flight Surgeons selected to attend flight training as Student Naval Aviators. These officers are awarded Naval Aviator insignia, but remain in the Medical Corps as "dual designator" officers, qualified as both a Naval Aviator and a Naval Flight Surgeon. Such officers are often assigned as research pilots.
The U.S. Army, which has more Flight Surgeons than the U.S. Air Force, has a combined training program. Most Army Flight Surgeons graduate from a basic course of 6 weeks taught at the US Army School of Aviation Medicine at Fort Rucker
Fort Rucker
Fort Rucker is a U.S. Army post located mostly in Dale County, Alabama, United States. It was named for a Civil War officer, Confederate General Edmund Rucker. The post is the primary flight training base for Army Aviation and is home to the United States Army Aviation Center of Excellence and...
, Alabama and are then assigned to their units. After some experience in the field, Army physicians are then eligible to participate in a RAM program as described above-- In the past, most Army RAMs have participated in the USAF program, but currently most take part in the USN program, while a few study in the only US civilian RAM program, at Wright State University. RAM training is the equivalent of other specialty residency training in the US, and a graduate of the program can take board certification tests and is then considered a fully-fledged specialist.
The training requirements in other nations than the US are different -- for example, in the United Kingdom, Aviation Medicine is considered a sub-specialty of Occupational Medicine rather than a fully separate specialty. Thus, Royal Air Force
Royal Air Force
The Royal Air Force is the aerial warfare service branch of the British Armed Forces. Formed on 1 April 1918, it is the oldest independent air force in the world...
, Royal Navy
Royal Navy
The Royal Navy is the naval warfare service branch of the British Armed Forces. Founded in the 16th century, it is the oldest service branch and is known as the Senior Service...
and British Army
British Army
The British Army is the land warfare branch of Her Majesty's Armed Forces in the United Kingdom. It came into being with the unification of the Kingdom of England and Scotland into the Kingdom of Great Britain in 1707. The new British Army incorporated Regiments that had already existed in England...
specialists in Aviation Medicine are usually required to be specialists in Occupational Medicine before undertaking the specialised training in Aviation Medicine.
During World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
, the head of the Army Air Forces, General of the Army
General of the Army
General of the Army is a military rank used in some countries to denote a senior military leader, usually a General in command of a nation's Army. It may also be the title given to a General who commands an Army in the field....
'Hap' Arnold, directed all flight surgeons in the U.S. Army Air Forces to fly regularly with their patients in order to better understand the aviation environment. Consequently, in the U.S. military, flight surgeons are rated aircrew
U.S. Air Force Aeronautical Ratings
U.S. Air Force aeronautical ratings are military aviation skill standards established and awarded by the United States Air Force for commissioned officers participating in "regular and frequent flight", The standard by which flight status has been defined in law, executive orders, and regulations...
members who receive flight pay and who are required to fly a certain number of hours monthly.
External links
- Flying Pilot Podcast - Podcast interview with an ex-USAF flight surgeon.