USAF Flight Surgeon Guidance & Online Resources


The Knowledge Exchange (CAC-protected) is the definitive source for all up-to-date official guidance for Air Force Medical Services.  This includes aerospace medicine.  Click the link labeled ‘Flight Medicine’ under the ‘Top 20 KJ’s’.  Bringing the latest digital or paper copies of the below guidance is a good idea when going TDY or deploying, but in the new digital age ALWAYS access the most recent version of the guidance via the KX2 when required.

The USAF Portal (CAC-protected) has a search engine for Air Force Instructions (AFI), DoD/USAF forms, and other publications.  This can be found on the left hand of the home page and is labeled ‘e-Publications Search’.  Many of the required databases that a USAF flight doc uses on a daily basis are also accessible via the Portal.

Most of this guidance can be found on the KX2 above, but the AFI’s and web-based databases may be more readily found thru the Portal.  Many of the documents below intentionally are not linked as they are frequently updated and it is important that you access the most recent version of this document.  Many of the ones that are linked are only accessible with a CAC.

  • AFI 48-123 Medical Examinations & Standards:  The definitive guidance on how to perform all medical examinations in the USAF.  Flight surgeons should pay particular attention to Chapter 6, which deals with flying and special operations duty.  In addition to information on all programs that aerospace medicine operates the process for performing flying class physicals (to include initial flying class physicals, annual fly preventive health assessments, initial base clearance exams, and orientation flight examinations) is found here.  Note that the specific medical standards were removed from this document in Nov 2013 and are now found in the MSD below.
  • AFI 48-101: Guidance describing the Aerospace Medicine Enterprise.
  • Medical Standards Directory (MSD):  This document reflects the current medical standards for retention, flying classes, and special operational duty for the USAF. This document organizes the medical standards by body system and displays the standards in a spreadsheet format that separates specific unique medical standards in rows and columns that point out which type of application this medical condition applies to.  For example, history of anaphylaxis from food is not a standard needed to maintain retention, but is required for several types of flying class physical.  This document NEEDS to be readily available to ALL USAF flight surgeons.
  • Aeromedical Waiver Guide:  There are a variety of medical standards that apply onto those on special operational status.  When the flyer, controller, or other special duty position does not meet a specific medical standard, they require an aeromedical waiver.  The waiver guide is your cookbook for this process.
  • Aircrew Medication List:  See left blue banner on the page after following this link.  Only a small subset of pharmaceutical medications can be used without impacting a flyer’s ability to continue their normal duties without limitation.  Here is the official list.  If its not on the list, it is not approved.  This document is updated frequently so make sure you have the most recent version.
  • OTC Medication List:  See left blue banner on the page after following this link.  Similar to the list above, this one applies only to over-the-counter medications.
  • MOD Medication List:  See left blue banner on the page after following this link.  Missile operators are also restricted from use of specific medications.  However, this list is much less comprehensive than those who are required to perform their duties in flight.  If you are at a missile base, this is your baby.  Get well acquainted.
  • EKG Library at USAFSAM & Disposition of EKG Findings in Aircrew:  As part of the Aerospace Medicine Consultation Division’s (ACS) Internal Medicine Branch at USAF School of Aerospace Medicine (USAFSAM), the USAF Central Electrocardiographic Library functions as the repository for cardiovascular studies accomplished on rated aviators in the USAF/USAFR/ANG.  Any questions about a finding on EKG in a flyer should be referred to the EKG Library.  For the Disposition of EKG Findings in USAF Aircrew document, see the link at the bottom right of the Library’s webpage.
  • Laser Injury Guidebook:  On occasion military members are exposed to LASERs, which can be damaging to one’s eyes.  This can happen inadvertently with military-grade lasers during training, as a direct attack from adversaries, or from civilian pranksters with common green astronomy LASERs.  Given the importance of vision for aircrew, any LASER exposure must be taken seriously.  This guidebook provides guidance on the process undertaken after a LASER incident.
  • Aerospace Medicine Consultation (ACS) Division:  The ACS is a branch of specialized aeromedical sub-specialists operating from within the USAF School of Aerospace Medicine (USAFSAM) at WPAFB.  Many young flight surgeons do not fully understand the process or value to using the ACS.  Some medical standards and aeromedical waivers require a review (patient’s records reviewed by ACS) while others require an evaluation (patient is physically evaluated by ACS physicians.  Read the ‘Obtaining an Appointment’ link under the ‘Information for Flight Surgeons’ section for full insight on the correct way to use this service.
  • Flight Surgeon Exam:
  • AFPAM 88-133 Physical Examination Techniques:  This particular document is the source guide for the exact procedures for performing a variety of physical exams.  This includes the operation of particular types of testing such as visual exams and audiograms.  It is important that the medical technician and the provider be well versed on these techniques to assure that the exam meets the expected quality standards.
  • DoDI  5210.42 & AFMAN 13-501 PRP Guidance:  Department of Defense and USAF specific guidance on all things PRP.  If you are at a location where you see PRP patients, you must know these regulations!



  • Aeromedical Services Information Management System (ASIMS):  Kind of a powerhouse medical database in the USAF AFMS.  Tracks individual medical readiness, duty/fitness/mobility restricting profiles, quarters, deployment health assessments, medical fitness for flying/special duty, medication ground-testing for flyers, occupational health and now even PRP status at some bases.  You WILL need to gain familiarity with this web-based software.
  • Physical Exam Processing Program (PEPP):  This database is used as a repository for enlistment, commissioning, and all special duty/flying class physicals.  The history and physical of these military examinations are input into PEPP and then submitted the appropriate approval authority electronically.  If the patient has a disqualifying medical condition (see Medical Standards Directory [MSD] above) for a special duty/flying class physical, an aeromedical waiver must be requested thru AIMWTS.  Waivers for enlistment physicals should be listed and communicated to the recruiter.
  • Aeromedical Information Management Waiver Tracking System (AIMWTS):  This web-based database is used to input, submit, and generally track aeromedical waivers.
  • Flight Surgeon Exam:  This Computer Based Testing (CBT) module is required of all flight surgeons annually and every time that there is a 60 day window between flights.  It can be found on AFMS learn by clicking on ‘My Courses’ and searching for ‘flight surgeon’.
  • Air Force Safety Automated System (AFSAS):  AFSAS was developed to be the single source for all USAF safety disciplines to report mishaps and query the resulting data.  AFSAS is used by the flight surgeon to both input information when submitting safety reports following mishaps of any class and also to retrieve information from previous safety investigations.
  • Residency of Aerospace Medicine (RAM) Page:  The RAMpage was created by residents of the U.S. Air Force School of Aerospace Medicine (USAFSAM) Residency in Aerospace Medicine (RAM). It is designed to improve communication among graduates of the residency program and provide reference information to aerospace professionals in the field.
  • USAF Administrative Investigation Board (AIB) Reports:  An open source online database of AIB investigation reports from various aircraft mishaps in the USAF.
  • SGP-earls:  A comprehensive resource specifically written for USAF flight surgeons serving as the Chief of Aerospace Medicine created by Lt Col (Dr) Todd “QUATTRO” Huhn.
  • Natural Medicines Comprehensive Database (Providers):
  • Human Performance Resource Center:
  • Society of United States Air Force Flight Surgeons (SOUSAFFS):   The Society of United States Air Force Flight Surgeons (SoUSAFFS) area constituent organization of the Aerospace Medical Association (AsMA) representing active, reserve, guard and retired Air Force flight surgeons. The society exists to advocate for USAF flight surgeons while advancing education, mentoring, and networking among all flight surgeons.
  • Alliance of ANG Flight Surgeons:
  • E-PEX:  Web-based version of the scheduling program used by aviators.  Get access from your local flying unit and you can more easily get yourself scheduled to fly.
  • Skybrary:  Europe’s reference for aviation safety knowledge