Aviation Medical Examiner Salary: What a Pilot Patient Is Really Worth

The short answer

Do aviation medical examiners get a salary?

No. An aviation medical examiner (AME) is a private physician designated by the FAA, not employed by it. The FAA doesn't set or pay exam fees. Each AME sets their own price, and the pilot pays directly. FAA medical exams aren't covered by regular health insurance.

That's why salary websites give misleading numbers for "aviation medical examiner salary." They treat AME as a job title with a paycheck. In practice, AME income is the number of exams times the fee, on top of whatever else the physician does.

How do AME practices differ?

In our conversations with AMEs, three kinds of practice stand out:

• Doing the minimum to keep the designation. Some AMEs, often pilots themselves, do just enough exams each year to stay designated. Being an AME keeps them close to aviation; they aren't trying to grow it.
• Late in a career, maintaining an established practice. Senior physicians who have done FAA exams for years often have a loyal base of pilot patients who come back every cycle. They want to keep serving those pilots through the rest of their career, not add new ones.
• A practice built around pilots. Some AMEs make aviation medicine the focus of their work rather than one part of a hospital or specialty practice. Many become Senior AMEs, and some go further and become HIMS AMEs. Their aim is to keep pilots flying: working through special issuances and other medical questions so a pilot with a health issue can stay in the air as long as safely possible.

Exam volumes suggest most AMEs fall into the first two groups. The FAA requires at least ten FAA exams per year to keep the designation (FAA Order 8520.2G), and AOPA reports that 55% of AMEs do 50 exams or fewer a year, while about 10% do more than 300.

How much does an AME charge for an FAA medical exam?

Each AME sets their own fee; the FAA publishes no fee schedule. On the published fee pages of 7 AME practices in different regions that we checked in November 2026, the base fee averaged about $180 for a third-class exam, $190 for second class and $225 for first class. Some of those practices charge $50–$115 extra for an ECG, which first-class exams require at certain ages. It's a small sample, but every figure comes from the practice's own website. Fees vary by region and local competition, and some practices also charge for special issuance paperwork.

What is one returning pilot worth over five years?

Exam frequency is set by 14 CFR 61.23 and depends on the pilot's medical class and age. Over five years, a pilot who keeps the same class and returns to the same AME needs:

The $200 fee is only an example (between the average second- and first-class fees in our sample). Use your own fee for each class.

Two things change the math:

• Retention. The value is in the pilot coming back. A pilot who switches AMEs after one exam is worth one exam.
• BasicMed. Many private pilots now fly under BasicMed, which needs a physical with any state-licensed physician every 48 months plus an online course every 24 months, with no AME required. This mainly reduces third-class demand. First- and second-class pilots can't use BasicMed for those privileges.

What are special issuance and HIMS pilots worth to a practice?

Pilots with certain medical conditions fly on a special issuance: a time-limited FAA authorization that requires follow-up documentation at each exam. For many conditions, AME Assisted Special Issuance (AASI) lets the AME re-issue the certificate at the exam without waiting for FAA review each time (FAA Guide for Aviation Medical Examiners). The FAA still makes the initial special issuance decision.

For the practice, this means more work per visit, and pilots who strongly prefer to stay with an AME who knows their file. HIMS AMEs, who oversee pilots in the FAA's substance-use treatment program, are a smaller group with the same pattern: about 250 HIMS AMEs (FAA HIMS AME list, Feb 2026) serve a national pool of pilots who often travel to see one.

Is becoming an AME worth it?

It depends on what you want from it. If you want to stay close to aviation, doing the minimum is a legitimate choice. If you want income, it depends less on the fee than on local demand: how many pilots near you hold medicals, how often they're due, and how many other AMEs already serve them. Honest counterpoints from physicians who've weighed it:

• Up-front training and travel to the initial seminar.
• Administrative load: MedXPress review, deferrals, and special-issuance documentation.
• Liability and FAA oversight of your decisions.
• BasicMed reducing third-class volume.
• Most AMEs do fewer than 50 exams a year. Low volume makes it a modest side income, not a practice.

How do you become an aviation medical examiner?

• Be an MD or DO with an active, unrestricted license, in clinical practice.
• Apply to the FAA. New AMEs are designated where there's local demand: the FAA compares the number of pilots in an area with the AMEs already serving them.
• Complete the FAA's prerequisite training and the Basic AME Seminar, run by the FAA's Civil Aerospace Medical Institute (CAMI) in Oklahoma City.
• New AMEs perform second- and third-class exams. Senior AME designation, required for first-class exams, comes after a period of satisfactory service. The FAA's designation application says this usually takes three years.
• Keep the designation: at least ten exams a year, plus recurrent training.

How many aviation medical examiners are there?

The FAA doesn't publish a current count. Its statistical handbook last reported 2,955 active AMEs in 2016; the newer editions report on pilots, not AMEs. Figures you'll see on other websites vary widely and usually carry no date or source.

The FAA's 2024 Aerospace Medical Certification Statistical Handbook does show the scale of the work: the FAA processed 468,508 medical applications in 2024, and 639,044 airmen held a medical certificate at the end of 2024. For comparison, there are 887,000+ active FAA pilots (FAA airmen statistics, end of 2025); many private pilots fly under BasicMed instead of an FAA medical.

How many pilots near me need exams?

This is the question that decides whether an AME practice is busy, and general answers can't settle it, because it depends on your ZIP code. FAA airmen data shows how many pilots in an area hold each class of medical and when they're due. See pilot medicals by state on our data page, or enter your ZIP code and radius in the calculator on our homepage. We show counts and density, never individual pilots.

Common questions