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NAMI: an aviator to flight surgeon perspective.


I began my Navy career as an aviator in 1997 and earned my wings in 1999. As an aviator, I've gained a keen awareness of how most aviators feel about the Naval Aerospace Medical Institute (NAMI). Getting past NAMI is one of the biggest hurdles to jump before realizing their dream of becoming a naval aviator.

After 10 years in aviation, I had the opportunity to return to school to complete a medical degree. Transitioning from a naval aviator to a naval flight surgeon has been an eye-opening experience. It has changed the way I view the goals and importance of NAMI.

NAMI was established in 1965 to train medical professionals as aviation-medicine providers and to conduct aerospace research. In 1970, the Naval Aerospace Medical Research Laboratory (NAMRL) took oversight of the research component of military medicine. This allowed NAMI experts to focus on training, with the added responsibility of providing medical clearances for aviation candidates. All aviation personnel must pass through the halls of NAMI in Pensacola, Fla., to receive medical clearance to fly.

As an aviation candidate, I viewed flight surgeons as malicious, ruthless, and unsympathetic physicians whose sole purpose was to medically disqualify (or "down") an otherwise healthy aviation applicant. My medical screening began as I nervously sat in an auditorium surrounded by dozens of other aviation candidates. The NAMI clearance process was a traumatic, agonizing, multi-day event that I remember as if it were yesterday. All I wanted to do was fly, and I was terrified that NAMI physicians would find some loophole to disqualify me from the program.

As I look back, I recollect several startling moments during this phase of my aviation career. On the second day of processing, we candidates were handed our medical records. The documents were in official government folders with individualized notes stuck to the front of each record. My folder had "HIV" written on it in large, bold, black letters. I felt like my stomach was in my throat. I immediately thought this meant that the numerous tubes of blood they extracted from my arm had tested positive for HIV. I would be disqualified, processed out of the aviation program and the Navy, and die shortly thereafter. I was terrified--but I was also an ensign who was too humble to clarify my suspicions. To my relief, it turned out they wrote HIV on several folders to alert the medical staff that certain candidates still needed an HIV lab test to complete medical processing.

A second upsetting experience occurred during the ophthalmology clearance process. Candidates were being disqualified for excessive near- and far-sightedness, and for defective depth perception or color vision. They also checked for vision-improvement procedures, such as LASIK eye surgery and photorefractive keratectomy (PRK). Aviators were not eligible to receive PRK or LASIK waivers back then. These surgeries meant you were packing your bags to go home or transferred to another job designator. I remember one candidate had to be physically removed from the ophthalmology department because he became so irate about being disqualified for his history of PRK. I later learned that he knew PRK was disqualifying, so he chose not to disclose this information in his original application. He had hoped the ophthalmologist would not notice.

Virtually every Navy and Marine Corps aviator has heard of the infamous slang term, "NAMI whammy." An aviation candidate is considered to have been hit with the NAMI whammy when their medical qualification is either delayed by what they view as medical bureaucracy, or by being deemed "not physically qualified," known as NPQ, without the possibility of a waiver. In my quest to become a naval aviator, I started the NAMI processing system with a large group of candidates and ended with a select few. Candidates slowly disappeared one by one, being disqualified in the selection process. That is what the NAMI whammy meant to me: hard-working folks just disappearing for reasons unknownto me, never to be seen or heard of again.

I NOW FULLY UNDERSTAND THE REASONS, and I've come to appreciate that NAMI performs a vital role in naval aviation. I believe that the aviator's perception of the NAMI process is in stark contrast to reality.

NAMI employs experts from many aviation medicine backgrounds to perform comprehensive medical clearances for all aviation candidates. NAMI trains aero-medical personnel for operational assignments. NAMI is the entity charged with training all Navy flight surgeons, aerospace residency-trained physicians, aerospace physiologists, aviation experimental psychologists, aviation optometrists and aerospace medicine technicians. Our Navy has the most intensive, rigorous six-month educational flight-surgeon-training course in the world. It's internationally recognized curriculum provides training for flight surgeons from Brazil, Canada, Finland, Germany, Italy, Netherlands and Norway.

An aviation medical clearance is a standard of criteria that makes sure aircrew are medically safe for flight training and aviation careers. Aerospace experts in multiple disciplines such as flight surgery, neurology, mental health, ear/nose/throat (ENT), and ophthalmology/optometry, along with their support personnel, both qualify and disqualify flight candidates. Some people have conditions that are deemed too high-risk to allow them to work in certain aviation professions. Fortunately, some conditions can be waived, and these candidates are allowed to continue in the program.

Ophthalmology provides a great example of how candidates can benefit from waivers. While the eye exam is one of the most dreaded portions of the NAMI physical-qualification process, it is also one of the most revolutionary areas of aerospace medicine. In 2000, the Navy's ophthalmology experts played an instrumental role in getting authorization to grant a PRK waiver. Over the past several years, this waiver paved the way for the development and authorization of a LASIK waiver. Because PRK and LASIK can improve a person's vision to within the required standards, these waivers changed the lives of countless pilots that previously would have been disqualified. Similar advancements in aerospace medicine allow NAMI providers to make aviation careers available to many more candidates.

Becoming a naval aviator is a long and challenging, but rewarding process. Transitioning from a naval aviator to a flight surgeon has opened my eyes to the risks associated with all aviation-related professions. It has given me an in-depth understanding of the importance of making sure candidates are medically qualified to safely pursue an aviation career. I take pride in knowing that it is my responsibility to medically protect aviation personnel. Their lives depend on it.


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Author:Johnson, Charles
Date:Jul 1, 2012
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