Introduction: Aviation personnel are expensive to train and challenging for the services to retain because of lucrative opportunities in the civilian aviation sector and a desire among pilots for agency. The military services' retention efforts have typically utilized a combination of high continuation pays and longer service commitments of up to 10 years following initial training. One area that the services have overlooked in their attempts to retain senior aviators is quantifying and reducing medical disqualifications. Much as aging aircraft require increasing maintenance to retain full operational capability, so may pilots and other aircrew members.
Materials and methods: This article reports on a prospectively collected cross-sectional research study evaluating the medical status of senior aviation personnel who reported being considered or selected for command. The study was deemed exempt from human subjects research by the Institutional Review Board and a waiver of Health Insurance Portability and Accountability Act was granted. The study, which collected data at the Pentagon Flight Medical Clinic over 1 year, used a chart review of routine medical encounters and flight physicals to collect descriptive data. The goals of the study were to establish the prevalence of medically disqualifying conditions, assess the association between disqualifying conditions and age, and generate hypotheses for further research. Logistic regression of waiver need was performed for variables including prior waivers, waiver count, service, platform, age, and gender. ANOVA of readiness percentages vs. DoD targets were assessed between the services individually and in aggregate.
Results: The study demonstrated medical readiness rates among command-eligible senior aviators ranging from 74% for the Air Force to 40% for the Army with the Navy and Marine Corps in the middle. The sample was insufficiently powered to demonstrate differences in readiness between the services; however, the population as a whole was significantly below the DoD's readiness target of >90% (P = .000).
Conclusions: None of the services met the DoD minimum readiness target of 90%. Markedly higher readiness was observed in the Air Force, the only service with a medical screening incorporated into its command selection process, but this difference was not statistically significant. Waivers increased with age and musculoskeletal concerns were common. A larger prospective cohort study should be considered to further elucidate and confirm the findings of this study. If further research confirms these findings, consideration should be made of screening command applicants for medical readiness.
Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.