Flight Surgeon Badging

USAF Flight Surgeon Aviation Badges—Time for Review?

BLUF: Recommend adding number of sorties as alternate determinant of flying experience– currently defined only by either number of flying hours or months receiving flight pay.


Flight Surgeons are awarded advanced badges for being operational—is it time to define operational flight months not simply by having received flight pay, but rather by number of sorties and accomplishing the multitude of flight medicine tasks such as flight safety briefings, aeromedical waivers, HUD reviews, shop visits, mishap investigation, deployments? (while still including flying to the extent necessary to support the mission)

Col Charles Fisher, Commander, USAFAM notes in the Winter 2010 Issue of Flight Lines the exciting changes occurring in Aerospace Medicine Education to keep flight medicine vital and relevant to the missions of today and tomorrow.  Fundamentals of Aerospace Medicine (AMP 101), Clinical Flight and Occupational Medicine (AMP 201) and Operational Aerospace Medicine Workshops (AMP 202) are followed by unique skills qualifications to guide flight surgeons’ career advancement.  With the many changes in aerospace medicine, is now the time to reevaluate how we guide career progression through the awarding of flight surgeon badges?

USAF Flight Surgeon Aviation Badges symbolize attainment of a high degree of professionalism in a flying specialty and are permanently awarded only to those aircrew members who, by virtue of extensive training, experience, and assignment to primary aircrew duty are considered part of the career flying force. Over the years, the prestige of aviation badges has been carefully and closely guarded through consistent and strict adherence to the award criteria.

Per AFI11-402, for the award of Senior Flight Surgeon, the physician must have

  • at least 7 years total rated service as flight surgeon,
  • permanent award of USAF flight surgeon rating,
  • 1 year on active flying status (ASC 8A and API 5), and either of the following:
    • at least 350 total hours logged as a flight surgeon, or
    • 72 months operational flying duty as a flight surgeon or pilot-physician

For the award of Chief Flight Surgeon, the physician must have

  • at least 15 years total rated service as flight surgeon,
  • permanent award of USAF flight surgeon rating,
  • 24 months on active flying status (ASC 8A and API 5), and either of the following:
    • at least 750 total hours logged as a flight surgeon, or
    • 144 months operational flying duty as a flight surgeon or pilot-physician

Interestingly, a well-intentioned “Note 6” defines operational flight months not by operational duties but rather by satisfying flight pay requirements. (Specifically, “Flight surgeons’ (API 5) must satisfy conditional ACIP {Aviation Career Incentive Pay} requirements IAW DoD FMR, Volume 7A, Chapter 22 in order to receive one month of Operational Flying Duty Accumulator (OFDA) credit.”)

For Reservists to receive flight pay, they must fly an average 2 flying hours per month or 4 hours per month when on active duty with the ability to “bank” hours 5 months forward.  Therefore, at a minimum, a Senior Flight Surgeon must have to have at least 144 evenly-spaced flying hours. While Active Duty must have 288.  Under the present regulations, a Reserve Chief Flight Surgeon Badge could be awarded with only 288 flying hours if such were appropriately spaced; whereas another flight surgeon could have 700 hours and multiple deployments, but not be eligible because the hours were not spaced in such a way as to receive flight pay for 144 months.All aircrew HARMS records (including those for flight surgeons) contain number of sorties, flying hours, combat missions, type of aircraft, and other information related to flying; however months receiving flight pay is a finance issue, so it may be absent from HARMS records, especially if the records cover a long period of time from several bases.  Flight surgeons may be deemed ineligible for an award in spite of many operational years as and hundreds of hours and sorties.

Determining the award by flight pay rather than sorties flown may create inequities as follow:

Flight Surgeon Alpha was stationed at a KC135 unit for 4 years with a one 4 month deployment to Afghanistan as surgeon (no opportunity to fly); he flew one 4-hour sortie each month at home station for a total of 176 hours and 44 sorties and 44 OFDA months.  He then transferred to an F16 unit and flew a 1-hour sortie every month for 4 years for another 48 sorties, 53 hours and 25 OFDA months. His 8 year total is 92 sorties, 229 flight hours, but only 69 OFDA months—he is not eligible for senior flight surgeon badge.

Flight Surgeon Bravo stationed at F16 unit for 12 years with two 4-month deployments and a safety board and an accident investigation board.  He  flew every month (except when deployed) for 12 years: 132 total sorties, 140 flight hours but only 70 OFDA months—he is not eligible for senior flight surgeon badge

Flight Surgeon Charlie was stationed at A10 unit for 8 years; API slots occupied, so he was not able to log “primary time.”  He did flight medicine, safety briefings, aeromedical summaries, shop visits and CCATT deployments—65 sorties, 21 CCATT missions and 200+ hours, but 0 OFDA months—he will never be eligible for senior flight surgeon badge.

Flight Surgeon Delta was stationed at several different bases over the course of 12 years, has 95 sorties and 197 hours, but inadequate records exist to establish flight pay for more than 69 OFDA months—he is not eligible for senior flight surgeon badge.

Flight Surgeon Echo was stationed at a KC 135 unit for 6 years; he flew a 4-hour sortie every other month for 6 years and has 36 sorties, 144 hours, but 72 OFDA months—he is eligible for senior flight surgeon badge even though his operational experience is clearly less than the preceding 4 examples.

Editorial comments: While flying plays an important part in the professional life of the flight surgeon, the doc’s job also encompasses flight safety briefings, aeromedical summaries, shop visits, deployments, mishap boards, HUD review, etc.  Does not a flight surgeon who logs a 1.1 hour sortie along with these other tasks fulfill the goal of “operational flight surgeon” even if he/she does not receive flight pay for the month?

Defining flight experience by a total number of hours or sorties would also make the criteria the same for Active Duty and Reserves.

 An Easy Interim Solution:
1) Leave unchanged the present requirement for a specified number of months as an operational flight surgeon (AFI11-402 Table 2.1, Line 33 & 34 column B {below}).
2) Modify line 33 column C by adding “at least 144 sorties logged as a flight surgeon, or”
3) Modify line 34 column C by adding “at least 72 sorties logged as a flight surgeon, or”.

 Looking into the future, as flight medicine adapts and we strive to maintain the prestige and integrity of the awards, we should be asking such questions as:

  • Is review of the HUD tape an acceptable surrogate for flying where there are no 2 seat aircraft in the unit?
  • What should count as flight surgeon experience supporting Remotely Piloted Aircraft?
  • Should an overseas flight medicine deployment be a requirement for Senior or Chief rating?
  • Should flight safety briefings, shop visits, aeromedical waivers, flight physicals be incorporated into the definition of operational flight surgeon?

 In short, the honor of Senior or Chief Flight Surgeon should not be defined simply by the number of months collecting flight pay, but rather defined by accomplishing those tasks that demonstrate breadth of experience and expertise in flight medicine—adding number of sorties is a good start.

Col William W. Pond, MD,
CFS, MC, INANG
Indiana State Air Surgeon