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BY ORDER OF THE SECRETARY OF THE AIR FORBEAR FORCE INSTRUCTION 11405 21 APRIL 2011 Flying Operations THE PILOTPHYSICIAN PROGRAMCOMPLIANCE WITH THIS PUBLICATION IS MANDATORY ACCESSIBILITY: Publications
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How to fill out form pilot-physician program

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To fill out the form pilot-physician program, you will need the following information:
1.1
Personal details such as your full name, address, contact information, and social security number.
1.2
Medical qualifications and certifications, including your medical school information, residency programs, and any additional specialties or sub-specialties.
1.3
Work experience, including a detailed list of previous positions held, dates of employment, and duties performed.
1.4
Continuing medical education (CME) credits earned and any ongoing professional development activities.
1.5
References from colleagues or supervisors who can attest to your abilities and qualifications as a physician.
02
It is essential to carefully review the form before filling it out. Ensure that you understand each section and the information required. If you have any doubts or questions, seek clarification from the program administrators or refer to any provided guidelines or instructions.
03
Begin by entering your personal details accurately and legibly. Provide complete addresses, phone numbers, and email addresses to ensure proper communication.
04
Move on to the section on medical qualifications and certifications. Include information about your medical school, including the name, address, and dates attended. Provide details about your residency programs, including the specialty or specialties involved and the dates of training.
05
In the work experience section, list your previous positions in chronological order. Include the name and address of the institution, your job title, dates of employment, and a brief description of your duties and responsibilities.
06
Document your continuing medical education (CME) activities, including any conferences, seminars, or workshops attended. Specify the number of credits earned and provide supporting documentation if required.
07
Finally, provide references from colleagues or supervisors who can vouch for your qualifications as a physician. Include their full names, professional titles, contact information, and a brief description of their relationship to you.

Who needs the form pilot-physician program?

The form pilot-physician program is typically required by physicians who are applying for pilot-related positions within their medical practice or organization. This program helps ensure that physicians possess the necessary skills and knowledge to safely and effectively operate in an aviation-oriented or pilot-related role. It may be necessary for physicians seeking employment in organizations such as airlines, air ambulances, governmental agencies, or research institutions where medical expertise combined with aviation knowledge is crucial. The form pilot-physician program helps assess the competency and suitability of physicians interested in such positions.
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Form pilot-physician program is a form administered by the Federal Aviation Administration (FAA) for pilots to report any medical conditions that may affect their ability to safely operate an aircraft.
Pilots who hold a medical certificate and have been diagnosed with a medical condition that could impact their flying abilities are required to file form pilot-physician program.
Form pilot-physician program can be filled out online through the FAA's MedXPress system. Pilots must provide detailed information about their medical condition and treatment.
The purpose of form pilot-physician program is to ensure that pilots are medically fit to operate an aircraft safely and to provide a mechanism for them to report any medical conditions that may affect their flying abilities.
Pilots must report information about their medical condition, treatment, and any medications they are taking. They must also provide contact information for their treating physicians.
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