When it comes to FAA medical certification, timing and preparation can make the difference between a smooth certification and months of frustrating delays.

This is the story of “Arthur” (name changed for privacy), a pilot who was diagnosed with melanoma in situ and needed to navigate the FAA medical certification process while protecting his career trajectory.

The Hidden Complexity of Melanoma and FAA Certification

Most pilots hear “melanoma” and assume it’s straightforward. Especially if their treating physician has cleared them of the disease.

But the FAA doesn’t just look at what the diagnosis is—it evaluates what the diagnosis could become.

Melanoma has the potential to metastasize, including to the brain. That’s where things get serious from an aeromedical standpoint. Brain metastases can lead to neurological complications, including seizures—an obvious safety risk in aviation and a major concern for certification.

The Federal Aviation Administration (FAA) exercises stringent oversight regarding a history of melanoma, analyzing several key factors to ensure pilot safety and fitness for duty. Because of this, the FAA pays close attention to:

• Depth of invasion (Breslow depth): This measurement is critical as it indicates the melanoma’s potential for spread.
• Pathology details: A comprehensive review of the pathology report is conducted to understand the specific characteristics and aggressiveness of the tumor.
• Evidence of spread or recurrence: The FAA requires documentation proving there is no evidence of metastatic disease or any local recurrence of the cancer.
• Treatment and follow-up: The specifics of the surgical treatment, any adjuvant therapies (if applicable), and the established long-term dermatological and oncological follow-up plan are thoroughly reviewed.

Even seemingly minor skin cancers can trigger deferrals if the documentation doesn’t clearly establish low risk.

Where Most Pilots Go Wrong

Arthur did what many pilots do—he got treated appropriately and planned to go in for his FAA medical exam. The problem? He didn’t yet have his records fully organized.

This is one of the most common mistakes we see. Pilots show up to their Aviation Medical Examiner (AME) without the right documentation, assuming things will “work themselves out.”

Without adequate records, an AME often has no choice but to defer the exam to the FAA. And as we’ve discussed in our article on FAA medical certification delays, once a case is deferred without proper documentation, the FAA will issue a request for additional information.

That process alone can add at least 3 months—possibly longer.

Delay the Exam, Expedite the Favorable Outcome

Instead of rushing into the exam, we advised Arthur to do something that seems counterintuitive to many pilots: WAIT!

Not indefinitely—but just long enough to gather the right documentation. This strategic pause provides enough time to ensure all paperwork was complete and organized, thereby creating a clear, comprehensive presentation for the FAA.

Providing pathology reports, operative notes from the excision, follow-up dermatology documentation, and current clinical status notes which his medical certificate application meant the FAA did not have to request it. Instead, his AME had all the information needed to make a decision about his certification. 

This aligns with what we emphasize in multiple Wingman Med resources—whether it’s obtaining the right documentation (doctor’s notes for the FAA) or ensuring you have current, detailed clinical progress notes—preparation upfront prevents delays later.

Why the Details Matter

With the complete records in hand, the FAA was able to determine that Arthur had non-invasive melanoma in situ (Stage 0) with very low metastatic risk. 

Because of the extremely low risk of metastasis, Arthur qualified for issuance at the time of his exam—no deferral required.

But here’s the key point: without documentation clearly proving that, the outcome could have been completely different.

Preparing the Pilot—and the AME

We didn’t just gather records—we made sure Arthur was prepared to present them effectively. We also provided supporting FAA guidance so his AME could confidently issue the certificate.

That matters more than most pilots realize. As highlighted in external discussions like The Three Types of AMEs, not all AMEs approach cases the same way. Some are more conservative, especially when documentation is unclear.

When you walk in prepared, you make it easier for the AME to say “yes.”

The Cost of Waiting (or Not Acting Early)

Timing was another major advantage in Arthur’s case. Addressing the issue immediately after his diagnosis meant his records were current and accessible and his treating physicians were readily available to provide clarifying documentation if required. Trying to reconstruct the record years later is much harder.

Compare that to cases where pilots wait. As we’ve outlined in our article on missing old medical records, missing records or difficulty obtaining updated documentation are some of the most common reasons pilots experience delays in certification.

The Outcome

Because Arthur took the right approach, he avoided an unnecessary FAA deferral and received his medical certificate at the exam. This meant he was able to move forward with job applications requiring a First Class Medical months earlier than he otherwise would have.

When navigating the FAA medical certification process, particularly after a new diagnosis such as melanoma, the key principle is that the goal isn’t just to get healthy—it’s to make sure your recovery is well documented. The most effective strategy for dealing with a medical issue is to address it early, thoroughly, and with the right guidance. This level of preparation is essential not only for reducing stress but also for preventing months of lost time and critical career opportunity.