5 Things Pilots Should Know Before Entering the HIMS Program
If you have been referred to the FAA’s HIMS program, you probably have more questions than answers right now, and that’s completely normal. HIMS exists to help pilots work through certain medical and psychiatric concerns without losing sight of their career in the cockpit. Before your first appointment, it helps to know what the program actually involves and what happens once evaluation turns into ongoing monitoring. Here are five things worth understanding early.
1. Understand Why You Are Being Referred to HIMS
Common Reasons for HIMS Involvement
Pilots land in the HIMS program for different reasons. For some, it’s a substance use concern that needs to be addressed before certification can move forward. For others, it’s a mental health diagnosis or psychiatric history that calls for a closer look.
And sometimes a pilot ends up in HIMS simply because their case involves circumstances that a standard exam isn’t equipped to evaluate fully. Whatever the trigger, the program serves the same basic purpose: giving pilots a clear, structured path toward continued medical certification.
It’s worth pointing out that a referral to HIMS isn’t a judgment on your character or your ability as a pilot. Plenty of pilots who go through this program have long, successful careers both before and after their evaluation. The referral simply means that something in your medical or psychiatric history needs a closer look before certification can move forward with confidence.
Thinking of it that way tends to make the whole process feel less personal and more procedural.
Understand Your Specific Requirements
No two HIMS files look alike, even when the referral reason sounds similar on paper. A pilot’s history and the specific concerns raised by their examiner all shape how the process unfolds for them individually. Because of that, it’s worth taking time early on to get a real handle on why you were referred and what is specifically being asked of you. Knowing this up front removes a lot of the guesswork later.
Some pilots find it useful to write down what they already know about their referral and what questions still feel unclear. That small step can make the first conversation with your evaluator much more productive, since you’ll spend less time trying to remember details and more time actually working through them.
Your evaluator will also be able to tailor their explanations to your situation once they understand what you already know and where the gaps are.
2. Know What a HIMS Evaluation May Involve
Review Your Medical History
Most HIMS evaluations start by looking backward. Your evaluator will want to understand your psychiatric and general medical background. If substance use is part of your history, expect that to come up too, along with any treatment or recovery work you’ve already gone through. Being open about this history isn’t a formality. It’s what allows the evaluator to see the full picture instead of a partial one.
It can feel uncomfortable to revisit parts of your medical history that you’d rather leave in the past. That discomfort is understandable, but it’s worth remembering that evaluators in this field have worked with many pilots facing similar circumstances.
Nothing you share is likely to be new to them, and the goal of gathering this history isn’t to dwell on the past. It’s to understand how that history connects to where you are today.
Assess Your Current Situation
The evaluation doesn’t stop at history. It also looks at how you’re doing right now. Your current functioning matters here, as does anything relevant to your certification specifically. In some cases, the evaluator may also pull in information from other healthcare professionals already involved in your care. All of this builds toward a picture of where you stand today, not just where you’ve been.
This part of the evaluation tends to feel more like a conversation than an interrogation. Your evaluator wants to know how you’re managing day-to-day, what support you have in place, and whether anything about your current situation raises concerns worth addressing before certification decisions are made. Answering honestly here matters just as much as it does when discussing your history.
Prepare for the Evaluation
A little preparation goes a long way with HIMS. Give accurate and have your documentation gathered before you walk in. It also helps to know going in that this process is thorough by design. That thoroughness isn’t there to slow you down. It exists so the evaluation actually reflects your situation, which works in your favor more often than not.
Arriving prepared also tends to ease some of the nerves that come with a first appointment. Bring a list of your current medications if applicable, along with contact information for any healthcare providers who might need to be part of the conversation.
Pilots who show up organized often find that their appointments move more smoothly and leave less room for follow-up requests down the line.
3. Be Prepared for Documentation and Follow-Up
Why Documentation Matters
Paperwork isn’t the fun part of HIMS, but it matters more than most pilots expect. Your medical records and any supporting documents form the backbone of your case. When these materials are organized and complete, the process tends to move faster and with fewer surprises.
Disorganized records, on the other hand, can slow things down simply because there’s more to sort through.
If you’ve received care from multiple providers over the years, it’s worth reaching out to each of them early to request copies of your records. This can take time, so starting the request process as soon as you know you’re entering HIMS is a smart move.
Keeping a simple folder, physical or digital, with everything organized by date can also save you a fair amount of stress later in the process.
Follow-Up After the Initial Evaluation
Don’t assume one appointment will wrap everything up. Many pilots go through additional evaluations, and ongoing communication with healthcare professionals is a normal part of the process for a lot of cases.
If your evaluator asks for more information after the first meeting, that’s not a red flag. It’s simply how the process is built to work for cases that need a closer look before a decision gets made.
Follow-up requests can range from a short phone call to a full additional evaluation, depending on what your case needs. Responding promptly to these requests tends to keep the overall timeline moving. Pilots who stay in regular contact with their evaluator and respond quickly to requests for information often find that their case progresses more predictably than those who let communication lapse.
4. Understand the Role of Monitoring
What HIMS Monitoring Is Designed to Do
Evaluation and monitoring are not the same thing, even though pilots sometimes lump them together. Evaluation is a snapshot. Monitoring is what comes after, and it’s built to provide ongoing oversight over time. Progress gets tracked, and compliance with whatever requirements apply to your case gets checked along the way. Together, the two pieces work as one continuous process rather than two separate hurdles.
Monitoring exists because a single evaluation, no matter how thorough, can only capture a moment in time. Ongoing oversight gives a more complete picture of how a pilot is doing over weeks and months, which is often more meaningful for certification purposes than a single appointment could ever be on its own.
What Pilots Can Expect
Once you’re in the monitoring phase, expect some kind of follow-up requirement to be part of your routine going forward. Staying consistent with those requirements matters quite a bit here. Monitoring plans vary a good deal from pilot to pilot, and that’s by design. Every case is shaped by different circumstances, so a plan built for one pilot won’t necessarily look like a plan built for another.
Consistency tends to matter more than intensity when it comes to monitoring. Showing up reliably for whatever check-ins or requirements are part of your plan builds a track record that works in your favor. Missing steps or falling behind, on the other hand, can add time to a process that’s already meant to move at a steady pace.
5. Understand the Connection to FAA Medical Certification
The Role of the HIMS Psychiatrist
The HIMS psychiatrist handles the clinical side of your case. Their job is to conduct a focused psychiatric assessment, work through any mental health or substance use concerns that are relevant to your file, and prepare the evaluation information that certification decisions rely on. This is the part of the process where your mental health history gets the attention it needs from someone trained specifically for this kind of review.
Because this role is so specialized, the psychiatrist working on your case will typically have experience specific to aviation medicine, not just general psychiatric practice. That background matters, since it means they understand both the clinical side of your situation and how it connects to the certification standards pilots are held to.
The Role of the HIMS AME
The HIMS AME brings a different lens to the table. Where the psychiatrist focuses on clinical assessment, the AME looks at how your overall health lines up with FAA certification standards and flight safety considerations.
An FAA HIMS AME is trained specifically to work within this program, so they know how to translate clinical findings into terms the FAA can act on. When the psychiatric and aeromedical sides of your case work together, you end up with an evaluation that covers more ground than either one could on its own.
This partnership between a psychiatrist and an AME is really what sets HIMS apart from a standard medical exam. Rather than looking at your case through a single lens, you get two professionals with different areas of expertise contributing to the same file. That combination tends to produce a more complete and accurate picture of where you stand.
Keep Your Aviation Career in Perspective
Try not to lose sight of the bigger picture here. HIMS is one piece of the broader FAA medical certification process, not a separate track that pulls you away from your career. Pilots move through this program while working toward the same certification goals they had before the referral. The structure HIMS provides is there to support that goal, not compete with it.
Many pilots who enter HIMS describe the process as more manageable than they initially expected once they understand how the pieces fit together. Knowing what each step is for, and why it exists, makes the whole experience feel a lot less like an obstacle and more like a defined path forward.
Conclusion
Going through HIMS can feel like a lot at first, but most of that feeling comes from not knowing what to expect. Once you understand why you were referred, what the evaluation involves, and how monitoring and follow-up fit into the bigger picture, the process starts to feel a lot more manageable.
Reach out to our team if you have questions about what your next steps should look like.
Questions Pilots May Have About HIMS
Is every HIMS case the same?
No. Your history, your current health, and the specific reason behind your referral all shape how your case is handled. Two pilots with similar-sounding referrals can still end up on fairly different paths, so it’s best not to assume your process will mirror someone else’s experience exactly.
Will I need more than one appointment?
Often, yes. Follow-up evaluations and monitoring check-ins are common parts of the process. How many appointments you’ll need depends on your specific circumstances, so it’s hard to predict without knowing the details of your case.
What should I bring to a HIMS appointment?
Bring whatever medical records and treatment documentation you have, along with a clear summary of your current health situation. It also helps to bring a list of current medications and contact information for any providers involved in your care.
How long does the HIMS process take?
This varies quite a bit from pilot to pilot. Some cases move relatively quickly, while others take longer depending on the evaluation results and any follow-up requirements that come up along the way.
Can I continue flying while going through HIMS?
That depends entirely on your current certification status and the specifics of your case. This is something to clarify directly with your evaluating professionals, since it isn’t the same answer for every pilot and can shift depending on where you are in the process.