Aeromedical Safety Coalition
ASC News
May 2026 – Modernizing Aeromedical Safety Through Data and Cross-Sector Collaboration
Commercial airline pilots face real-world challenges when attempting to address their mental health concerns, as documented by a December 2025 Reuters article. A 2022 study by WR Hoffman et al. found that more than half of the 3,765 pilots surveyed reported healthcare avoidance behavior out of fear that they could lose their medical certificate, which would effectively ground them.
The current Federal Aviation Administration (FAA) medical certification framework relies on a physician’s exam alongside broader considerations of operational safety. The 6% of pilots who don’t initially pass the exam must complete additional requirements to obtain a special issuance before they can fly, often resulting in process delays and financial burden. Data linking medical conditions to pilot performance to aviation safety is lacking, making it difficult to fully assess the cost/benefit of this framework.
“Through dozens of interviews, we heard that airlines and pilot unions would like to better align aeromedical oversight with current safety management and medical practices,” explains Ted Sienknecht, a MITRE expert in data-driven solutions helping the FAA to modernize its aeromedical oversight.
Advances in healthcare, connected technologies, and safety management have created an opportunity to augment this framework by making it more data-informed, continuous, and aligned with modern medical and safety management system practices. An augmented framework could improve understanding of how health-related factors influence human performance and thus safe aviation operations. These advances could, in turn, improve the precision, timeliness, and effectiveness of safety risk identification and mitigation.
Joining Forces to Advance Aeromedical Safety
In 2024, the FAA began participating, along with other stakeholders, in a collaborative research effort to incorporate data and indicators of pilot performance into the medical certification system, with the goal of connecting health, human performance, and aviation safety. As a first step, dozens of partners representing a range of perspectives were asked to identify common challenges and opportunities: Where can the system better support pilots and the flying public? How can we promote pilot health while maintaining an equivalent level of safety?
This collaboration laid the foundation for the Aeromedical Safety Coalition (ASC), a cross-sector effort focused on improving aviation safety by elevating physical and mental health as drivers of safety risk mitigation.
Since its launch, the ASC has elected airline, union, and government tri-chairs: William McDonald (Airlines for America), Captain Travis Ludwig (Air Line Pilots Association), and Dr. Anthony Tvaryanas (FAA). It has also established a charter, approved a 10-year roadmap, and published results from an exploratory study of pilot peer support programs (PSPs) at seven major U.S. airlines.
“Through the ASC, leaders from airlines, unions, and the FAA are collaborating to design and conduct groundbreaking studies that clarify the contribution of health to aviation safety,” notes McDonald, Managing Director of Flight Operations at Airlines for America.
The non-profit MITRE Corporation serves as an independent convener of the coalition, contributing aviation safety, health, and analytics expertise. “We’re accelerating ASC members’ ability to work in mutually beneficial ways to elevate health and human performance as a safety risk topic,” says MITRE’s Sienknecht.
Characterizing Major U.S. Pilot Peer Support Programs to Enhance Safety Risk Management
Last fall, the ASC embarked on its first major research study focused on pilot PSPs. These programs, which are hosted by pilot unions, provide confidential support to pilots experiencing stressors, mental health concerns, or adverse life events. PSP volunteers, who are pilots themselves, receive initial and recurrent training.
Pilot PSPs are widely perceived as a valuable resource, and their confidential design helps build trust and promote acceptance. Confidentiality has historically limited PSP data collection, however, making it difficult to understand how they operate and contribute to health and safety outcomes. To address this gap in understanding, ASC members co-designed a privacy-protected exploratory study about PSPs.
“Every year, peer support program volunteers help thousands of pilots proactively manage their life stressors and fly safer.” says Ludwig, the Air Line Pilots Association’s Pilot Assistance Chair.“By studying PSPs in context of aviation safety management systems, the ASC is promoting preventative safety and pilot health while maintaining the confidentiality that is so important to the PSPs.”
Study participants contributed insights about seven major PSPs for pilots at U.S. mainline passenger airlines, representing about 73,000 pilots and 84% of the U.S. aviation industry based on passenger revenue miles. Ten experts characterized PSPs in interviews and used a structured process to estimate PSP usage and perceived impacts on pilot health and safety.
The ASC Study team implemented the ASC-approved study design, analyzed the data, and identified findings. Based on these findings, they formulated insights related to peer supporter qualifications and training, call handling procedures, pilot outreach approaches, program innovations, and integration points with broader airline safety processes.
These insights enabled the ASC to draft several recommendations to strengthen PSP implementation, such as:
- Increasing awareness of PSP services
- Providing a PSP presence at mandatory pilot training events
- Proactively contacting struggling pilots, when appropriate
The findings further highlighted the opportunity for aviation leaders to integrate PSPs into safety management systems and collect privacy-protected data to support their continuous improvement. In other words, consider PSPs as structured safety-related programs with the kinds of monitoring, evaluation, and ongoing refinement found in other operational safety risk controls.
Read more about the study here.
What’s Next for ASC
Based on its roadmap, future ASC research and activities is expected to explore how anonymized, aggregated indicators of health and human performance may inform system-level aviation safety analysis and research.
“MITRE has provided ASC members with a safe space to explore solutions at the intersection of health, human performance, and aviation safety,” says McDonald. “The ASC offers a unique forum for cross-sector collaboration on these issues, bringing together stakeholders who share a commitment to improving aviation safety.”
Notes: The ASC operates as a voluntary collaborative. Members’ affiliations are for identification only and do not imply organizational endorsement. All content and views are solely those of the authors. The ASC does not establish future regulations, policies, or requirements. Because PSPs are confidential by design, the PSP study relied in part on structured expert elicitation to estimate program metrics. These estimates reflect participant-informed judgments under uncertainty and should be interpreted cautiously.