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USAF vs USN/USMC Medicine for Pilot Accessions - Is the Air Force Generally Stricter? (cross-posted)

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Hello ladies and gentlemen,

I am a prior-enlisted Marine who is trying to become a military officer and aviator, and I am hoping some of the members here with Air Force, Air National Guard, Reserve,and/or cross-service experience might be willing to share their perspectives.

I spent well over a year pursuing a Marine Corps officer/aviation path, but encountered significant medical issues during the accession process. Ultimately, I had to work through a lengthy medical-records correction process with U.S. Navy Bureau of Medicine and Surgery (they are responsible for both USN and USMC and maybe even USCG). I am told that the process has finally been resolved, but it cost a great deal of time and effort. I still expect medical hurdles, but at least now malpractice and/or erroneous records are purportedly eliminated successfully.

I have not yet submitted an officer package to any branch because I never made it past the medical hurdles.

If I could choose my ideal path, I think it would probably be an Air National Guard or Air Force Reserve fixed-wing pilot DSG/TR UPT slot. I realize that it is an extremely competitive route and that many applicants never receive such an opportunity. I am grateful for the chance to serve in any capacity and understand that I may ultimately need to pursue a different path.

I also realize many successful DSG/TR UPT applicants possess prior military aviation experience, and/or FAA civilian pilot ratings, or some combination thereof. In my case, I may eventually need to spend significant money pursuing FAA medical certificate before I can even begin PPL training on my own dime.

On the testing side, I took the ASTB without any formal preparation and scored an 8/8/8 with a 59 OAR, which I understand is competitive for USN/USMC/USCG aviation programs, notwithstanding all other non-testing requirements.

If I decide to pursue Air Force aviation, I understand that I will need to take the AFOQT and TBAS. I have googled how that works, and I still feel like I have no idea how to attack scheduling and studying, but I will research further (I didn't study for the ASVAB and I didn't study for the ASTB, but maybe I should study for the AFOQT/TBAS!).

Also, I know the Air Force may not let me fly because I didn't go to a really awesome school and get a STEM degree. I know the Marine Corps will let anyone fly if they can run 3 miles fast enough (half-joking). The Air Force wants you to have a bigger brain, and the pedigree to match!

Likewise, I understand that USAF medical accession is only one hurdle. If I successfully navigate MEPS and/or DODMERB, I would still need to satisfy the Air Force's aviation medical requirements through ACS? My understanding is that the Navy and Marine Corps use NAMI, while the Army uses DAM, but USAF uses ACS.

My primary question is this:

Do you all suspect that, based on the rumors of what you've heard, Air Force medical in general is stricter than other branches' accession standards, and/or Air Force ACS is stricter than the other branches' aviation medicine (NAMI and/or DAM)?

I understand that every case is unique and that waiver decisions depend on the specific medical issue involved. I am not asking anyone to predict my chances. Rather, I am trying to determine whether it is worthwhile to invest significant time in pursuing Air Force pilot opportunities before beginning that process. (I am mid/late 20s and don't have unlimited time or money).

Even if I can potentially eek into flying as an airman, finding a AirGuard and/or AirFR unit to sponsor you for DSG/TR UPT slot could be an even more difficult feat than an active duty USAF aviator.

My ultimate hope is that someone who was experienced in multiple branches might give me their thoughts and advice (I know that is a Hail Mary). I appreciate anyone's thoughts!

I also have juvenile misconduct. As a sixteen and fifteen-year-old, I was drinking and smoking marijuana. The Marine Corps had to get the Marine Corps recruiting command to waive that when I enlisted back in the day. Obviously, even though it is now more-ancient of a concern, it still matters, and requires a waiver again!

I would also like to thank some of the aviators and military leaders who inspired my interest in military service and aviation over the years, including my Buck Sergeant grandfather, and also Joe Foss, Jimmy Stewart, and a certain Air Force colonel/general who spent a suspicious amount of time around a Stargate.

Thank you all for your time, your service, and any advice you may be willing to share.

Semper Fidelis, and Aim High.

I can’t answer your “who’s more strict” question, but it sounds like you’re 26+, don’t have flight experience, have a medical issue that you may even have to fight to get a class 3 FAA medical, haven’t even remotely started the process (no AFOQT, etc.) All of that honestly adds up to highly unlikely to get a slot in the ANG. If my understanding of your situation is correct, I would not put in the money and time to go after that route. AD off the street (e.g. OTS route) is also very competitive, and I think you’re probably way too far behind the timeline on that path as well.

I wish I didn’t have such a tough answer for you, but I think you need the truth before you sink a ton of money and effort into something that is very unlikely to happen. If you were 22, then you’d have time. Consider civ flying options (assuming medical stuff works out) - there is a lot of cool flying out there, the mil does not have the market cornered on that.

No idea on the "who's more strict" question. Poking around yielded this Reddit thread, which had some discussion. I'm sure there is more info out there.

It's been a long time for me, and maybe things have changed, but the AF used to use a pretty wonky test for depth perception, that threw a lot of people off. There were various "techniques" for passing it (moving your eyes back and forth while taking it, it's never the first or last dot, etc). Lots of stuff out there.

Like @brabus said, your age would be working against you for a ANG slot (albeit not impossible). There are study guides out there for the AFOQT that can help a lot. If you really wanted to fast-track a pilot's license, there are training programs that will allow you to do that too.

Regarding "I may eventually need to spend significant money pursuing FAA medical certificate before I can even begin PPL training on my own dime," what makes you think that? To get a PPL, you only need an FAA Class III physical (as far as I know, it's been awhile). An FAA Class III is not a high bar, as I recall, it was just a basic eye exam and physical. As long as you could see decent-ish, and were basically healthy, you were good to go. Certainly, if there is something that is going to be a showstopper for an FAA Class III, it's going to be a showstopper for an Air Force Initial Flying Class I.

  • Author
On 6/14/2026 at 11:15 AM, brabus said:

I can’t answer your “who’s more strict” question, but it sounds like you’re 26+, don’t have flight experience, have a medical issue that you may even have to fight to get a class 3 FAA medical, haven’t even remotely started the process (no AFOQT, etc.) All of that honestly adds up to highly unlikely to get a slot in the ANG. If my understanding of your situation is correct, I would not put in the money and time to go after that route. AD off the street (e.g. OTS route) is also very competitive, and I think you’re probably way too far behind the timeline on that path as well.

I wish I didn’t have such a tough answer for you, but I think you need the truth before you sink a ton of money and effort into something that is very unlikely to happen. If you were 22, then you’d have time. Consider civ flying options (assuming medical stuff works out) - there is a lot of cool flying out there, the mil does not have the market cornered on that.

I thought I got zero responses on my posts because I got no emails or notifications; I thought all I got was a laughing reaction. So happy I investigated further. Thanks for the comment!

I'm a little younger than you're thinking but only by a smidgen.

All your intuitions are right on the ball or just a hair off.

I thought AirNG/USAFR is ~42 age limit? Even with prior service and a PPL, you think I'd have zero chance?

I agree, even if I ever get granted a class 3 or class 2 or class 1, it could take year(s)!!! Might be a pipe dream! Won't stop me from at least trying, though!

Correct, I haven't taken the AFOQT but I kicked ass at the USMC/USN/USCG test/their-equivalent-of-the-TBAS. I got a 95 ASVAB when I was 18. So maybe I have a shot... not sure.

Thanks so much for your candor and not sugarcoating. very generous of you to comment. I may be biased and unrealistic with my advocating right now, but I will admit, it might be a bleak

Edited by Lord Farquaad

  • Author
On 6/14/2026 at 3:45 PM, Blue said:

No idea on the "who's more strict" question. Poking around yielded this Reddit thread, which had some discussion. I'm sure there is more info out there.

It's been a long time for me, and maybe things have changed, but the AF used to use a pretty wonky test for depth perception, that threw a lot of people off. There were various "techniques" for passing it (moving your eyes back and forth while taking it, it's never the first or last dot, etc). Lots of stuff out there.

Like @brabus said, your age would be working against you for a ANG slot (albeit not impossible). There are study guides out there for the AFOQT that can help a lot. If you really wanted to fast-track a pilot's license, there are training programs that will allow you to do that too.

Regarding "I may eventually need to spend significant money pursuing FAA medical certificate before I can even begin PPL training on my own dime," what makes you think that? To get a PPL, you only need an FAA Class III physical (as far as I know, it's been awhile). An FAA Class III is not a high bar, as I recall, it was just a basic eye exam and physical. As long as you could see decent-ish, and were basically healthy, you were good to go. Certainly, if there is something that is going to be a showstopper for an FAA Class III, it's going to be a showstopper for an Air Force Initial Flying Class I.

that thread is helpful. No idea what my depth perception is.

Remember when I said juveniel alcohol and marijuana use? The FAA requires months or year(s) of alcohol and drug testing to the tune of tens of thousands of dollars for FAA class III or II or I, purportedly, allegedly.

I was told to expect to spend at mininum $20,000 up to a ceiling of $100,000, and I could be denied. Google 'HIMS Program FAA AME' or something to that effect

If I was a military pilot, I would have to get still do that if I wanted to convert to FAA ratings - I assume that entails asking your squadron commander if you can miss work to go to AA, pee in a cup, and get breathalyzers a couple times per month from a civilian facility.

I thought the age ceiling for USAFR/AirNG was like ~40 or something absurd. I am in my mid 20s so maybe it is already too late! I was 22 when I started trying to do this, and I'm prior enlisted. I did not drag ass or take my time or procrastinate. I have been fighting BUMED (US Navy Bureau of Medicine and Surgery - they handle all of USN and USMC) to fix medical records, for over a year. Allegedly they finished last week but I haven't see the document yet

Thank you for the information and your honest opinion! yup, might be a pipe dream but I'm not giving up anytime soon, but I'm happy to transparently get the information that it might be a pipe dream. I'm under zero illusions that I'm 'special'. Well, maybe special in how stubborn and/or how much of a pain in the ass and/or how ridiculous I am, but doubtful that I'm special in any other ways

Edited by Lord Farquaad

2 hours ago, Lord Farquaad said:

I thought the age ceiling for USAFR/AirNG was like ~40 or something absurd.

  • Author
3 hours ago, wikz said:

Thank you so much. I'm pretty darn far within/underneath age 33, and ever further away from age 35; So I'm a little confused what @Blue and @brabus meant. I'm gonna give it a closer re-read. Really appreciate the help! Certainly, unless I either 1: get an FAA third class and/or 2: become an active duty USAF, USMC, USN, and/or USCG aviator first, they will probably never take me LOL. I never considered it until now and it would certainly be a last resort, but maybe they would take sport pilot? I kind of doubt it, and I'm sure someone here has asked before. I'll look around. Edit: https://www.flyingsquadron.com/forums/topic/23227-does-have-a-sports-pilot-license-help-or-is-it-ppl-or-nothing/

Edited by Lord Farquaad

Alots getting waived on the USAF side, atleast from what I've been told. My unit just sent a guy to UPT with partial color blindness and I met another guy going through IFF at 38.

I say start working towards that goal now and in 3-5 years you could be in a prime spot to get picked up. If you can keep your record clean (both medically and judicially) with nothing new, start building hours and show leadership potential it could pan out. Nobody knows how the landscape will look by then but you can still stack the odds in your favor.

  • Author
2 hours ago, sketch2 said:

Alots getting waived on the USAF side, atleast from what I've been told. My unit just sent a guy to UPT with partial color blindness and I met another guy going through IFF at 38.

I say start working towards that goal now and in 3-5 years you could be in a prime spot to get picked up. If you can keep your record clean (both medically and judicially) with nothing new, start building hours and show leadership potential it could pan out. Nobody knows how the landscape will look by then but you can still stack the odds in your favor.

Just to confirm with 100% certainty (this being the Aviation Medicine forum rather than the USAFR/AirNG forum), are you referring to a USAFR or Air National Guard unit?

I ask because, as a layperson, I would not necessarily assume that a waiver-friendly environment on the active-duty USAF side automatically means waivers are being approved as readily on the Guard/Reserve side.

I also assume you must be Guard or Reserve, because on the active-duty side the terminology would likely be different. On active duty, an enlisted airman who gets selected for UPT is generally taken by the Air Force and sent off to training, whereas in the Guard/Reserve world people often describe it as the unit "sending" someone to UPT.

To further educate me, if you feel so inclined: when a Guard/Reserve unit hires someone for a UPT slot, are they typically hired as a DSG/TR first? Is it possible for someone to have an AGR position lined up from the beginning, or does that generally never happen?

FYI, I have considered whether enlisting in the Air Guard or Air Force Reserve might make me a more competitive future UPT applicant (and because I might simply want to Aim High in general, like Clark Gable). However, I sometimes wonder whether enlisting at this stage of life could create complications. Once someone signs an enlistment contract, I imagine there is at least some possibility that obtaining a DD-368 later could become more difficult.

Furthermore, a unit may not necessarily want one of its enlisted members to leave for a commission, may not be hiring pilots at that time, or may already have a large pool of highly competitive applicants, including former active-duty military aviators. If a unit has a strong enlisted airman filling an important or difficult-to-fill billet, I do not know whether leadership generally views releasing that person to pursue a pilot slot elsewhere favorably.

I would especially be curious whether units are generally willing to approve a DD-368 for an enlisted member to pursue a pilot slot with another squadron or even another state's Guard unit. Perhaps they are; perhaps they are not. I genuinely do not know and plan to do more research.

In any event, learning an enlisted aircrew-related job beforehand would not seem like a bad thing, other than that one primary concern.

Thanks so much!

Edited by Lord Farquaad

@Lord Farquaad I re-read the medical part - confirm the only medical thing you’re worried about is alcohol and pot use as a minor (and you haven’t done illegal stuff like that in many years)? If that’s correct, then I think you’re actually fine to get a FAA medical and likely will not even require a special issuance.

With the medical “problem” not actually a problem, the next part is timeline…

You have to knock out the AFOQT and do very well (how is your college GPA?) It behooves you to get a PPL, or at least start knocking out flight hours. You have to get your application package together for each squadron you want to apply for. If you’re hustling hard on these things, it’ll take you a year or so. Most people spend another couple years rushing units before getting hired. Then, you have approximately 2 years for the process to work before you start UPT.

So, without a big medical issue, I think you can make it before age waiver territory. It will be easier by a good margin to get hired by a heavy unit.

On 6/18/2026 at 6:27 PM, Lord Farquaad said:

Just to confirm with 100% certainty (this being the Aviation Medicine forum rather than the USAFR/AirNG forum), are you referring to a USAFR or Air National Guard unit?

I ask because, as a layperson, I would not necessarily assume that a waiver-friendly environment on the active-duty USAF side automatically means waivers are being approved as readily on the Guard/Reserve side.

This would be on the AD side, its the same waiver authority for everyone (AF Surgeon Gen), the key difference being whether or not a Guard/Res unit would be willing to push a package up for you. Like I said before the more chips you can stack in your favor, the higher the chance a unit would be willing to put in for a waiver or an ETP if you needed it. I have a friend in the USMC who got an ETP because she was shit hot and beyond persistent and had backings of some very high level people including a 3-star and a Senator.

  • Author
21 hours ago, brabus said:

You have to knock out the AFOQT and do very well (how is your college GPA?)

The school that gave me my bachelor's degree is not a particularly prestigious institution, and my major was non-STEM. The institution is fully accredited. However, I graduated summa cum laude with a 3.92 GPA. My community-college GPA years earlier was only 2.7, so I'm not sure how pilot/commissioning boards evaluate that. I got a D in one class at the community college and have wondered whether retaking it would materially change how my academic record is viewed. Does the USAF primarily look at the bachelor's GPA, or do they calculate some sort of cumulative GPA across all institutions? Regardless, my final transcript showing the 3.92 also reflects the earlier community-college coursework (and my degree accepted some non-accredited credits as well from the USMC and study.com).

21 hours ago, brabus said:

@Lord Farquaad I re-read the medical part - confirm the only medical thing you’re worried about is alcohol and pot use as a minor (and you haven’t done illegal stuff like that in many years)?

As far as legal history goes, I have no adult criminal history. I have had a few minor civil traffic matters, including a recent citation related to vehicle registration/equipment issues and an older junior enlisted seatbelt citation that was ultimately dismissed. No adult substance-abuse issues of any kind. The alcohol and marijuana use was limited to my teenage years before age 18.

No, I do have other medical issues. I've discussed the full story in other forums, but it's lengthy. Remember when I mentioned malpractice earlier? That's part of it; there are lots of lawyers involved. I'd tell you the whole story if you want. It's all potentially waiverable but it's a headache (and there is the issue of a stranger's record being mixed in with mine when they pull it up on Genesis, and we had to get BUMED (US Navy Bureau of Medicine and Surgery and a Marine Corps General to do a report to prove I wasn't fraudulently hiding my medical history - part of it was someone ELSE's medical history!). My understanding is that it's probably that none of the issues are necessarily permanent disqualifiers, but they would likely require significant review and potentially waivers.

21 hours ago, brabus said:

I think you’re actually fine to get a FAA medical and likely will not even require a special issuance.

I've spoken with a couple FAA Aviation Medical Examiner offices, and they have generally told me that the FAA side may be what sounds even considerably more complicated than the military side. I've also spoken with an aviation attorney, who felt there could be substantial challenges to obtaining a first-time-initial FAA medical certificate, and it could cost me tens of thousands of dollars to get an initial medical certificate, or it may not even be possible, but he can't guess until I pay him thousands of dollars more to read all the documents. Two of the medical examiner offices I've talked to seem pretty clownish; I posted some of their redacted words, and I talked to some pro bono people, who said the one Aviation Medical Examiner was dead wrong, so I am steering clear of anyone who is confirmed to have told me anything untrue. One thing literally everyone agrees on, because supposedly in the last few years, the Federal Air Surgeon has tightened FAA rules, is that I would presumably have to do months of alcohol and drug testing, and Alcoholics Anonymous, because I drank some alcohol and smoked some weed when I was 15 and 16. And of course I have to pay for all that

The biggest immediate issue in my unique situation may actually be FAA medical certification rather than military standards. At the same time, even if everything is technically waiverable for USAF and/or military purposes, I don't know whether a squadron would want to take on a complicated applicant when there are plenty of applicants who require little or no waiver work.

I'm trying to spend extensive time trying to find appropriate competent FAA aviation medical examiners because even if I can't fly in the military, I want to put myself on the trajectory to do so, and critically, the medical certificate is step one

Edited by Lord Farquaad

I would not waste my time with that lawyer or either of the AMEs you talked to. HIMS is for when the FAA determines you have an abuse problem, which would be hard to argue when it’s been 10+ years since those incidents. In the end, just set up an appointment with an AME for a 3rd class and see what happens. You’ll create a MedExpress account and fill out the pre-appointment questions. Read them slowly and carefully before you answer. The question that probably pertains most to this subject is 18v. Read this website before answering that question: https://pilot-protection-services.aopa.org/news/2022/april/01/the-notorious-18v

If you have to answer yes to 18v, and that causes consternation with the AME and he says you need HIMS, etc., then the worst financial case is you’re out $150 or so. Don’t get sucked into paying thousands to lawyers.

  • Author
33 minutes ago, brabus said:

The question that probably pertains most to this subject is 18v. Read this website before answering that question: https://pilot-protection-services.aopa.org/news/2022/april/01/the-notorious-18v

Thank you so much for this link. I am reading it right now.

I have been meaning to give AOPA a call, and maybe I can try to do that on a business day this week.

But regardless, I am 99% sure I will have to answer yes to 18v, if nothing else, due to the fact that my driver's license was suspended for 30 days for a driving offense committed when I was 14 years old, even though it involved zero alcohol nor drugs (part 3 of 18v says "even if it involves no alcohol or drugs")

35 minutes ago, brabus said:

would be hard to argue when it’s been 10+ years since those incidents

Not really any more than ten years, but yes, about ten.

HIMS is for when the FAA determines you have an abuse problem

Don't feel obligated to read this, it is absolutely ridiculous and never-ending, but all these people said I probably need to do HIMS, including a super controversial, but seemingly-beloved-by-many HIMS AME named Dr. Bruce Chien (who is a former Navy flight surgeon, I believe):

https://www.pilotsofamerica.com/community/threads/should-i-consider-a-consult-with-and-or-fully-undertake-the-hims-process.154058/

I'm not sure if Doctor Chien is a Seventh-day Adventist and/or Jehovah's Witness or what, and frankly it's none of my business, but I heard he is one of those affiliations. I would not think any less of him regardless of his affiliation, or piety, or lack thereof. What I have heard with more certainty is that he is an alcoholic in a long-term state of successful recovery, and a teetotaler in general, and he doesn't believe anyone should drink ever for any circumstances, purportedly. I also see him say over and over again on multiple forums, "the FAA will charge you with a Class 4 Felony if you do X or Y", but Google says Federal Felony Classification classes are lettered, not numbered (I.e., supposedly Classes A, B, C, D, etc., not Numbers like 'Class 4'). Also, I've heard a lot of people report Dr. Chien has an abrasive personality, and if you offend him even by accident, he will drop you as a client mid-submittal. Also, if you navigate to his website, he enumateres all the different misteps or faux pas's a client can make which will irritate him and you should be sure to avoid doing (some of them are totally reasonable, like "if you ever lie to me or conceal anything from me I will drop you as a client"). I am nervous, although it was very kind of him to comment on my thread. I was also told that Dr. Chien actually wrote the HIMS policies for the FAA. Although I've also heard the HIMS study is a privately owned or at least privately operated for-profit entity. I cannot remember if I already mentioned it, but I spoke with some people at an organization that fights and petitions the FAA, and they were telling me/alleging some pretty sketchy things about HIMS. I won't claim to have an opinion worth any salt; I barely know anything. All I know is if I do spend thousands of dollars on HIMS, I do not have the money to fail to get it correct the first try/go-around.

37 minutes ago, brabus said:

I would not waste my time with that lawyer or either of the AMEs you talked to. Don’t get sucked into paying thousands to lawyers.

I definitely am unlikely to ever interact with any of those same AMEs, nor anyone else in their offices again. If a medical professional or other super-educated-professional tells you basic facts, and they turn out to be incorrect, even if they have nothing to do you with the particular situation, run-for-the-hills is my opinion on the matter.

In regards to the attorney, I am less sure whether him/they are good or bad, but @brabus, you and I both share the same suspicion. The firm is Ison, and some people seem to allegedly say good things about the firm online. The attorney was admittedly generous with his time; Albeit I paid him some money, he went over the allotted time without charging me further. The attorney claimed that he has seen or had people or clients who haven't drank a drop of alcohol in years for any reason, neither abuse nor responsible occasional drinking, but still, the FAA makes the applicant do AA and treats them totally like an alcoholic who is fully abusing. I asked the attorney if I was gonna have to admit in writing that I am an alcoholic, because I am adamant I am not and never have been an alcoholic, and the attorney said "maybe." The lawyer advised I just don't even bother ever trying to fly, but he explained what I should do if I want to attempt to get a medical certificate and which medical people he recommends. The lawyer recommended I first go see a doctor who is purportedly some type of FAA medical expe.rt, but NOT an AME, if I understand correctly. Maybe this expert is some type of HIMS expert; I'm not sure. And only once that is complete and if they write good things then maybe supposedly I go to a HIMS AME. Well, actually, there might be an expert or two more before I finally get to the first AME, who happens to be a HIMS AME. He described a complicated process, and I did write down the names. Maybe that lawyer sucks, or maybe he's 100% right; I have no idea. I will try to be cautious regardless.

37 minutes ago, brabus said:

If you have to answer yes to 18v, and that causes consternation with the AME and he says you need HIMS, etc., then the worst financial case is you’re out $150 or so.

I was under the impression that 1: I should NOT immediately first fill out a MedXPress; But I should instead first do a paid initial consultation with AME(s) before I do anything (I have never yet met an AME in-person, nor had a phone call, nor paid any AME(s)). I spoke to one AME office that told me that is not allowed but everybody else says that the office was wrong and full of baloney and that with my crazy set of drama, I should pursue a paid consultation without a MedXPress, to do a game plan. Unsure if the conventional wisdom is to do this with a normal AME, senior AME, and/or HIMS AME

  1. I was under the impression that not approaching it via HIMS from the get-go could result in a denial and/or deferral that would make it more expensive in the long run. I was told that a denial can be very expensive to appeal and make your life more difficult. Regardless, I was told that not approaching it correctly, sometimes they say "okay you filled out your MedXPress, you have sixty more days to submit all these documents, and if you don't have your application complete and ready and fully submitted by day sixty, you automatically get a denial".

Thank you so much

Edited by Lord Farquaad

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