AETC’s Aerospace Medicine: Last hope for every recruit’s medical waiver Published Aug. 25, 2017 By Marilyn C. Holliday Air Education and Training Command Public Affairs JOINT BASE SAN ANTONIO-RANDOLPH, Texas -- Air Education and Training Command Surgeon General’s Aerospace Medicine Division reviewed more than 45,000 case files for medical waivers in fiscal year 2016, averaging about 25 cases per person per work day. The Physical Standards Branch, or SGPS, is an 11-person office and serves as the designated service medical waiver authority for all applicants to the active duty Air Force component outside of the United States Air Force Academy. “Our Airmen are our most important asset,” Col. Richard Baker, AETC Surgeon General Aerospace Medicine Division chief, said. “The goal is to make sure that commanders across the Air Force have the most reliable and highest performing individuals within their ranks in order to prosecute our worldwide mission to fly, fight and win.” During the past three years, AETC SGPS has approved nearly 10,000 previously disqualified applicants for Air Force military service. “As we recruit and grow the force, it's a significant challenge to ensure we have the best Airmen," Lt. Gen. Darryl Roberson, commander for AETC, said. "Last year, members of aerospace medicine were a key component to us meeting the largest accession increase since the Vietnam War. Members of the surgeon general's office ensure that if a waiver is approved, we as a military service have agreed upon an acceptable level of medical risk for a recruit expected to serve anywhere in the world." Medical reviews increased by about 60 percent since October 2014 and aerospace medicine members have played a key role in ensuring the right Airmen enter the Air Force. “Ensuring applicants’ performance begins with ensuring the right candidates become Airmen,” Baker said. “Not everyone is physically or emotionally suited to serve in the U.S. military, and military service is not equivalent to traditional employment. Airmen serve at remote locations, in austere conditions and encounter extreme risks. Part of our charge is to assure that these volunteers are fully prepared to meet the rigors of combat duties.” Military stressors are known to produce disease in normal individuals, and can worsen pre-existing conditions to a point where they cannot accomplish the mission. SGPS members regularly coordinate with members from: 27 recruiting squadrons at more than 1,200 locations 144 college Air Force ROTC detachments The U.S. Air Force Academy Joint service special training schools 65 Military Entrance Processing Examination Stations DOD Medical Evaluation Review Board Air Force surgeon general’s office Air Force major commands Base-level medical units stateside and overseas U.S. Air Force School of Aerospace Medicine International partner nations seeking U.S. training Congressional liaison offices from all states and territories Retired senior officers and enlisted Individual applicants Parents of applicants The coordination process includes obtaining information and clarifying medical conditions for accession or special duty qualification determinations. “Recent work by AETC SG has revealed that applicants who have medical accession waivers have increased risks of future aeromedical evacuation from operational theater and of obtaining an assignment limitation code, in comparison to Airmen who met all accession medical standards,” Col. Thomas Harrell, AETC’s command surgeon, said. “Accessing individuals by the DoD medical standards produces a highly physically and psychologically reliable force to meet national objectives. “In addition, members of the office have undertaken a systematic review of waiver criteria in use to validate that medical waiver decisions are based on current medical science and expert opinion and balances the needs of the Air Force with acceptable individual and institutional risk,” Harrell said. The overall medical waiver rate is at about 49 percent. All of these recruits had been previously disqualified before reaching the SGPS office. “Cases seen over the past 12-18 months seem to have more medical issues than those reviewed in recent years,” Michael Landez, deputy branch chief, said. “This is likely attributable to the upper age limit to enlist being raised from 28 to 39 years of age, as medical conditions tend to have a higher prevalence in older populations.” A few of the criteria considered during the waiver process for appointment, enlistment or induction are: Free of contagious diseases that probably will endanger the health of other personnel. Free of medical conditions or physical defects that may require excessive time lost from duty for necessary treatment or hospitalization, or probably will result in separation from the service for medical unfitness. Medically capable of satisfactorily completing required training. Medically adaptable to the military environment without the necessity of geographical area limitations. Medically capable of performing duties without aggravation of existing physical defects or medical conditions. ”We, in concert with members from the Human Performance Wing, are looking to field technology that will optimize which career fields Airmen pursue, prevent injury, and speed recovery once they are in the field,” Baker said. “Preventive principles applied during BMT [Basic Military Training] have reduced medical attrition in trainees by one third, producing an additional 400 graduating Airmen each year.” Through the strong efforts of the SGPS team, AETC ensures the Air Force is manned with the most combat-able force possible. “Our mission is to sustain, optimize and enhance Airman performance,” Baker said. “When Airmen perform, we win.”