Integrity - Service - Excellence
You’re The Flight
Surgeon
ARMA
Colonel Brett A.
Wyrick,
USAF, MC, SFS, MPH
brett.a.wyrick.mil@mail.mil
One Day in the AOR…
You’re the deployed Flight Surgeon for a fighter
squadron at a forward operating base in combat
zone. You come into the Ops area one morning,
and the squadron commander says, “Hey Doc,
do you have a minute to talk?”
Your response is:
A) No way, I am late for my brief!
B) No, last time we flew I got no stick time.
C) Only if I get the next landing…
D) Sure, Boss- what is on your mind?
Integrity - Service - Excellence
The Answer is D
One of the primary duties of a Flight Surgeon
is to act as an advisor and counselor for the
commander. The assigned Flight Surgeon
has a role in the squadron to know the
emotional, psychological, and morale status
of assigned aviators including the squadron
commander.
Integrity - Service - Excellence
The CC’s Tale…
The Squadron CC pulls you aside into his office,
and begins to speak in a low voice- “This is about
one of the new guys, a 2nd Lieutenant, I am having
problems with him, and I just do not know if he is
going to work out.”
Your response is:
A) This sounds like a personal problem
B) I am a Flight Doc, not a psychiatrist (Unless you
are Jill Hendra)
C) I am just here to fly, and I do not want to get
involved
D) Sounds like a problem, tell me more
Integrity - Service - Excellence
The Answer is D
A nice open ended statement may
encourage further conversation, and
validation of a potential problem will further
the conversation.
Integrity - Service - Excellence
The problem with the new
guy…
“He transferred in a few weeks ago, and he has been
pretty much ostracized by the pilots. On his first
combat mission, he turned tail and headed for home
just about the time the triple A started popping- said
his plane had mechanical issues. The guys gave him
a hard time, and he has started acting pretty weird.”
OK, this is different your working diagnosis is now:
A) Fear of Flying
B) Anti Social Personality Disorder
C) Cowardice
D) Mechanical Issues
E) Any of the Above
Integrity - Service - Excellence
The Answer is E
While this could be any combination of the
above do not be to hasty to rush to
judgment. You need more facts, and you say,
“Please tell me more about this guy.”
Integrity - Service - Excellence
A former ballroom dance
instructor…
He sits by himself most of the time and types up action
reports for future combat missions. His only friend was
killed in action a week ago, and he has been morose and
combative, since. These two were closer than brothers,
and we did not care too much for him either, they were
both pretty strange. I am just not sure he is going to hack
it here.
Your working differential diagnosis should now include:
A) Adjustment disorder
B) Pathological grieving
C) PTSD
D) Suicidal Ideation
E) All of the above
Integrity - Service - Excellence
“He has even been insubordinate
to me…”
OK, this is highly unusual behavior for any
pilot, let alone a “Butter Bar”. There seems to be
a problem here. Your next response should beA) I wonder where the nearest mental health unit
is?
B) Is this guy a danger to himself, or others?
C) Maybe we should talk to this guy before he flies
again.
D) A DNIF might be in order here…
E) All of these should be considerations
Integrity - Service - Excellence
The Answer is, of course, E
This really needs to be sorted out quickly,
and you need to have safety in mind. Flight
Safety, personal safety, and workplace
violence must be considerations. You tell the
squadron commander, “Let’s go talk to this
guy before something happens.” The
squadron commander looks down
sheepishly at his feet, and says, “That might
be difficult, he just took off on an
unauthorized flight, and I have issued orders
for his arrest when he lands.”
Integrity - Service - Excellence
ARMA
Adaptability Rating for Military Aviation is rated
Satisfactory or Unsatisfactory.
In the opinion of the Flight Surgeon, an
Unsatisfactory adaptability rating for military
aviation (ARMA) is made if maladaptive
personality traits (not meeting diagnostic
criteria for a personality disorder) or a pattern of
maladaptive behavior is present that
significantly interferes with safety of flight, crew
coordination, or mission completion.
Motivational issues are referred to
administrative channels.
Integrity - Service - Excellence
ARMA

“More flight surgeons are dissatisfied with the ARMA
than are satisfied, and the regulation is perceived as
unclear in the area of final disposition for candidates
with equivocal ARMA's. A post-hoc analysis to rule out
the influences of rank, gender, experience and residency
training was performed. Residency training in Aerospace
Medicine is beneficial in terms of doing an ARMA, when
required, and covering recommended areas. Females
and those with less than 1 year experience perform an
ARMA more frequently than males and experienced flight
surgeons. Despite the limitations of the current ARMA, it
should not be abandoned. Recommendations to improve
it are provided. Doing better ARMA's can lead to
decreased illness, injury, accidents, and attrition.”
Integrity - Service - Excellence
The Rest of the Story…
 Predictably,
our
young aviator was
Killed in action later
that same evening…
after scoring three
victories in aerial
combat
Integrity - Service - Excellence
“Contemptuous disregard of
danger…”

He was the only person
to win the Medal of
Honor while technically
under arrest
 18 Victories in 14 days,
3 of which he did not fly
 At the time of his death,
he was America’s
leading ace
 Fighter pilots still train
at the base named in
his honor, Luke AFB,
AZ
Integrity - Service - Excellence
Lt. Frank Luke, Jr
 ARMA:
SAT or
UNSAT?
Integrity - Service - Excellence