F-22 pilot-physician takes healthcare, safety to new heights

  • Published
  • By Staff Sgt. Kirsten Wicker
  • 325th Fighter Wing Public Affairs
TYNDALL AIR FORCE BASE, Fla. --  Most people know what a doctor is, and most people know what a pilot is. But what most don't know is that one of Tyndall's very own is both a doctor and a pilot in the most advanced jet fighter on the planet.

F-22 Raptor operations involve the combination of complex technology with the human body at altitudes and G-forces rarely experienced by other fighter pilots. The medical community's first-hand knowledge of these unique conditions is limited by the fact that flight surgeons can't ride shotgun in the single-seat F-22.

But while it is true a doctor could not ride tandem in the Raptor, the Air Force has the capability to put qualified physicians in the driver's seat under the Pilot-Physician Program. Lt. Col. (Dr.) Jay Flottmann - a former flight surgeon and now fully qualified F-22 pilot and 325th Fighter Wing chief of flight safety - does just that and he is making strides in the fighter community helping to improve the safety of the aircraft.

Colonel Flottmann is one of 11 pilot-physicians in the Air Force, making him a member of a small, unique band of knowledgeable experts who are becoming more valuable as new technology offers new tasks for the human body.

The Pilot-Physician Program is not necessarily a new program to the military, having been around since the early days of Air Force aviation. However, still in its infancy as an official "11 series flying regulation" program and having just recently revised the Air Force Instruction bolstering the career field, it merges the line and medical corps, making aviation history. According to a report written in 1989 by Maj. Thomas F. Koritz, the first Pilot-Physician to die in the line of duty as an F-15E Strike Eagle combatant in Desert Storm, Pilot-Physicians have made many contributions to the general knowledge of aviation physiology, human factors and flight safety.

"One of the ultimate goals always is improved flight safety. The Pilot-Physician, properly trained in human factors, can help identify and assist in correcting man-machine interface problems that arise either operationally, or in flight test and evaluation," he writes. "The Pilot-Physician is uniquely qualified to identify, evaluate, and integrate information from the various factors affecting the pilots' ability to interface with the aircraft and weapons systems."

"Through these inputs there is an extra margin of safety which often helps save lives and equipment. The Pilot-Physician should serve as the ultimate interface between the line and the health professions," according to the late Major Koritz.

While some have come before him in various other aircraft, Colonel Flottmann is the first Pilot-Physician to drive the Raptor, but he began his journey as a man with a calling for medicine.

"I started as an active duty flight surgeon, coming into the Air Force via the Health Professions Scholarship Program that paid for medical school," he said. "Once I graduated medical school I was commissioned as a captain in the medical corps and was assigned to Keesler Air Force Base, Miss., to begin post-graduate training. While at Keesler, I decided that I wanted to be a flight surgeon, not knowing what that was, in fact."

The doctor went to Brooks Air Force Base, Texas, to attend the Aerospace Medicine Primary Course, commonly called AMP. While he was there, he and some classmates got a ride in a T-37 Tweet, a small economical twin-engine jet trainer.

"Prior to that time, I couldn't tell you what a T-37 was from a T-38 [Talon] and I couldn't really tell you what any airplane in the Air Force inventory looked like or sounded like," said Colonel Flottmann.

After that ride, he was hooked.

"I could not believe that people get paid to fly airplanes," he said. "It was the most fun thing I had done and I was amazed at how awesome the experience was."

Following the course at Brooks, his first operational assignment was as a flight surgeon at MacDill Air Force Base, Fla., supporting the KC-135 Stratotanker mission there, and although flying in the KC-135 wasn't quite the same as the maneuverable T-37, he began asking the question as to whether there was a program where he could be a pilot and a doctor.

"I called the Pilot-Physician Program director who was at Brooks, and at that time, was Col. Roger Vanderbeek. The way the program worked, typically, was guys who were already pilots, went to medical school, and then came back, so nearly all of them were pilots first," said Colonel Flottmann.

The program director wasn't confident there was a way for a doctor to attend flight school and asked him to keep in touch. After one year at MacDill, Colonel Flottmann was selected to be the flight surgeon for the famous Thunderbirds Aerial Demonstration Team at Nellis Air Force Base, Nev.

"That was an outstanding tour, but during that time, I kept in contact with the Pilot-Physician Program director and the assumption was early on was that I could not participate in the program because I was not a pilot before I became a qualified physician. However, while I was at Nellis, by keeping in contact with the program director, I found out that a flight surgeon up at Eielson Air Force Base, Alaska, applied to the active duty pilot training board and was accepted," Colonel Flottmann said. "So here's a guy who cracked the nut. Now that it had been done, I told my commander at that time I wanted to do the exact same thing and he helped me put together an application for pilot training."

Colonel Flottmann's medical commitment was nearly complete, so Air Force leaders agreed if he was accepted to pilot training, they would release him from the medical corps knowing that he would accrue another 10-year commitment to the service. And sure enough, as the process went through, he was accepted and went right away to Moody Air Force Base, Ga., to begin pilot training in the T-6 Texan.

He progressed through training and went to Laughlin Air Force Base, Texas, to continue training in the T-38. From there, he was the only student in his graduating class to be awarded a slot for the F-15C Eagle, his first choice. Following graduation, he progressed through Tyndall's F-15 training course, finishing in 2004. His first F-15C assignment was to RAF Lakenheath, United Kingdom.

"When I made the transition to be a pilot, I essentially severed my ties with the medical corps and became a line Air Force officer, having to re-commission as a captain in the line Air Force, and because of the difference coming in as a captain-doctor, being assessed as a captain in the line Air Force, my date of rank changed so that I could be more in line with my peers.

"So at that time, I was not actually a Pilot-Physician per Air Force Instruction. While I was at Lakenheath, I went to the hospital chief of staff and I told him I would like to be credentialed to be a flight surgeon; all through pilot training I had not seen any patients on an official basis, so through a small credentialing process and with coordination of the medical staff and my squadron commander at Lakenheath, we worked out a way for me to go over to the clinic once or twice a month and see patients. So functionally, I was doing both, but I did not actually hold the Pilot-Physician Air Force Specialty Code."

Despite serving as a line Air Force officer, Colonel Flottmann began putting together an application to be considered for the AFSC per recommendations of the Pilot-Physician Program director. He submitted it in lieu of approval as he was preparing to leave Lakenheath for his next duty assignment at Laughlin as an instructor pilot in the Introduction to Fighter Fundamentals course.

"It's an application process that has to be approved and coordinated through the Air Force Surgeon General's office. While I was at Laughlin, I finished the application process and started working an exception to policy to go back to the medical corps in the AFSC Pilot-Physician career rating, because the medical corps owns that duty code and it required a competitive category transfer," he said. "It went through, and my AFSC was changed and that's about the same time that the F-22 began to experience a rash of physiologic problems."

In 2009, the 325th FW commander, then Brig. Gen. Daryl Roberson, met with then Brig. Gen. Tom Travis (the current Air Force Surgeon General, now Lt. Gen. Tom Travis - former F-15C Pilot-Physician) during a general officer course and through conversation, knew he needed somebody with medical and operational flying knowledge to assist with the jet. The program director of the Pilot-Physician Program recommended Colonel Flottmann for the job, and they agreed to transfer him to Tyndall after some coordination moving the unit manning document to the 43rd Fighter Squadron.

"Many people didn't know about this program or this job, and many still don't know about it," said Colonel Flottmann. "When I first arrived at Tyndall as part of the F-22 program, I wasn't initially placed in the F-22 transition course here. Most weren't even sure what to do with someone like me. So I was able to re-qualify in the F-15, and then I deployed for six months. When I came back in November 2010, that's when I began to train in the F-22."

Just as he finished the course in May 2011, the stand-down occurred. But even with the jets on the ground, the Pilot-Physician was about to become more busy than ever before.

"At that point, I became heavily involved in the safety investigations. I was brought on board as a pilot and medical member and we started a comprehensive and thorough, deep-dive investigation," he said.

Colonel Flottmann and his team conducted exhaustive interviews and performed extensive, thorough research, looking at all avenues that could possibly exist to understand what, at the time, were unexplained physiological incidents. Members made recommendations to senior Air Combat Command and Air Force leaders on how to study the incidents and mitigate risks. They also helped keep current information on the investigation flowing to the F-22 community, U.S. Navy and NASA researchers who partnered with the Air Force, and interested members of Congress and the media.

"We introduced the idea of flying with a pulseoximeter and incorporating it into the helmet - something unique to the F-22 - no other aircraft has that feature. We developed an incident response protocol and scrubbed all factors. We identified a problem with the upper pressure garment - which was functioning differently in an F-22," said Colonel Flottmann. "I became an advisor to the Air Force Scientific Advisory Board, convened by the Secretary of the Air Force, and became further involved when ACC stood up the F-22 Life Support System Task Force. I became a uniquely qualified medical and safety representative for the F-22."

Trained as a pilot and as a qualified medical professional, Colonel Flottmann was able to evaluate the occupational medical environment, studying the human factors involved with piloting the multi-million dollar airframe.

"We found verifiable and tangible issues and we addressed them. Some things I even experienced myself while flying the F-22 and I did the research to discover what was going on physiologically," he said.

The fighter community continues to become more technologically advanced and more capable, even now as the F-35 Lightning is being fielded. Colonel Flottmann agrees many factors affecting the jet have been introduced by people seeking to push the envelope of speed and height.

"Man has introduced some of these variables on human physiology and we are more thoroughly examining the effects of those variables and seeking to alleviate them while maintaining the high-performance of the fighter itself," said Colonel Flottmann.

Now, with the restructuring of AFI 11-405 to allow qualified flight surgeons to apply to pilot training, Capt. William Smith, 325th Medical Group, was recently selected as the first flight surgeon to attend pilot training through this official channel.

"Right here at Tyndall we are engaged and active in growing the program, so getting people like Captain Smith in the program is important for its viability," Colonel Flottmann said. "We are thrilled for him; and who knows if he will come back to fly the F-22 like I do, the sky's the limit."