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Helicopter Air Ambulance Ramblings

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
Since there's not much dedicated helo career info here, and most of what I learned in the process was either networking or Googling stuff, I've started typing up what I experienced with trying to get hired for a HAA/HEMS job. I know there's some other HEMS guys on here, so please, feel free to add your perspectives.

Much of this is semi-stream of consciousness typed over several days, so here's your warning...

Pre-Hiring Planning:

First, figure out what different job options you might be interested in. When I started my process, Gulf of Mexico (GOM) jobs weren't really around. I've heard good things about the industry, especially for the IFR/dual piloted guys, but it didn't appear to be an option. It's also typically a 14/14 schedule at some base that isn't your home.

I had also been engineering a DoD contract job INCONUS that I was excited about, but it evaporated at the last minute, so I was back to looking at HEMS or possibly CBP. CBP would have taken me in a second, but due to an injury right before retirement, I slowed that process down. Throughout the whole process, my priority for which job I wanted kept changing, as each offered different experiences.

So first things first, I needed intel and connections. I knew several guys I served with who went on to HEMS and had been doing it for a while and they were happy to answer my endless questions and made it possible that when I ran into people that might be able to help get my foot in the door, I could ask educated questions and sound like I gave a crap about the job.

Meanwhile, I started building a resume. This took way more time than I was expecting, partly because of SHARP logging errors and partly due to refining my Excel spreadsheet to get the correct data out of it. There are resume templates online, specifically from Stacey Sheard (google her), and they'll give you a 95% solution that you can then tweak to make your info fit on one page.

The next major thing I did was to go to Heli-Expo, and specifically the Military-to-Civilian Transition seminar that HAA puts on the day before the Expo. The seminar is free and if you're social during the event, it's incredibly valuable. The whole seminar lasts about 4-ish hours, but it's made up of short industry overviews, given by former military guys, but is also broken up with short breakout sessions where you can go to different groups and ask people one-on-one about their specific industry.

Heli-Expo also has a career fair on the first day of the Expo. There's several different industries represented at the fair (Tour, Log, HAA/HEMS, CBP, etc) and chances are you're going to be speaking to either the company hiring manager or the Chief Pilot (or both) while you're there. I've noticed the two years I've gone that not all of the HAA companies have been there, but the one I was targeting was, so I was happy. When going to this, bring your resume (and business cards...make your own, don't use your Navy business card, if you have one). I found that when I would give my resume to someone, my instrument time would stand out, as much of the industry is made up of either civilian trained guys who may not have much, if any, actual time, or Army guys who just fly in a different environment. Throughout the whole process, I've noticed that Navy/Marine guys generally seem to excel and be well-respected for their instrument flying ability.

One side note on the networking/interaction thing... When it comes to your military background, don't be "that" guy. Don't hide your service, as it's very valuable, but don't bore everyone with stories about how the military couldn't have completed its mission without you. When asked, talk generally about what you did as it pertains to the job, but be humble and be open to learning new ways of doing things. A lot of stuff is going to be different.

Last major thing about planning...Figure out where you want to end up first. If you're flexible, great, you'll have more choices, but typically people have an idea on where they want to end up. Once you figure that out, you can then target the companies that service that area. One caveat to that is there might not be a base where you want to live. There may be a base nearby though, so you'll have to figure out how flexible your schedule is with family.

Some bases will have apartments for you to live in during your hitch. Some won't. Some should, but still won't. Some will have Geo modifiers (cost off-set...basically a bonus to go to that base). Some bases will have both. I would caution you on chasing the money, though. Figure out what will work for you (commute or no commute) and it wouldn't be a bad thing to do a little research on the company (and/or the program at that base).

There are three types of bases/programs: Company-owned, Hybrids, and Hospital-owned. The hospital-owned program seems to be more rare nowadays, but is still out there. A company-owned program is a program where one company owns the pilot, Med Crew, and the helicopter. Everyone ultimately answers to the same boss. A hybrid program is made up of a company-owned aircraft and pilot, but the Med Crew is owned by the hospital. The pilot will work in parallel with the Med Crew, but the two have different bosses to answer to.

You'll hear different thoughts on which kind of program you would want to be a part of, but honestly I think it has much more to do with the individual people you work with and how much drama they (or you) create. I happen to work for a hybrid program and it's been fine.
 
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Gatordev

Well-Known Member
pilot
Site Admin
Contributor
Hiring Process:

So what actually happens? Since I already had my name and resume on file, I reached out to the company recruiter/hiring manager periodically to keep my name on his radar. He was completely good with that. It helps him know your timing and look ahead at what he has coming open. I dealt with two hiring managers (first one went back to the line) and both outright asked me where I wanted to live. They're realistic and understand it's part of the process. I had also put my name into the company's automated job notification system, so I was watching the various bases that were popping in my area (and noting how frequently or not frequently they were popping).

There was initially some discussion about being a float pilot in another region. In the end, I didn't end up doing that and a base nearby me opened up, so I applied to that. For my particular company, there was no salary negotiation. There was also no benefit to having Tricare. It is what it is. The job offer is put in an hourly rate, with a minimum annual salary stated. I was hired for an IFR program, so once qualified, I would get an additional stipend for that. Overtime and holiday pay is extra (1.5x and 2x, respectively).

Pay:

As with everything else, it is what it is. It's obviously not airline pay. What seems to be understood is that the benefit of the job is all the time off. Where it can be frustrating is if you have to commute and there's no off-set for that base.

We were recently given a fairly substantial pay raise for all line pilots, which helps. Plus getting IFR pay is a minor bonus, as well, but there are way more VFR bases than IFR bases. As a retiree, I make a comfortable living and am happy to turn down overtime if I don't want it.

There are some bases that have a crazy bonuses and apartments, but those are typically the bases no one wants to go to because they're in the middle of nowhere. If you're good with commuting anyway, it might be an option.

New Hire Training:

For my particular company, New Hire was about 10 days. It started out with a day of HR followed by a day or two of classroom stuff. The aircraft we had was down, so we did several days of classroom stuff to get ahead. Typically it was a day of classroom and then it would be classroom split with flying each day. Initially the classroom was systems training. The big thing to keep in mind is this is all FAA driven, so they have to cover what's in the training manual. It's a little bit like going to a SWO-controlled school in the Navy (I'm looking at you Shipboard Fire Fighting). Everything has to be covered, but certain portions are more relevant than others. The instructor(s) were helpful with conveying what was important.

I went through training with one other guy who flew Apaches and then did a couple of months flying for a VFR program. Once we started flying, we'd alternate who would start up front each day and the other one would sit in the back and observe. Then we'd switch. We did several day flights trying to catch up, then started doing nights. The first night was unaided, then every other flight was aided (AN/AVS-9s). While I was hired for an IFR program, the initial training was only VFR with Inadvertent IMC training. After I did a few months on the line, the company would then send me through IFR training.

Overall, the training was very good. They gave us some excellent gouge to study for the oral portion of the checkride and I felt prepared for the check flight. By the time of the checkride I felt like I had just enough proficiency to be confident, but not overly so. Of course with more time, skill will improve. As it worked out, I ended up doing my checkride with the guy who was observing our primary instructor throughout training, and had flown with him twice during training, so I had a good idea what to expect. I also had the FAA observing during my checkride, but he wasn't there for me.

The big hurdles during training and then starting the job was learning the new rules. You have two major governing sets of rules: the CFRs and the company Operational Manual (think of it as a 3710). The Army has infiltrated the FAA, so there's some Army-isms in both sets of rules, but the company GOM isn't too bad once you get familiar with it. One of the biggest things the company would make clear is that this isn't the military, and there's no "we have to get this mission done now" mindset. If something is broken, stop and get it fixed. If the weather isn't within mins, decline the mission and/or don't launch. No questions asked.

As it is anytime you're learning a new aircraft, proficiency fades very quickly, so I was eager to start work so I could try and remember how to start the damn aircraft.
 

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
On the job...

This is where there can be a lot of variation on life at the base. Big picture, I work a 7on/7 off for 12 hours at a time. Anything over 12 hours or over a total of 84 hours during a pay period is overtime. I can't fly with more than a 14 hour crew day, but I can still do paperwork. I always have to have a 10 hour rest period, no matter how long I work. Realistically, I rarely work more than 12 hours. It's been split between an early morning launch that runs over or an evening call 45 minutes before turnover.

How busy a base is will vary greatly. Additionally, how much you fly will vary. This isn't always the same thing. Bases that have a longer transit time to or from a hospital will have more flight time. All flight time is Hobbs time, so just because you're spinning at the scene doesn't mean you're logging time. You can keep track of this separately and log additional time in your personal logbook, but the company only logs Hobbs time for the aircraft. My particular base usually has a transit time of 15-20 minutes between hospital or base. Typical hours/x is .7 or .8 unless we do a interfacility between a hospital that's far away. But another important number is calls/month (or really, accepted calls/month). Some bases will be 20 or less. We've been slow lately so we're down around 30-40-ish/month. When I was hired, we were averaging 40/month. Some bases can be busier. Personally, I like flying, so the 30-40 is about right and gives some time for a "safety nap" during the day or a couple of hours of sleep at night.

Some bases will do more inter-facilities than others. We do some, but greater than 50% of our calls are scene calls, which can be much more interesting (and sometimes not). I've had more strokes/cardiac issues than MVCs, but I guess such is the life of our fat nation. But some calls you won't take at all due to weather. My company is very safety-conscious, sometimes to the point of amusement, but if you say no because of weather, there's no questioning (unless it starts to become excessive for no reason). In the summer with storms or in the winter with fog, it's not uncommon to turn down multiple calls in a day. Even though I'm in an IFR program, because we get so many scene calls, we can't launch because there's no way to get to the scene in weather or even if you could, getting to the hospital requires pretty high mins, so it's usually not worth it. Also because I fly in a place that doesn't have terrain, an ambulance can get someone somewhere almost as fast as trying to file IFR, pick up a clearance, launch, shoot an approach and land. The single-biggest thing why I like IFR is because it can get us home if the weather comes down below company mins. Although home base is still only serviced by a RNAV and we don't have anything other than LNAV MDA capability.

Bases can vary as well. I'm super-lucky to have a very nice base and after working at another base last week, I appreciate our base even more. We're in the sticks, so other than pizza and some cat-on-a-stick, we're on our own for food, but we have a full kitchen and grill outside. We're located on an airport and our base is an old FBO building (emphasis on old). As an aviation geek, I'd much rather hang out at an airport than a hospital, as you get to see interesting things every so often. Today some Task Force guys diverted for fuel so we got to look at their birds. Another time some Sikorsky guys came through with a newly refurbished -60 headed to the FMS world. It's the little things like this that help with the daily boredom.

I heard a lot about the drama that can be created by Med Crew (and sometimes pilots, based off some of the stories I've heard). I've been extremely lucky and our crews are all great. Sure, there's the little things that pop up when you live with other people, but it's still way better than being on a frigate, and the internet works...most of the time, unlike a frigate.

The flying... It can be interesting.

Most of LZs we go to are either pre-designated or they're pads at local community hospitals. Sometimes you'll get LZ changes to random fields or a road. Generally the fire truck that shows up knows what to look for, but we as a crew will still recon a LZ before landing (basically just like using SWEEP for those that are familiar). Where it gets interesting is when you get a random field at night, because it's much harder to find wires (or sticks/posts/fences). Again, Highway Patrol and Fire have been pretty good lighting up wires/power poles. Today our LZ was changed to a random farmer's field where the farmer opened the gate to the property for EMS.

What was pointed out to me on my first couple of indoc days on the line was that while there isn't a lot of flight time per call, most of the flying is the actual stick and rudder stuff (startup/takeoff/landing/takeoff/landing/etc). Once you're up and away, you're on autopilot anyway. And after picking up someone at a scene, there's actually a decent amount of radio work, as well, so it's helpful to off-load the flying so you can manage talking and navigating.

The bads…

It's all what you're looking for. I like flying, so the stretch of days of not flying can get boring fast. When it's Xmas and you're at work not doing a damn thing and not at home with family, it can be frustrating. Some people like all the down time, it's just what you're into.

Another frustration is that many of the rules, both FARs and company, are generated by Army pilots and as one of the (Army) IPs was ranting about over beers one time, Army IFEs aren't always the most open-minded and just want to do it the Army way when there's other ways of doing things. But it could be worse, I could actually be in the Army. So at least there's that.

I'll wrap this up here and can add more stuff as time goes on. There's plenty more, I've just run out of steam on writing this tome.
 
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ChuckMK23

FERS and TSP contributor!
pilot
Nicely written - fun to read! A lot of this rings familiar/true from my 24 months with PHI (20 years ago now, holy cow).

My interview at the time was short and to the point - I remember faxing my resume, flight time summary, airman certificate to PHI - getting a phone call the next day and given a time later in the week to interview in person with the hospital Chief Flight Nurse, Medical Director, and the base lead pilot. But it was a "personality fit" interview - not a technical interview relating to aviation or flying experience at all.

After that interview, PHI gave me a "conditional" offer of employment - based on a flight evaluation. I drove myself the 650 miles or so to Lafayette, LA where I got to fly with a PHI check airman - who was also a former HT IP. The aircraft was an old B206A Jet ranger on big floats. Little in the way of instrumentation. Airspeed, wet compass, altimeter. I got to shoot full autos to the water on a man made water runway. I remember that was fun and even after being a STAN pilot, NI, and CAT I guru, the PHI dude taught me a crap load about airspeed/energy/Nr management in an auto and how to get every ounce of performance in a power off situation.

My initial Part 135 training was in the BO-105 - and that consisted of 4 flights - and I clearly remember the emphasis on single engine work and the PHI way of landing on an elevated platform. The Check Airman/Instructor I had also taught me a ton of practical things about flying a helo single piloted and purging my brain of the Navy dual pilot mentality. How to "flow" checklists, use of friction settings to give you a spare hand, trimming, cockpit management. This was still less mature days of HAA/EMS and a lot of this was taught from a GOM/Offshore context. Flying a helo solo was still a new concept to me at the time.

I remember showing up to the base for paperwork and introductions with our Lead Pilot and Regional Manager. I was checked out in the BO-105 but not yet checked out in the BK-117. I spent 3 or 4 days riding shotgun in the left seat of the BK-117 observing our Lead Pilot - I remember first learning to do the manifest/computation card/W&P paperwork for each leg without the pressure of flying and getting a very practical take on how things actually worked and how to fly efficiently and safely. On that first day, I was told to take the BO-105 to KLUK and have it refueled before it came on line at noon - my first time off a hospital urban elevated heliport was solo. In an aircraft that was configured much differently than the one I had trained in (high skid gear, different avionics, etc etc).

My BK-117 training was done on a cross country from Cincinnati to Chapel Hill, NC to ferry the Midwest region spare BK-117 - with a check airman. After dropping him off at the regional airport so he could catch a flight home, he signed me off on the BK-117 and flew the ship home 2 days later - solo.

We were issued 6 white airline pilot type shirts with epaulets and captain stripes, navy blue chino type pants (both from Cintas Uniform Company). Also issued a red nylon and fleece type jacket with hospital/program embroidery. David Clark passive type headsets on a coiled chord. No Nomex at the time, or helmets, or NVG's. The "Night Sun" searchlight was standard equipment and there was a collective mounted shut off that we would depress upon landing - the power of the light could ignite foliage if it wasn't secure on landing.

We flew Nurse /Physician / Pilot/ The Physicians were 2nd or 4th year Emergency Medicine Residents that rotated in and out of flying. The flight nurse really owned the cabin of the aircraft. Neither flight nurse or physician were really useful for any aviation crew duties - and PHI /training / ops manual emphasized that fact. The Physician sat up front with me in the BK-117 (copilot controls removed) - and on the BO-105 he / she sat facing rearwards. They were more or less useless even for traffic lookout/ID.

I made $32,400 per year for 7 days on/ 7 days (12 hour days) with 1 week of paid vacation and medical benefits/health insurance. Work over beyond that paid a higher rate - I want to say it was $200 per day or something like that.

A lot of great memories and fun flying - but also a lot of unmanaged risk and VFR weather mins that were at best fictional. Also you your district manager called you for an explanation as to why you turned down a flight. The hospital also religiously tracked whether we would get airborne in the 8 minutes allotted from initial dispatch - a metric that defies safety culture.

Anyways, forgive the long retrospective - I really enjoyed the job. My life took another turn - a high drama divorce and need to have more stability to raise 2 kids. I went into the tech field and doubled my salary so I could afford to have a home to raise kids on my own. It was not a career move motivated by interest or passion in the field but rather practicalities of life situation. I'm now an empty nester ....

I read @Gatordev 's transition story with envy. Life is all about timing.
 
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Gatordev

Well-Known Member
pilot
Site Admin
Contributor
I see you caught on to my writing style...

My apologies. I meant to credit you in the first post since your airline write-up(s) were an inspiration.

Anyways, forgive the long retrospective -

I think the good thing is a lot of those risk inducing (or the potential for induced risk) have been removed or tempered in the industry. Couple that with being with a "good" company helps too. As a new hire, there was no launch time requirement. I'm sure if I was taking as long now as I was then, the RAM would probably have a chat with me, but there's still no set time. Also having an atmosphere of constant risk management instead of just before you go fly is good. Weather cuts you off? Turn around and cancel the call. Better to not die or get violated than push it.

So @Gatordev how about a review of the H135 from a pilot perspective?

I feel like I don't have a enough time to really give a great perspective, but I've made some comments here and there on the site (mostly the Rucker thread). I can add more later. For now, we just got back from another call and one of the Med Crew made tacos.
 

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
Instrument Flight Examiner. Rob may disagree since he's been assimilated, but the impression I get (from Army guys talking about Army things) is that certain quals are held to a certain prestige, more so than in the Navy. It's certainly not all Army guys, but it seems like there's some who want to take the Army way and make it gospel as opposed to accepting that there are other ways other people do things that aren't right or wrong, just different and different for very good reason.

It's not specific to IFEs, per se, but it does seem to apply more to instrument related flying, which can be frustrating when one comes from a background of flying significantly more actual time than a lot of Army guys. Even more so when one has flown multiple Types under instrument conditions.

As always, some guys are more open-minded than others. At the end of the day, you gotta do what the boss says, or do it elsewhere.
 

Gatordev

Well-Known Member
pilot
Site Admin
Contributor
I assume Army guys don't appreciate our Special Instrument "Card"/rating....

I can't speak to that. Think much bigger picture, more basic stuff. Things that the CFRs may say, but get interrupted more restrictively because the more restrictive interpretation goes more in line with what they know. We're all guilty of it in some way, just some are more guilty of it than others.
 

ChuckMK23

FERS and TSP contributor!
pilot
I can't speak to that. Think much bigger picture, more basic stuff. Things that the CFRs may say, but get interrupted more restrictively because the more restrictive interpretation goes more in line with what they know. We're all guilty of it in some way, just some are more guilty of it than others.
Oh I am familiar with the type :)
 

Jim123

DD-214 in hand and I'm gonna party like it's 1998
pilot
The naval aviator special instrument rating is kind of strange in the big picture of greater aviationdom. It says you're allowed to takeoff when the weather is below 1/2 mile visibility because... you have sound judgment and the boss marked a different checkbox on a piece of paper in your training record attesting to your experience and sound judgment. I mean that's it, pretty much.

3710 standard takeoffs minimums are a detailed set of rules, but special mins have no mention of any of risk mitigation strategies for low visibility takeoffs. There is no mention of takeoff alternates, nothing about visual aids, no mention of training requirements (never mind quantifying any of this... like the FARs do for this very thing), just some vague and redundant guidance about using sound judgment for a maneuver that is ostensibly so risky that it's prohibited for a pilot with a standard instrument rating.

With all of the good idea paperwork that the safety-minded people have piled on in the past 20-30 years, I'm just surprised that this particular section of the 3710 has survived, basically unchanged.
 
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