To the Editor.
—As a healthy, life-style— minded physician at Loma Linda University (LLU) seriously considering obtaining an airplane pilot's license, I found the article by Ullmann et al1 to be particularly disturbing. In dismay, I imagined a future newspaper clip stating, "Another LLU vegetarian pilot died in a fatal plane crash—but the autopsy revealed no atherosclerotic disease."Unfortunately, the authors were unable to offer an apparent reason for the significantly higher rate of fatal aircraft accidents among LLU physicians as compared with University of Southern California (USC) physicians, although a disparity of skill and judgment was suggested. A better interpretation of the impact that the USC physicians' apparent "advanced pilot training" may have had on this finding could have been attained if the authors had adjusted for the effects of instrument rating by applying appropriate covariance methodology. Aviation epidemiologic studies certainly demonstrate that inexperienced pilots have up to
Doram KR. Loma Linda MD/Pilots Should Train at USC. JAMA. 1991;266(12):1651. doi:10.1001/jama.1991.03470120053031