FALLS CHURCH, Virginia –
Midway through a training mission, a pilot begins experiencing blurred vision and disorientation - symptoms that could signal a serious underlying issue. With the flight aborted and the next sortie at risk, an aeromedical nurse practitioner steps in. Drawing from their flight medicine training and operational experience, the ANP quickly assesses the situation, stabilizes the pilot, and clears them - or grounds them - with confidence, protecting both the Airman and the mission.
Five years after the Air Force officially welcomed ANPs to the flight medicine community, the career field has grown to become a vital force in ensuring pilots are fit to fly, fight, and win.
ANPs are advanced practice registered nurses who begin their careers as family nurse practitioners and complete specialized training to operate in the demanding world of aerospace medicine. They conduct medical examinations and provide medical care to aircrews and missile crews, which helps determine flight status and readiness.
To become an ANP, nurses must first gain at least 24 months of primary care experience, then complete the Aerospace Medicine Primary Course at the U.S. Air Force School of Space and Medicine. Once qualified, they earn the 46YXF Air Force Specialty Code and serve as operational support flyers - often joining aerial missions to better understand the physiological and environmental stressors that aircrew face while flying.
U.S. Air Force Maj. Jessica Knizel, ANP, Consultant to the Air Force Surgeon General and Wing Surgeon for the 492nd Special Operations Wing at Hurlburt Field, Florida, said approximately 50 trained ANPs will be ready for deployment by the end of summer 2025. With their breadth of capabilities, they arrive not a moment too soon.
“We’re even considered a suitable substitute for a flight surgeon in some cases,” Knizel said. “We can serve in the flight operational medicine clinical setting … we can also [be] substitutes for deployments and serve in the line of the Air Force as an operational medical element.”
By Knizel’s count, since 2021, five ANPs have served on safety and accident investigation boards as a medical representative for aircraft mishap investigations, a position typically filled by a flight surgeon. The versatile capabilities of ANPs mark them as indispensable to the flight medicine community’s operational readiness. By 2027, the career field is projected to fill 70 billets, further expanding operational support.
Knizel was one of the first medical Airmen trained as an ANP - a path she pursued after serving with a flight medicine group as an Air Force Reservist.
“In my 22 years of service, this is the most rewarding job I have ever had ... I feel like I have a direct impact on our ability to execute the mission,” she emphasized.
In addition to direct mission impact, Knizel described the tight-knit support within the flight medicine community as another benefit to joining the career field.
For U.S. Air Force Maj. Nathan Del Rio, ANP with the 964th Airborne Air Control Squadron at Tinker Air Force Base, Oklahoma, the opportunity to support the front lines of the Air Force became his true calling. He worked elbow to elbow with flight medicine practitioners as a FNP in a warrior clinic and sought to be part of the action.
“As the ANP career field developed, I knew pretty early that that was something I wanted to pursue,” he said. “Working in flight medicine is one of the closest ways that you can connect to the mission [especially] with opportunities like being assigned to a flying squadron.”
Del Rio once deployed with a squadron in which he adapted to using limited medical resources to address an eye injury. He utilized his ANP training and collaborated with the Air Force Environment, Safety, and Occupational Health Service Center to return the Airman to flying status within 48 hours and prevented the need for an emergency medical evacuation.
“It was one of my proudest moments supporting the mission,” he said.
To learn more about the AFSC, what they do, and what resources are available to those considering becoming an ANP, visit the Nurse Corps webpage.