Unfortunately, many AMEs are not quite correct in the guidance they offer (hence the AME Guide), especially as the guidance updates and improves regularly. Vaso

Unfortunately, many AMEs are not quite correct in the guidance they offer (hence the AME Guide), especially as the guidance updates and improves regularly. Vasovagal syncope is not necessarily disqualifying unless a cause cannot be determined (and therefore, risk of recurrence cannot be determined). There are plenty of commercial and private pilots flying who've experienced vasovagal syncope. I absolutely empathize with the significant cost associated with getting endless tests and deferral limbo (in part due to a shortage of AMEs). Pilots who have the benefit of really good aeromedical teams (e.g., through their labor representation) are better informed and more successful. We really have to weigh the cost and effort associated with the tests against the information gained around safety. Too many pilots are deciding they don't want to deal with the hassle, and ultimately that results in _less_ data about the true safety risk!