BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic neurological disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity. The most common treatment for this disorder is methylphenidate, which is a disqualifying medication for flight. Candidates with previous use of methylphenidate are not necessarily disqualified from the Israeli Air Force (IAF) flight academy.METHODS: Flight cadets from 12 consecutive flight courses who have used methylphenidate at least once in the past were identified according to their medical records. The graduation ratio of cadets with previous use of methylphenidate was compared with that of the rest of the cadets. A comparison was also made with regard to the causes of disqualification from the flight course. Statistical significance was assessed using the Fischer Test.RESULTS: Among the 90 flight cadets who have used methylphenidate, only 2 (2.2%) successfully graduated from the IAF flight academy. Among the 2983 flight cadets who have no history of methylphenidate use, 461 (15.4%) successfully graduated. We found no significant differences in the disqualification causes between the two groups.CONCLUSION: The IAF flight academy graduation rate was meaningfully and significantly lower among cadets who reported previous use of methylphenidate. The study design, however, limits the inference of causal relationship.Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success rates at an air force pilot academy and its relation to methylphenidate use. Aerosp Med Hum Perform. 2019; 90(9):788–791.