A doctor who decides whether a pilot is fit to hold a licence.

An AME is a qualified physician with additional aviation medicine training and a delegation from the regulator. The examination is not a general check-up: it is a specific assessment against a published standard, covering vision, hearing, cardiovascular health, medication and mental health. The finding can end a career, which is why the standards and the appeal routes are written down.
Qualify and practise as a doctor first. Aviation medicine is a designation added afterwards, not a separate degree.
Physicians and surgeons · US Bureau of Labor Statistics, Occupational Outlook Handbook, May 2024 wages and 2024–34 projections.
An AME is a physician first; the designation is added afterwards and is not a separate occupation. These are the figures for physicians and surgeons as a whole.
Your finding can end somebody’s career in a ten-minute appointment, and they know it when they walk in. That changes the consultation: people minimise, and part of the skill is noticing. The standards move as the evidence does, and keeping current is on you.