Medical Certificate

Introduction:

  • Medical certificates aeromedically qualify aviation professionals to conduct their roles in the aviation system safely
  • Pilots must therefore meet medical certificate class requirements
  • Pilots must then apply for/renew a medical certificate on a prescribed interval, based on the duration of medical certificate validity
  • All pilots must meet medical certificate standards, and with some exceptions, possess a valid medical certificate to exercise the privileges of their airman certificates
  • Initial, and periodic medical examinations thereafter, are conducted by designated Aviation Medical Examiners, who are physicians with a special interest in aviation safety and training in aviation medicine
  • Anyone who meets the medical standards in this part (part 67) based on medical examination and evaluation of the person's history and condition is entitled to an appropriate medical certificate
  • For certain pilots who qualify, relief from medical requirements is available through the BasicMed program
  • While not subject to the medical certificate process, even Small Unmanned Aircraft Systems must be mindful of any medical considerations
  • Think you've got a solid understanding of medical certificate? Don't miss the medical certificate quiz below, and topic summary

WARNING:
All aeromedical topics are GENERALIZED.
Always consult with a doctor or physician to understand your specific situation

Medical Certificate Class Requirements:

  • First-Class Medical Certificate:

    • A first-class medical certificate is required when exercising the privileges of an airline transport pilot certificate;
    • If that person has reached his or her 60th birthday and serves as a pilot in 14 Code of Federal Regulations (CFR) part 121 operations
      • Notwithstanding the provisions of Sec. 61.23(d)(1)(iii), that person's first-class medical certificate expires, for 14 CFR part 121 operations, at the end of the last day of the 6th month after the month of the date of examination shown on the medical certificate

  • Second-Class Medical Certificate:

    • A second-class medical certificate is required when exercising the privileges of a commercial certificate
    • Flight instruction medical requirements comes with additional nuance, explained below

  • Third-Class Medical Certificate:

    • A third-class medical certificate is required:
      • When exercising the privileges of a private pilot certificate;
      • When exercising the privileges of a recreational pilot certificate;
      • When exercising the privileges of a student pilot certificate;
      • When exercising the privileges of a flight instructor certificate and acting as the pilot in command;
      • When exercising the privileges of a flight instructor certificate and serving as a required pilot flight crewmember;
        • Note that a flight instructor may not be considered as acting as the PIC nor a required crewmember if the student is appropriately rated, meaning in that instance, a medical certificate is not required
      • When taking a practical test in an aircraft for a recreational pilot, private pilot, commercial pilot, or airline transport pilot certificate, or a flight instructor certificate;
      • When performing the duties as an Examiner in an aircraft when administering a practical test or proficiency check for an airman certificate, rating, or authorization

Medical Certificate Application:

  • To apply for a medical, you must schedule an appointment with an Aviation Medical Examiner (AME) and been examined per Part 183
  • An applicant may search for an AME online or by contacting the Manager of the Aerospace Medical Education Division, P.O. Box 26200, Oklahoma City, Oklahoma 73125
  • Before your appointment with your AME, go online to FAA MedXPress at https://medxpress.faa.gov/ and electronically complete FAA Form 8500-8
    • Information entered into MedXPress will be available to your AME to review before and at the time of your medical examination, if you provide a confirmation number
  • Must show proof of age and identity by presenting government-issued photo identification (drivers license, military ID, passport)
    • If an applicant does not have government-issued identification, he or she may use non-photo, government-issued identification (such as a birth certificate or voter registration card) in conjunction with photo identification (such as a work identification card or a student identification card)
  • Each person who applies for a medical certificate shall execute an express consent form authorizing the Administrator to request information contained in the National Driver Register about the person to the Administrator
  • The administrator shall make information received from the National Driver Register, if any, available on request to the person for review and written comment
  • Any AME may grant a second or third class medical, but only those AMEs specifically designated may grant first class

Duration of a Medical Certificate:

  • No matter how long you have a medical certificate, it never changes class, but the privileges which you can execute your license may

  • First-Class Medical Certificate Duration:

    • 40 or older: 6th month after the month of the date of examination shown on the medical certificate before you can only execute the privileges of a Second-Class for the remaining six-months and then drop to the privileges of a Third-Class
    • Under 40: 12th month after the month of the date of examination shown on the medical certificate before you can only execute the privileges of a Third-Class

  • Second-Class Medical Certificate Duration:

    • Valid for the same as a third-class (see above); however, you can only execute the privileges of a Second Class for 12 months after the month of the date of the examination shown on the medical certificate

  • Third-Class Medical Certificate Duration:

    • 40 or older: 24th month after the month of the date of examination shown on the medical certificate (2 years)
      • Note that a medical exam taken before 40 is good for 60 months, even if taken at age 39
      • It is not until the pilot takes an exam at or greater than than 40 that the 24 month limitation applies
    • Under 40: 60th month after the month of the date of examination shown on the medical certificate (5 years)

Medical Certificate Standards:

  • Distant Vision:

    • 20/20 or better in each eye separately, with or without correction (First/Second)
    • 20/40 or better in each eye separately, with or without correction (Third)

  • Near Vision:

    • 20/40 or better in each eye separately (Snellen equivalent), with or without correction, as measured at 16 inches

  • Color Vision:

    • Ability to perceive those colors necessary for the safe performance of airman duties

  • Hearing:

    • Demonstrate hearing of an average conversational voice in a quiet room, using both ears at 6 feet, with the back turned to the examiner or pass one of the audiometric tests below

  • Audiology:

    • Audiometric speech discrimination test: Score at least 70% reception in one ear.Pure tone audiometric test. Unaided, with thresholds no worse than:
      500 Hz
      1,000 Hz
      2,000 Hz
      3,000 Hz
      Better Ear(Db)
      35
      30
      30
      40
      Poorer Ear (Db)
      35
      50
      50
      60

  • Ear, Nose, Throat:

    • No ear disease or condition manifested by, or that may reasonably be expected to maintained by, vertigo or a disturbance of speech or equilibrium

  • Pulse:

    • Not disqualifying per se. Used to determine cardiac system status and responsiveness

  • Blood Pressure:

    • The current guideline maximum value is 155/95

  • Electro-Cardiogram:

    • An Electro-Cardiogram, or EKG, is required at age 35 and annually after age 40 (not generally required for third-class)

  • Mental:

    • No diagnosis of psychosis, or bipolar disorder, or severe personality disorders

  • Substance Dependence & Substance Abuse:

    • A diagnosis or medical history of substance dependence is disqualifying unless there is established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding two-years. A history of substance abuse within the preceding two-years is disqualifying. Substance includes alcohol and other drugs (i.e., PCP, sedatives and hypnotics, anxiolytics, marijuana, cocaine, opioids, amphetamines, hallucinogens, and other psychoactive drugs or chemicals)

  • Disqualifying Conditions:

    • Unless otherwise directed by the FAA, the Examiner must deny or defer if the applicant has a history of:
      1. Diabetes mellitus requiring hypoglycemic medication;
      2. Angina pectoris;
      3. Treated coronary heart disease or, if untreated, that has been symptomatic or clinically significant;
      4. Myocardial infarction;
      5. Cardiac valve replacement;
      6. Permanent cardiac pacemaker;
      7. Heart replacement;
      8. Psychosis;
      9. Bipolar disorder;
      10. A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
      11. Substance dependence;
      12. Substance abuse;
      13. Epilepsy;
      14. Disturbance of consciousness and without satisfactory explanation of cause, and
      15. Transient loss of control of nervous system function(s) without satisfactory explanation of cause

Medical Certificate Exceptions:

  • A medical certificate is not required when:
    • When exercising the privileges of a student pilot certificate while seeking:
      • A sport pilot certificate with glider or balloon privileges;
      • A pilot certificate with a glider category rating or balloon class rating;
    • When exercising the privileges of a sport pilot certificate with privileges in a glider or balloon;
    • When exercising the privileges of a pilot certificate with a glider category rating or balloon class rating in a glider or a balloon, as appropriate;
    • When exercising the privileges of a flight instructor certificate with:
      • A sport pilot rating in a glider or balloon;
      • A glider category rating;
    • When exercising the privileges of a flight instructor certificate, if the person is not acting as pilot in command or serving as a required pilot flight crewmember;
    • When exercising the privileges of a ground instructor certificate;
    • When serving as an Examiner or check airman and administering a practical test or proficiency check for an airman certificate, rating, or authorization conducted in a glider, balloon, flight simulator, or flight training device;
    • When taking a practical test or a proficiency check for a certificate, rating, authorization, or operating privilege conducted in a glider, balloon, flight simulator, or flight training device; or
    • When a military pilot of the U.S. Armed Forces can show evidence of an up-to-date medical examination authorizing pilot flight status issued by the U.S. Armed Forces and:
      • The flight does not require higher than a third-class medical certificate;
      • The flight conducted is a domestic flight operation within U.S. Airspace
  • A person must hold and possess either a medical certificate issued under part 67 of this chapter or a U.S. driver's license when:
    • Exercising the privileges of a student pilot certificate while seeking sport pilot privileges in a light-sport aircraft other than a glider or balloon;
    • Exercising the privileges of a sport pilot certificate in a light-sport aircraft other than a glider or balloon;
    • Exercising the privileges of a flight instructor certificate with a sport pilot rating while acting as pilot in command or serving as a required flight crewmember of a light-sport aircraft other than a glider or balloon;
    • Serving as an Examiner and administering a practical test for the issuance of a sport pilot certificate in a light-sport aircraft other than a glider or balloon

  • Operations that require a medical certificate:

    • No person who holds a medical certificate issued under part 67 may act as pilot in command, or any other capacity as a required pilot flight crewmember, while that person:
      • Knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation; or
      • Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation

  • Operations that do not require a medical certificate:

    • A person shall not act as pilot in command or any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner

BasicMed:

  • Pilot Requirements:

    • Must hold a valid U.S. driver's license, comply with any restrictions, and consent to a National Driver Register check;
    • Have held a valid FAA medical certificate, regular or special issuance, on or after July 15, 2006; and not had their most recent medical revoked, suspended, or withdrawn, or most recent application denied
    • Pilots with a medical history or diagnosis of certain cardiac, neurological, or mental health conditions will need a one-time-only special issuance for each condition
    • Get a physical exam with a state-licensed physician (every four years (48 calendar months)), using the Comprehensive Medical Examination Checklist (CMEC)
    • Complete a BasicMed medical education course (within the past 24 calendar months):

  • Aircraft Requirements:

    • Any aircraft authorized under federal law to carry not more than six-occupants
    • Has a maximum certificated takeoff weight of not more than 6,000 pounds (no limitations on horsepower, number of engines, or gear type)

  • Operating Requirements:

    • Carries not more than five passengers Operates under Visual Flight Rules or Instrument Flight Rules, within the United States (unless authorized), at less than 18,000 feet Mean Sea Level, not exceeding 250 knots
    • Flight not operated for compensation or hire
    • Geographic Limitation: Within the United States (unless authorized)

  • Required Documents:

    • Pilots must have two documents "available:"
      • BasicMed course completion certificate, and;
      • CMEC
      • U.S. Drivers License
    • AOPA goes on to say: "While the medical course certificate and the CMEC must be in your logbook, only certain pilots need to carry their logbook while flying. If you hold a private pilot or higher certificate, you need not carry your logbook onboard an aircraft in most circumstances; so, if you are not carrying your logbook, there is no need to carry the BasicMed documents"
    • You can learn more from the AOPA's Pilot Protection Services at https://pilot-protection-services.aopa.org/news/2021/july/01/basicmed-documents
  • FAA guidance: https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/
  • A list of frequency asked questions may be found at: https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/media/basicmed_faq.pdf

Small UAS Medical Considerations:

  • No person may manipulate the flight controls of a small unmanned aircraft system or act as a remote pilot in command, visual observer, or direct participant in the operation of the small unmanned aircraft if he or she knows or has reason to know that he or she has a physical or mental condition that would interfere with the safe operation of the small unmanned aircraft system
  • Essentially, FAR 107.17 states that the burden of medical certification or assessment of medical fitness falls entirely on the pilot. Reference manned Requirements for fitness and emphasize see-and-avoid

Medical Certificate Knowledge Quiz:

Conclusion:

  • Pilots who do not meet medical standards may qualify under special issuance provisions or the exemption process
    • This may require additional medical information or practical flight tests
  • Student pilots should visit an Aviation Medical Examiner as soon as possible in their flight training to avoid unnecessary training expenses should they not meet the medical standards
    • For the same reason, the student pilot who plans to enter commercial aviation should apply for the highest class of medical certificate that might be necessary
  • The CFRs prohibit a pilot who possesses a current medical certificate from performing crewmember duties while the pilot has a known medical condition or increase of a known medical condition that would make the pilot unable to meet the standards for the medical certificate
  • Note that a medical certificate is one of the required documents, if your operation requires one, to comply with Federal Aviation Regulation 61.3
  • Remember your medical readiness is not just at the time of your exam but before each flight
  • Over the counter medications can also disqualify you from flight
  • Remember, the CFRs prohibit a pilot who possesses a current medical certificate from performing crewmember duties while the pilot has a known medical condition or increase of a known medical condition that would make the pilot unable to meet standards
  • You can find more about how medication impacts your ability to fly by visiting the FAA's Pilot Information - Over-the-Counter Medications
  • Have a disability you're worried about disqualifying you from flight? AMEs may petition the Federal Air Surgeon for a Statement of Demonstrated Ability (SODA)
  • If you are worried about taking your medical, especially your first, check out the AOPA's medical certificate guidance
  • If a medical certificate is issued with limitations (such as wearing glasses), those limitations must be followed
  • Those applying for a medical certificate can track its status on the FAA's MedXPress page
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