Medical Certificate

Medical certificates aeromedically qualify aviation professionals to conduct their roles in the aviation system safely.

Medical Certificate

Introduction to Medical Certificate

  • Medical certificates aeromedically qualify aviation professionals to conduct their roles in the aviation system safely.
  • Based on the operation, pilots require a specific medical certificate class.
  • Pilots must then apply for/renew a medical certificate at a prescribed interval based on the duration of the medical certificate.
  • All pilots must meet medical certificate standards and, with some exceptions, possess a valid medical certificate to exercise the privileges of their airman certificates.
  • Under 14 CFR § 61.3(c), a required pilot flight crewmember generally must hold the appropriate medical certificate issued under part 67, or other medical-qualification documentation acceptable to the FAA, and keep it in physical possession or readily accessible in the aircraft. The exceptions in § 61.3(c)(2) include qualifying operations conducted under alternatives such as sport-pilot medical eligibility and BasicMed.
  • 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 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.
  • Test your understanding of Medical Certificate by completing the knowledge quiz, applying your knowledge in the interactive scenario, comparing your performance against the applicable Airman Certification Standards, and concluding with the topic summary to reinforce the key concepts before moving on to the next lesson.

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

    Medical Certificate Key Highlights

    • Medical certificates verify that pilots meet established medical standards required for specific aviation operations.
    • The Federal Aviation Administration (FAA) issues first-class, second-class, and third-class medical certificates with different privileges and duration requirements.
    • First-class medical certificates are generally required for airline transport pilot operations and commercial airline employment.
    • Second-class medical certificates are typically required for commercial pilot operations conducted for compensation or hire.
    • Third-class medical certificates are commonly used for private pilot and recreational flight operations.
    • BasicMed provides an alternative medical qualification pathway for eligible pilots operating certain aircraft and missions.
    • Pilots must disclose medical history, medications, and health conditions accurately during the medical certification process.
    • Certain medical conditions, medications, or physiological impairments may require special issuance authorization from the FAA.
    • Pilots are responsible for determining fitness for flight regardless of possessing a valid medical certificate.
    • Understanding medical certification requirements supports regulatory compliance, aeronautical decision-making, and overall aviation safety.
    Medical Certificate

    Medical Certificate Requirements

    • First-Class Medical Certificate:

      • A first-class medical certificate is required when exercising pilot-in-command privileges of an airline transport pilot certificate and for the other operations specified in 14 CFR § 61.23(a)(1).
      • A first-class medical certificate is also required when a person who has reached his or her 60th birthday serves as a required pilot flightcrew member in a 14 CFR part 121 operation.
        • 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:

      • At least a second-class medical certificate is generally required when exercising commercial pilot privileges in an aircraft other than a balloon or glider. Section 61.23 contains additional provisions for commercial balloon operations.
      • Flight instruction medical requirements come 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 if the student is appropriately rated, the flight instructor is not acting as the PIC or a required crewmember, so 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

    Medical Certificate Application

    • To apply for a medical certificate, you must schedule an appointment with an Aviation Medical Examiner (AME) and undergo an examination in accordance with 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.
      • Before the examination, review the FAA Guide for Aviation Medical Examiners for any condition reported on the application and bring the supporting medical records, status reports, test results, or other documentation the FAA may require; complete documentation may allow the AME to upload the records immediately and can substantially reduce delays if the application is deferred.
    • Must show proof of age and identity by presenting government-issued photo identification (driver's license, military ID, passport).
      • Suppose an applicant does not have government-issued identification. In that case, they 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 must execute an express consent form authorizing the Administrator to request information contained in the National Driver Register about the person.
    • The Administrator shall make available, upon request, to the person any information received from the National Driver Register for review and written comment.
    • Any AME may grant a second or third class medical, but only those AMEs specifically designated may grant a first class medical.
    Medical Certificate

    Duration of a Medical Certificate

    • No matter how long you hold a medical certificate, it never changes your class, but the privileges that you can exercise with your license may.

    • First-Class Medical Certificate Duration:

      • Age 40 or older on the examination date: The certificate expires for operations requiring a first-class medical at the end of the last day of the 6th month after the examination month. It remains a first-class certificate, but may continue to satisfy operations requiring a second-class medical through the 12th month and a third-class medical through the 24th month.
      • Under age 40 on the examination date: The certificate expires for operations requiring a first-class or second-class medical at the end of the last day of the 12th month after the examination month. It remains a first-class certificate, but may continue to satisfy operations requiring a third-class medical through the 60th month.

    • Second-Class Medical Certificate Duration:

      • At any age, the certificate expires for operations requiring a second-class medical at the end of the last day of the 12th month after the examination month. It remains a second-class certificate, but may continue to satisfy operations requiring a third-class medical through the 60th month when examined under age 40 or the 24th month when examined at age 40 or older.

    • Third-Class Medical Certificate Duration:

      • Age 40 or older on the examination date: The certificate expires for an operation requiring a third-class medical at the end of the last day of the 24th month after the examination month.
        • Note that if you take a medical exam before turning 40, it remains valid for 60 months, even if you take it at age 39.
        • It is not until the pilot takes an exam at or greater than 40 that the 24-month limitation applies.
      • Under age 40 on the examination date: The certificate expires for an operation requiring a third-class medical at the end of the last day of the 60th month after the examination month.
      • Calendar-month examples:
        • An examination on May 12, 2026, while under age 40 supports an operation requiring a third-class medical through May 31, 2031. Turning 40 after the examination does not shorten that period.
        • An examination on May 12, 2026, at age 40 or older supports that operation through May 31, 2028.
        • A second-class certificate issued after a May 12, 2026, examination at age 45 ceases to satisfy an operation requiring a second-class medical after May 31, 2027, but may satisfy an operation requiring a third-class medical through May 31, 2028. The certificate itself remains second class.
    Medical Certificate

    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 expected to be 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.

    • ElectroCardiogram:

      • An Electrocardiogram, or EKG, is required at age 35 and annually thereafter at age 40 (not generally needed for third-class certification).

    • Mental:

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

    • Substance Dependence & Substance Abuse:

      • A diagnosis or medical history of substance dependence disqualifies a pilot unless clinical evidence, satisfactory to the Federal Air Surgeon, shows recovery with at least two years of sustained total abstinence.
      • A history of substance abuse within the past two years also disqualifies a pilot.
      • Substances include alcohol and other drugs, such as PCP, sedatives, hypnotics, anxiolytics, marijuana, cocaine, opioids, amphetamines, hallucinogens, and other psychoactive 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 without a satisfactory explanation of the cause, and;
        15. Transient loss of control of nervous system function(s) without satisfactory explanation of cause.
    Medical Certificate

    Medical Certificate Exception

    • 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 a 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 an aircraft meeting the performance limits and design requirements of § 61.316 other than a glider or balloon;
      • Exercising the privileges of a sport pilot certificate in an aircraft meeting the performance limits and design requirements of § 61.316 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 an aircraft meeting the performance limits and design requirements of § 61.316 other than a glider or balloon.
      • Serving as an Examiner and administering a practical test for the issuance of a sport pilot certificate in an aircraft meeting the performance limits and design requirements of § 61.316 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 may not act as pilot in command or in any other capacity as a required pilot flight crewmember while that person knows or has reason to know of a medical condition that would make the person unable to operate the aircraft safely.
    Medical Certificate

    BasicMed

    • A Guide to Understanding BasicMed – Brought to you by AOPA

    • 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):
      • AOPA further offers a BasicMed process.

    • Aircraft Requirements:

      • Any aircraft authorized under federal law to carry not more than seven occupants.
      • Has a maximum certificated takeoff weight of not more than 12,500 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.
        • \t\t\t\t\t\t\t\t\t\t
      • An eligible applicant may use BasicMed during an in-aircraft practical test for a recreational, private, commercial, or ATP certificate, or a flight instructor certificate, when the operation complies with FAR 61.113(i) [FAR 61.23(a)(3)(iii)].
      • Geographic Limitation: Within the United States (unless authorized).

    • Required Documents:

      • Pilots must have two documents "available:"
        • BasicMed course completion certificate.
        • CMEC.
        • U.S. Driver's 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.
    • See also: the basics of BasicMed.
    • FAA guidance: https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/.
    • A list of frequently asked questions is at: https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/media/basicmed_faq.pdf.
    Medical Certificate

    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 they know or have reason to know that they have 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 pilot bears the burden of providing medical certification or assessing their own medical fitness. Reference manned Requirements for fitness and emphasize see-and-avoid.
    Medical Certificate

    Medical Certificate Interactive Scenario

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    Medical Certificate

    Medical Certificate Knowledge Check

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    Core Knowledge Review

    Review foundational knowledge, key concepts, and practical considerations. Topic: Medical Certificate.

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    Medical Certificate

    Medical Certificate Conclusion

    • Pilots who do not meet medical standards may qualify under special issuance provisions or the exemption process.
      • Special issuance 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.
      • In contrast, the pilot has a known medical condition or an exacerbation of a previously known medical condition that would render 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.
      • In contrast, the pilot has a known medical condition or an exacerbation of a pre-existing medical condition that would render the pilot unable to meet the 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 includes limitations (such as wearing glasses), the pilot must strictly follow them.
    • Those applying for a medical certificate can track its status on the FAA's MedXPress page.
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    Medical Certificate

    Medical Certificate References