1.medical-certificates. Medical Certificates
A medical certificate is the FAA's formal verification that a pilot meets the physical and mental standards required to safely exercise the privileges of a pilot certificate. With limited exceptions (sport pilot operations under a U.S. driver's license, glider, and balloon pilots), a medical certificate is required before a student pilot may solo and is required at all times to act as pilot in command (PIC) or as a required flight crewmember.
Three classes of medical certificates are issued by Aviation Medical Examiners (AMEs)—physicians specifically designated by the FAA. Each class corresponds to the privileges being exercised, with the first-class standards being the most stringent and third-class the least.
- First-Class Medical — required for airline transport pilot (ATP) privileges.
- Second-Class Medical — required to exercise commercial pilot privileges (operations for compensation or hire).
- Third-Class Medical — required to exercise private pilot, recreational pilot, and student pilot privileges.
Duration of a medical certificate is governed by 14 CFR 61.23. A medical is valid through the last day of the month it was issued, and durations depend on class and the airman's age at the time of the exam:
- First-class: 12 calendar months for ATP privileges if under age 40; 6 calendar months if age 40 or older. (When used for lower privileges, it then continues per the second- or third-class durations below.)
- Second-class: 12 calendar months for commercial privileges, regardless of age.
- Third-class: 60 calendar months (5 years) if under age 40 at the date of the exam; 24 calendar months if age 40 or older.
When a higher-class medical lapses to its lower-class duration, the lower privileges remain valid until that lower class also expires. For example, a first-class medical issued at age 35 supports ATP privileges for 12 months, then continues to support commercial privileges through 12 months total, and private privileges for 60 months total from the exam month.
Application process. Applicants complete FAA Form 8500-8 through the FAA's MedXPress online system, then visit a designated AME for the physical examination. The exam evaluates:
- Distant, near, and intermediate vision; color vision
- Hearing
- Equilibrium
- Cardiovascular condition (blood pressure; ECG required for first-class at age 35 and annually after age 40)
- Neurological and mental health
- General physical condition, including history of substance dependence or abuse
The AME may issue the certificate on the spot, defer the application to the FAA for further review, or—rarely—deny it. Conditions such as a history of myocardial infarction, diabetes requiring insulin, certain psychiatric diagnoses, epilepsy, and substance dependence historically required deferral; many of these are now eligible for special issuance authorizations under 14 CFR 67.401, which allow medical certification subject to specific monitoring and reporting.
BasicMed. Created by Congress in 2017 and codified in 14 CFR Part 68, BasicMed allows pilots who have held a valid FAA medical certificate any time after July 14, 2006 to fly without obtaining a new FAA medical, provided they:
- Hold a current and valid U.S. driver's license
- Complete a comprehensive medical exam by any state-licensed physician using the FAA Comprehensive Medical Examination Checklist (CMEC) every 48 months
- Complete an FAA-approved BasicMed online medical education course every 24 months
- Comply with operating limitations: aircraft certificated for not more than 6 occupants and a maximum certificated takeoff weight of 6,000 pounds, no more than 5 passengers, altitude not above 18,000 feet MSL, indicated airspeed not exceeding 250 knots, and operations within the United States (unless authorized by the foreign country)
BasicMed cannot be used to exercise ATP privileges or to operate for compensation or hire beyond what 14 CFR 61.113 already permits a private pilot.
Student pilot considerations. Under current rules, a student pilot certificate is issued separately from the medical certificate via FAA Form 8710-1 through IACRA. The medical certificate must be in the pilot's physical possession (or readily accessible in electronic form) along with photo ID and the pilot certificate during all flights as PIC.
Disqualifying conditions and pilot responsibility. 14 CFR 67 lists medical standards. Even with a current medical, a pilot must not act as PIC if they know or have reason to know of any medical condition that would make them unable to meet the standards (14 CFR 61.53). Use of certain medications, recent surgery, or temporary illness can ground a pilot regardless of the certificate's expiration date. The IMSAFE checklist (Illness, Medication, Stress, Alcohol, Fatigue, Emotion) is the standard self-assessment tool taught for go/no-go fitness decisions.
Pilots are also reminded that 14 CFR 91.17 prohibits flight within 8 hours of consuming alcohol, while having a blood alcohol concentration of 0.04% or greater, or while using any drug that affects faculties contrary to safety.