FAA Medical Exam – The Ultimate Guide to Requirements and Classes
Before you can fly solo, earn a private pilot license, or step into the cockpit as a commercial pilot, there’s one thing you absolutely must have: a valid FAA medical exam. This is not just a formality—it’s a legal and safety requirement that proves you’re physically and mentally fit to operate an aircraft under federal aviation rules.
In the U.S., the Federal Aviation Administration (FAA) requires nearly all pilots to pass a medical evaluation conducted by a certified Aviation Medical Examiner (AME). Depending on the type of flying you plan to do—private, commercial, or airline—you’ll need to qualify under one of three medical certificate classes: first, second, or third. Each has different standards and validity periods, and knowing which one you need is essential before starting flight training or scheduling a checkride.
This guide breaks down everything you need to know about the FAA medical exam—from requirements by class and how to prepare, to what disqualifies applicants and what happens if you fail. If you’re serious about becoming a pilot, understanding this step is non-negotiable.
What Is the FAA Medical Exam?
The FAA medical exam is a mandatory health evaluation required by the Federal Aviation Administration for most pilots in the United States. Its purpose is simple but critical: to confirm that you are physically and mentally fit to operate an aircraft safely under all expected conditions.
This exam must be performed by an FAA-certified Aviation Medical Examiner (AME). These doctors are specially trained to evaluate pilots based on medical standards set by the FAA. You can’t just visit any regular doctor for this—only an AME can issue a valid FAA medical certificate.
The exam itself includes a review of your health history, a physical examination, and basic vision and hearing tests. Depending on the certificate class you apply for—first, second, or third class—the medical standards may vary in strictness, especially when it comes to cardiovascular, neurological, or psychiatric conditions.
Whether you’re training for your private pilot license or aiming to fly for an airline, passing the FAA medical exam is the first official step toward becoming a pilot in the U.S.
FAA Medical Certificate Classes Explained
There are three classes of FAA medical certificates. Each one corresponds to the level of flying you plan to do, and each has different requirements and validity periods. Before scheduling your FAA medical exam, you need to know which class applies to your training or license level.
First-Class Medical Certificate
This is the most stringent certificate and is required for pilots operating under an Airline Transport Pilot (ATP) license. It’s valid for 12 months if you’re under 40 and only 6 months if you’re 40 or older. First-class applicants must meet higher cardiovascular and vision standards than other classes.
Second-Class Medical Certificate
If you’re training to become a commercial pilot, this is the certificate you need. It’s valid for 12 months regardless of age. While less strict than first-class, it still requires strong physical health and mental stability.
Third-Class Medical Certificate
This is the entry-level certificate, typically required for private pilots and student pilots. It’s the easiest to qualify for and is valid for up to 60 months if you’re under 40, or 24 months if you’re 40 or older. It covers basic health, vision, and hearing standards.
Each class of certificate follows the same FAA medical exam process, but the standards vary depending on the license you’re pursuing.
FAA Medical Exam Requirements
To pass the FAA medical exam, you must meet specific health standards related to vision, hearing, cardiovascular function, and overall physical and mental health. These requirements ensure you can safely operate an aircraft without putting yourself or others at risk.
Vision is one of the most critical areas. You must have 20/20 distant and near vision, either naturally or with correction (glasses or contact lenses). Color vision and depth perception are also tested to ensure you can read instruments and identify lights in flight.
Hearing must be good enough to understand a normal spoken conversation at six feet. You’ll also be tested for inner-ear balance issues or any history of hearing loss.
Blood pressure must be below 155/95 at the time of your exam. While some medications are allowed, uncontrolled hypertension can lead to deferral.
Neurological and psychiatric health are also evaluated. If you’ve experienced conditions like depression, anxiety, or head trauma, you’ll need to provide documentation and, in some cases, further testing.
Substance use and current medication lists are reviewed in detail. Any history of substance abuse, DUIs, or use of disqualifying medications must be fully disclosed before the FAA medical exam.
Meeting these baseline health requirements is essential. If something falls outside FAA limits, you may still qualify through a Special Issuance—but only with additional documentation and review.
Common Disqualifying Conditions
Not everyone passes the FAA medical exam on the first try. Some medical conditions are considered high-risk for flight safety and can result in automatic deferral or denial—unless you’re granted a Special Issuance Authorization from the FAA.
One major disqualifier is uncontrolled epilepsy or seizure disorders. These conditions pose a direct threat to pilot control in flight. Even a history of seizures may require years of documented stability before medical clearance is possible.
Severe psychiatric disorders like schizophrenia, bipolar disorder, and major depression with suicidal history are also disqualifying. The FAA requires extensive mental health evaluation for any pilot with a history of psychiatric care.
Insulin-dependent diabetes, if not well-controlled, can lead to disqualification. However, pilots with stable blood sugar levels and proper documentation may qualify through special issuance.
Other disqualifiers include:
- Substance abuse
- Active addiction
- Vision problems
that are not correctable to FAA standards. Failing to disclose these conditions—intentionally or by accident—can delay your pilot career or lead to a permanent ban.
Knowing these red flags before your FAA medical exam can help you prepare the right paperwork and avoid unnecessary setbacks.
How to Prepare for the FAA Medical Exam
Proper preparation can make the difference between passing and facing delays. The FAA medical exam isn’t difficult for healthy individuals, but being organized ensures a smooth process—especially if you have any medical history to disclose.
Start by completing the MedXPress application online. This is the FAA’s official form where you’ll enter your full medical history, including past surgeries, medications, mental health treatments, and substance use. Be honest and thorough—omissions can cause delays or lead to FAA investigation later.
Bring all relevant documents to your exam. If you take prescription medications, bring a current list from your doctor. If you’ve had any condition that required hospitalization, bring discharge summaries or a letter from your physician explaining your current health status.
In the days before your exam, avoid alcohol, get proper sleep, and limit caffeine if you have concerns about elevated blood pressure. Show up well-rested and prepared to answer follow-up questions from the Aviation Medical Examiner (AME).
Taking these steps shows you’re serious about your fitness to fly—and it helps the AME issue your certificate without delay.
What Happens During the Exam?
The FAA medical exam typically takes 30–60 minutes and follows a structured process. Once you’ve completed and submitted your MedXPress form online, you’ll bring the confirmation number to your appointment with an FAA-certified Aviation Medical Examiner (AME).
The exam begins with a review of your medical history, including medications, past conditions, and any relevant treatments. The AME will compare your MedXPress entries to your verbal answers—so consistency is key.
Next, the examiner will check your vitals, including blood pressure, heart rate, and pulse. Your vision and hearing will be tested using standard charts and audio screenings. A urine test is usually conducted to check for signs of diabetes, kidney issues, or hidden conditions—not drugs.
You’ll then go through a physical exam covering neurological reflexes, coordination, heart and lung function, and overall physical appearance. If you’re applying for a first-class certificate, expect a closer look at cardiovascular health and possibly an EKG (especially if you’re over 40).
At the end, the AME will either issue your certificate on the spot or defer the application to the FAA for further review. If deferred, you may be asked to submit supporting medical records or see a specialist before a decision is made.
The entire FAA medical exam process is designed to verify that you’re safe to fly—not to disqualify healthy applicants. Preparation and honesty go a long way.
How Long Is Each FAA Medical Certificate Valid?
The validity of your medical certificate depends on two things: the class of certificate you hold and your age at the time of the exam. These timelines affect how often you’ll need to renew and retake the FAA medical exam to stay legal and current as a pilot.
For younger pilots, certificates generally last longer. However, the FAA shortens validity periods as you age to ensure ongoing medical fitness—especially for those flying commercially or under an airline transport pilot (ATP) certificate.
Here’s a quick breakdown of how long each certificate remains valid:
| Certificate Class | Under Age 40 | Age 40 and Over |
|---|---|---|
| First-Class | 12 months | 6 months |
| Second-Class | 12 months | 12 months |
| Third-Class | 60 months | 24 months |
If your certificate “expires,” you don’t lose your pilot license—but you can no longer exercise the privileges tied to that medical class. For example, if your first-class certificate lapses, you may still operate under second- or third-class privileges if the certificate is still valid for those categories.
Knowing your expiration timeline helps you plan ahead and avoid disruptions to your flight training, checkrides, or employment.
How to Find an FAA Aviation Medical Examiner (AME)
You can’t take the FAA medical exam with just any doctor—it must be done by an FAA-authorized Aviation Medical Examiner (AME). These professionals are trained to evaluate pilots based on FAA medical standards and are the only ones permitted to issue valid FAA medical certificates.
The easiest way to find one is by using the FAA’s official AME locator tool. You can search by zip code, city, or state to find certified examiners near you.
When choosing an AME, look for someone who regularly works with pilots, especially if you have a complex medical history. Some examiners are more experienced with first-time applicants, Special Issuance cases, or pilots on medications. Reading reviews or asking your flight school for recommendations can help you choose wisely.
Once you’ve selected an AME, contact them directly to schedule your FAA medical exam and ask what documentation you need to bring. Some clinics allow you to complete the MedXPress portion ahead of time; others may assist you on-site.
Choosing the right AME can make the difference between a fast approval and a frustrating delay—so take your time and pick someone who understands pilot needs.
What If You Fail the FAA Medical Exam?
Failing the FAA medical exam doesn’t necessarily mean the end of your pilot dreams. In many cases, a failed or deferred application can be resolved with additional paperwork, medical tests, or a process called Special Issuance.
If your Aviation Medical Examiner (AME) finds something outside the FAA’s medical standards—such as high blood pressure, a history of mental illness, or unreported medication—they may defer your application to the FAA. This means your case will be reviewed in more detail by the FAA’s medical certification team.
You may be asked to submit additional records, undergo specialist evaluations, or provide a detailed explanation of your condition. If approved, the FAA may issue a Special Issuance medical certificate, which comes with specific limitations or renewal conditions.
In other cases, you might be denied outright. If that happens, you can request reconsideration, appeal the decision, or wait to reapply after resolving the disqualifying condition.
The key is transparency. If you disclose everything honestly during your FAA medical exam and follow through with any extra steps requested, you’ll stand a much better chance of earning your certificate—even if it takes longer than expected.
How Much Does the FAA Medical Exam Cost?
The FAA medical exam isn’t free—it’s a private service provided by Aviation Medical Examiners (AMEs), and fees can vary depending on location, exam class, and complexity.
For most applicants, the typical cost ranges are:
- First-Class Certificate: $150 – $250
- Second-Class Certificate: $125 – $200
- Third-Class Certificate: $75 – $150
These prices include the full physical exam, vision and hearing tests, urinalysis, and issuance of the medical certificate—if approved. However, if your exam requires additional review or tests (such as an EKG for first-class over age 40), the price may be higher.
Keep in mind, these exams are not covered by insurance, since they are considered aviation-specific and non-medically necessary. You’ll pay the AME directly, and pricing is usually posted on their website or provided when you call to book.
While the FAA medical exam itself is relatively affordable, it’s smart to plan ahead—especially if you’re training on a tight budget.
Conclusion – Be Prepared, Pass Confidently
The FAA medical exam is one of the first and most important milestones on your journey to becoming a pilot. Whether you’re training for a private license, flying commercially, or aiming for the airlines, passing this exam is non-negotiable—and entirely within your control if you prepare properly.
By understanding the certificate classes, meeting the medical requirements, and choosing the right Aviation Medical Examiner, you can avoid delays and move forward confidently. Even if you face a disqualifying condition, there are still pathways through Special Issuance and FAA review.
Your pilot career begins with your health—and the FAA medical exam is where it all starts. Show up informed, prepared, and ready to prove you’re fit to fly.
Contact the Florida Flyers Flight Academy Team today at (904) 209-3510 to learn more about how to transfer flight schools.
