FAA Medical Certificates — What’s the Difference Between Them?

One of your first tasks as a new student pilot is to get your first FAA medical exam.

The result of the exam—hopefully—is to be issued an FAA medical certificate. Basically, it’s a certificate that says the doctor found you fit to fly. 

However, there are several different types of FAA medical certificates. What’s the difference, and which one do you need? Here’s a look at the three classes.

What Is an FAA Medical Certificate, and How Do You Get One?

The FAA requires pilots to have regular checkups to ensure that they have no medical issues that might make it dangerous to fly.

If a person is about to have a heart attack, it’s probably best that they don’t have that heart attack while helming a 777 with 300 people onboard, right? 

In addition to the big items like cardiovascular health, the FAA ensures that pilots meet some basic standards. For example, their eyesight must be decent; if not, they must have corrective lenses. 

Everything a doctor looks for during the exam is standardized and part of the FARs (Federal Aviation Regulations). 

To get an FAA medical, you must visit an AME—an Aviation Medical Examiner.

These are doctors trained and approved by the FAA to issue medical certificates. Not every doctor is an AME.

Some general practitioners are also AMEs, while some doctors specialize in aviation medicine only. 

Classes of FAA Medical Certificate and Who They’re For

There are three classes of medicals: third, second, and first. The one you need depends on what type of flying you do. 

Third Class Medical

Third-class medicals are required for pilots exercising the privileges of a Private Pilot certificate.

Third-class medicals are good for either 24 months (if issued after your 40^th birthday) or 60 months (if issued before your 40^th birthday).

The Third Class is the easiest medical, with the most lenient standards. This makes sense because it’s used by pilots flying for fun or pleasure.

Sometimes, you can use your state-issued driver’s license instead of a third-class medical. This applies to Sport and Private Pilots flying under the BasicMed program. 

Second Class Medical

Second-class medicals are required for pilots exercising the privileges of a Commercial Pilot certificate.

Therefore, they’re needed by pilots who work for hire, such as the copilot on a charter flight (Part 135), banner tow pilots, or sightseeing pilots. 

Second-class medicals are good for 24 months. 

First Class Medical

First-class medicals are required for pilots exercising the privileges of an Airline Transport Pilot (ATP) certificate.

They’re required for the captain and first officer on Part 121 airline operations and for the pilot in command of Part 135 charter operations.

The First Class is the most restrictive medical, and therefore the “hardest” one to get.

First Class medicals are good for 12 months if you’re under 40 and six months if you’re over 40.  

Fine-Print Details About Medical Certificates

There are a couple of nuances about medicals that every pilot should know.

First off, the expiration date is based on months, not days. So if you get a medical on the 4^th of May, it will expire on the 31^st of May in 12, 24, or 60 months, depending on the class.

When a First Class expires, it becomes a Second Class and then a Third Class.

This is important to know because the medical certificate is tied to the privileges you are using it for, not the certificate you hold.

Anyone can get a First Class, including Student Pilots. But they aren’t an ATP, so they only need a Third Class.

So, for them, the First Class certificate expires after 12 months, and then it will be good as a Third Class certificate for another 48 months (assuming the student is under 40 years old when they take the medical exam).

For this reason, there’s no expiration date printed on your medical. It’s up to you to know when it expires and which one you need.

Here at Thrust Flight we require all of our Zero Time to Airline students to get a First Class medical before they can enroll in the program. This way they know there isn’t a medical issue that would prevent them from a career as an airline pilot.

What to Expect on Your First FAA Medical Exam

The first step to getting your medical is to find an AME. Some require appointments, while others are “walk-in.” A complete list of AMEs can be found on the FAA’s website. 

If you’re planning a career as an airline pilot, it’s a good idea to apply for a First Class Medical when you go as a Student Pilot. That way, you’ll find out early if you have any medical conditions or history that will need follow-up. 

Next, you’ll fill out the application form on the FAA website, called MedXPress.

This is simply an online version of the form you’d fill out in the office of the AME. Once complete, it goes into the database and can be pulled up at the doctor’s office. 

In many ways, your answers on the form are the most important part of the medical. It’s here that you must disclose any medical history, drug use (prescription or otherwise), and any DUI convictions.

Falsifying the form is grounds for revocation of your FAA certificates, so complete honesty is always the best course of action.

When you show up for your appointment, you’ll be asked for a urine sample, and they will take your vitals, like weight, height, blood pressure, and pulse.

Expect a basic vision checkup, including color blindness screening. It’s a quick and simple medical checkup in most cases.

If you’re over 40 and getting a First Class, expect to take an echocardiogram. Other tests or follow-ups may be required depending on what the doctor finds and your medical history.

In most cases, the exam is done within 15 to 30 minutes. You cannot use medical insurance to pay, and the standard fee is between $100 and $180.

All medical standards and tests you may encounter are published in the FARs. More details can be found on the FAA’s medical certification page.

What Happens if You’re Denied an FAA Medical Certificate?

The actual medical exam at the AME’s office is only one small step of the whole medical process. When things go well, that’s all you’ll have to deal with. You’ll walk out of the appointment with your medical in hand.

But if the doctor finds an issue, there will be follow-up requirements.

What the follow-up actions are will depend entirely on the issue that was found.

Sometimes, it’s a simple matter of getting further records from previous doctors or switching your medications to FAA-approved ones.

Take, for example, color blindness.

Many people (particularly males) are color deficient and never know it until they apply for their medical. If you’re found to be color blind, you may receive a medical with limitations like “NOT VALID FOR NIGHT FLYING OR BY COLOR SIGNAL CONTROL.” 

In many cases, you can follow up if you are denied a medical or have a limitation placed on one.

In some cases, you can apply for a SODA (Statement of Demonstrated Ability), where you prove to the FAA that you’re medically capable of meeting the standards. 

In these cases, dealing with the FAA’s medical system can be a little intimidating. The Aircraft Owners and Pilots Association (AOPA) has medical resources on its website that list common medical issues and FAA procedures. They also help members who need to make follow-ups and appeals.