FAA Medical Certificate: Classes, Requirements, and BasicMed Explained

OVERVIEW OF FAA MEDICAL CERTIFICATES

Every pilot who exercises the privileges of a pilot certificate in the United States must hold a valid medical certificate or qualify under BasicMed. The Federal Aviation Administration issues three classes of medical certificates, each corresponding to different pilot privileges and operational requirements. The regulations governing medical certification are found primarily in FAR Part 67.

THE THREE CLASSES OF MEDICAL CERTIFICATES

THIRD-CLASS MEDICAL CERTIFICATE

The third-class medical is required for student pilots, recreational pilots, and private pilots. It permits all operations that do not require a higher class of medical. The standards are the least restrictive of the three classes. • Vision: 20/40 or better in each eye, with or without correction. Near vision of 20/40 at 16 inches. • Hearing: Ability to hear a conversational voice at 6 feet or pass an audiometric test • Blood pressure: No specific numerical limit, but must not have uncontrolled hypertension • Duration: 60 calendar months for pilots under age 40; 24 calendar months for pilots age 40 and over

SECOND-CLASS MEDICAL CERTIFICATE

A second-class medical is required for commercial pilots operating under Part 91 or Part 135. The vision and cardiovascular standards are somewhat more stringent than third-class requirements. • Vision: 20/20 or better in each eye, with or without correction. Near vision of 20/40 at 16 inches. • Duration: 12 calendar months for second-class privileges; reverts to third-class privileges after that period

FIRST-CLASS MEDICAL CERTIFICATE

The first-class medical is required for Airline Transport Pilot (ATP) operations. It carries the most rigorous standards, including an electrocardiogram (EKG) requirement beginning at age 35. • Vision: 20/20 or better in each eye, with or without correction • EKG: Required at first application after age 35, then annually after age 40 • Duration: 12 calendar months for pilots under age 40; 6 calendar months for pilots age 40 and over (for first-class privileges)

THE AVIATION MEDICAL EXAM

Medical examinations are conducted by Aviation Medical Examiners (AMEs), physicians designated by the FAA. Before the appointment, applicants must complete the MedXPress application (FAA Form 8500-8) online at medxpress.faa.gov.

WHAT THE EXAM INCLUDES

• Review of medical history and medications • Vision testing (distance, near, color) • Hearing test • Blood pressure and pulse measurement • Urinalysis • General physical examination (heart, lungs, abdomen, spine, extremities, neurological) • EKG for first-class applicants meeting age thresholds

COMMON DISQUALIFYING CONDITIONS

Certain conditions require special review or may result in denial. These include: • Epilepsy or seizure disorder • Insulin-dependent diabetes (Type 1) — though special issuance is now possible under certain protocols • Bipolar disorder or psychosis • Substance dependence (alcohol or drugs) • Coronary artery disease requiring surgery or stenting • Use of certain medications (most psychoactive drugs, sedatives, narcotics)

Many of these conditions may be approved through the Special Issuance process (FAR 67.401), where the FAA grants a medical certificate with specific conditions after reviewing additional documentation from treating physicians.

BASICMED: THE ALTERNATIVE TO TRADITIONAL MEDICAL CERTIFICATION

Introduced in 2017, BasicMed allows pilots to fly without holding a traditional FAA medical certificate, provided certain conditions are met. The program was established under Public Law 114-190, Section 2307.

BASICMED ELIGIBILITY

• Must have held a valid FAA medical certificate at any time after July 15, 2006 • That medical must not have been revoked, suspended, or withdrawn • Must not have been denied a most recent medical application

BASICMED REQUIREMENTS

• Physical examination: Completed by any state-licensed physician (not necessarily an AME) using the BasicMed Comprehensive Medical Examination Checklist (CMEC) every 48 months • Online medical education course: Completed every 24 months through an FAA-approved provider such as AOPA

BASICMED OPERATING LIMITATIONS

Pilots flying under BasicMed are subject to several restrictions: • Aircraft must have a maximum certificated takeoff weight of 6,000 pounds or less • Maximum of 6 occupants (including the pilot) • Flights must be conducted within the United States at altitudes below 18,000 feet MSL • Maximum indicated airspeed of 250 knots • Pilot may not fly for compensation or hire

SPECIAL ISSUANCE MEDICAL CERTIFICATES

When a pilot has a condition that does not meet regular medical standards, the FAA may issue a Special Issuance (SI) authorization. This process involves submitting medical records, test results, and physician statements to the FAA Aerospace Medical Certification Division (AMCD) in Oklahoma City.

Common conditions approved under Special Issuance include controlled hypertension, treated depression (using approved SSRI medications), diabetes managed with oral medications, and certain cardiac conditions following successful treatment. Processing times vary from weeks to several months.

TIPS FOR A SMOOTH MEDICAL CERTIFICATION PROCESS

• Complete the MedXPress form carefully and honestly. Omissions or false statements can result in certificate revocation and legal consequences under 18 U.S.C. 1001. • Bring all relevant medical records, especially for any previously treated conditions • Consult with AOPA's medical services or an aviation medical examiner before the exam if there is any concern about a condition • Maintain a list of all current medications for the examiner • Consider BasicMed if traditional certification presents challenges for conditions that fall within BasicMed's scope