FAA Medical Certificate Classes: Which One You Need and How Long It Lasts
Three classes, one exam, one doctor. Almost every student pilot needs a third-class medical, which costs $100 to $175 and is valid for five years if you are under 40. First class is for airline pilots. Second class is for anyone being paid to fly. The differences are smaller than the internet suggests.
You almost certainly need a third class, and you need it before your first solo
The class is set by what you are doing with the aeroplane, not by how good a pilot you are. Fly for fun, third class. Fly for money, second class. Fly for an airline as captain, first class.
FAR 61.23 sets it out. A first-class medical is required to exercise airline transport pilot privileges. A second-class medical is required to exercise commercial pilot privileges — anything you are paid for. A third-class medical covers student, recreational, private pilot and flight instructor privileges, which is what the overwhelming majority of pilots hold.
They are the same examination performed by the same doctor. The higher classes simply apply tighter standards and, for first class, add an electrocardiogram at the first application after age 35 and annually after 40. There is no separate first-class doctor and no separate appointment type. If you turn up asking for a first-class exam and the standards are met, you leave with a first-class certificate.
Timing matters more than class. You do not need a medical to start flight training, but you need one before your first solo, which typically arrives somewhere between hour 15 and hour 25. Get it in week one anyway. It is the only item in the whole process that can genuinely stop the plan, and finding out in month four is an expensive way to learn that.
The three classes, and the fourth option
Validity is counted in calendar months from the month of the examination, and it steps down rather than expiring outright — a lapsed first class still works as a third class until the third-class clock runs out.
| Class | Who needs it | Distant vision | Validity, under 40 | Validity, 40 and over |
|---|---|---|---|---|
| First Class | ATP privileges, airline flying | 20/20 each eye, corrected | 12 calendar months | 6 calendar months |
| Second Class | Commercial pilots, charter, sightseeing, survey | 20/20 each eye, corrected | 12 calendar months | 12 calendar months |
| Third Class | Student, recreational, private pilot, CFI as PIC | 20/40 each eye, corrected | 60 calendar months | 24 calendar months |
First Class
Required to exercise airline transport pilot privileges. The standard airline pilots hold and renew for their whole career.
| Measure | Standard |
|---|---|
| Who needs it | ATP privileges, airline flying |
| Distant vision | 20/20 each eye, with or without correction |
| ATP validity, under 40 | 12 calendar months |
| ATP validity, 40 and over | 6 calendar months |
| ECG required | first application after 35, then annually after 40 |
| Then downgrades to | 2nd class for 12 months, 3rd class after |
Second Class
Required to exercise commercial pilot privileges. If someone is paying you to fly, this is your floor.
| Measure | Standard |
|---|---|
| Who needs it | commercial pilots, charter, sightseeing, survey |
| Distant vision | 20/20 each eye, with or without correction |
| Commercial validity | 12 calendar months, any age |
| Then downgrades to | 3rd class privileges |
| 3rd class period, under 40 | 60 calendar months from exam |
| 3rd class period, 40 and over | 24 calendar months from exam |
Third Class
What a student, recreational or private pilot needs, and what a flight instructor needs when acting as pilot in command.
| Measure | Standard |
|---|---|
| Who needs it | student, recreational, private pilot, CFI as PIC |
| Distant vision | 20/40 each eye, with or without correction |
| Near vision | 20/40 at 16 inches |
| Validity, under 40 at exam | 60 calendar months |
| Validity, 40 and over at exam | 24 calendar months |
| Typical cost | $100–$175 |
The alternatives
Two routes let you fly without holding a current FAA medical certificate at all. Both have real conditions attached.
| Route | Condition |
|---|---|
| Sport pilot | US driver's licence in place of a medical |
| BasicMed | private pilot privileges, physician exam every 48 months |
| BasicMed course | online, repeated every 24 calendar months |
| BasicMed prerequisite | an FAA medical held at some point after 14 July 2006 |
| Deal-breaker for both | a denied medical application |
Validity is measured in calendar months from the month of the examination, so a third-class medical issued on 3 March 2026 to a 32-year-old is good until 31 March 2031. The age that counts is your age on the date of the exam, not the date it would otherwise expire.
MedXPress, then the AME, then usually the same-day certificate
Most people are in and out in under an hour. The paperwork is the part that trips people up, and it is all done before you arrive.
Fill out FAA MedXPress online first
Go to medxpress.faa.gov, create an account and complete FAA Form 8500-8. It asks for your full medical history, every doctor visit in the last three years, every medication, and any arrests or driving offences. Answer it honestly — the FAA cross-checks against the National Driver Register, and a falsified application is a far bigger problem than any condition you were worried about.
If you have any history at all, phone an AME before you submit
This is the most important sentence on this page. Once you submit an application and it is denied, you lose eligibility for BasicMed and for the sport pilot driver's-licence route as well. A ten-minute conversation with the examiner beforehand, with your records in hand, can turn a denial into a straightforward special issuance.
Find an aviation medical examiner
Only an FAA-designated AME can issue a certificate. Use the FAA's designee locator on faa.gov to find one near you — Los Angeles and the San Fernando Valley have plenty, and several are within a short drive of Van Nuys Airport. Book the appointment, quote your MedXPress confirmation number, and ask what their fee is before you go.
The examination itself
Vision, hearing, blood pressure, pulse, urinalysis, and a general physical. Hearing is usually tested by whether you can hear a conversational voice at six feet with your back turned. Bring your glasses or contacts and any specialist letters. It takes 20 to 40 minutes.
You normally walk out with the certificate
For a straightforward third class the AME issues on the spot. If something needs review the AME defers to the FAA, which is not a denial — it means the Aerospace Medical Certification Division in Oklahoma City looks at it. That can take weeks to a few months, which is exactly why you start this in week one.
Deferral, special issuance, and the things that genuinely slow you down
Fourteen CFR Part 67 lists a set of specifically disqualifying conditions — among them epilepsy, an unexplained disturbance of consciousness, coronary heart disease that has required treatment, diabetes requiring hypoglycaemic medication, and substance dependence. Being on that list is not the end. It means the AME cannot issue in the office and the file goes to the FAA.
From there the usual route is an Authorization for Special Issuance under 14 CFR 67.401 — a time-limited medical certificate granted on the strength of your treating physician's records and, often, periodic follow-up testing. Thousands of pilots fly on special issuances. Insulin-dependent diabetics, pilots with treated heart disease and pilots on some antidepressants all hold them.
There is also a faster path most students have never heard of. The FAA publishes a list of Conditions AMEs Can Issue, covering common things like controlled asthma, hypothyroidism, migraine and treated hypertension, where the examiner can issue in the office provided you bring the right paperwork. Ask the AME which documents they need when you book, and bring them the first time. That single phone call saves months.
The class follows the flying, not the other way round
Three kinds of flying, three classes of certificate — and one alternative route that needs no FAA medical at all.
The school, the fleet and the people who will walk you through it
Van Nuys Airport — and the front desk that will tell you which AME to call.
LA Flight School — 7900 Balboa Blvd, Suite 108A, Van Nuys, CA 91406. Open 9am to 9pm, seven days.
You do not need the medical to take the first lesson
You need it before you solo, which is usually 15 to 25 hours away. So the sensible order is: fly once, decide you want this, then book the AME in the same week you enrol.
Discovery Flight For One
No medical certificate required. You fly it, it is logged as dual instruction, and it counts toward your 40 hours.
Book nowFree Consultation
Talk through the medical before you spend anything. If you have a condition you are worried about, this is the conversation to have first.
Book a consultationRedbird Simulator Session
Full-motion and FAA-approved. No medical needed, ever, and never cancelled for weather.
Book a sessionThe medical exam fee goes to the aviation medical examiner, not to us. Budget $100 to $175 for a third class; first and second class exams cost more because they include additional testing, so ask the AME for their fee when you book.
Fly first. The paperwork can wait a fortnight.
A discovery flight needs no medical certificate, no paperwork and no commitment — sixty minutes over Los Angeles with your hands on the controls, logged as dual instruction. Enrol within 24 hours and the $229 comes off your program. Call (818) 290-8249, 9am to 9pm, seven days.
FAA medical certificate questions
Each answer is self-contained, with the regulation and the number attached.
Three. A first-class medical is required to exercise airline transport pilot privileges, a second-class medical to exercise commercial pilot privileges, and a third-class medical for student, recreational and private pilot privileges. All three are the same examination performed by the same FAA-designated aviation medical examiner, with progressively tighter standards. FAR 61.23 sets out which class each privilege requires.
Sixty calendar months if you were under 40 on the date of the examination, and 24 calendar months if you were 40 or over. The clock runs from the end of the month you were examined, so a certificate issued on 3 March to a 32-year-old is valid until 31 March five years later. The age that matters is your age at the exam, not your age when it would expire.
For airline transport pilot privileges, 12 calendar months if you were under 40 at the examination and 6 calendar months if you were 40 or over. After that it does not vanish — it continues to serve as a second-class medical for 12 calendar months from the exam, and then as a third-class medical for the usual 60 or 24 calendar months depending on your age.
Distant visual acuity of 20/20 or better in each eye separately, with or without correction, near vision of 20/40 at 16 inches, and for applicants aged 50 and over an intermediate standard of 20/40 at 32 inches. You must also be able to perceive the colours necessary for safe airman duties, meet the hearing standard, and provide an electrocardiogram at the first application after age 35 and annually after 40.
No. You can fly with an instructor from day one without one, including a discovery flight. You need at least a third-class medical certificate before your first solo flight, which usually arrives between hour 15 and hour 25. Apply in week one anyway, because it is the single item that can stop your training and the only one with an unpredictable timeline.
Complete FAA Form 8500-8 online through FAA MedXPress at medxpress.faa.gov, note the confirmation number, then book an appointment with an FAA-designated aviation medical examiner using the designee locator on faa.gov. The exam takes 20 to 40 minutes and covers vision, hearing, blood pressure and a general physical. Most third-class applicants are issued the certificate in the office the same day.
The examiner defers the application to the FAA's Aerospace Medical Certification Division rather than denying it, and the FAA reviews your records. Many conditions are then cleared through an Authorization for Special Issuance under 14 CFR 67.401, which is a time-limited certificate with follow-up requirements. Deferral commonly adds weeks to a few months, so start early and bring your specialist's records to the first appointment.
Talk to an aviation medical examiner before you submit anything. A denied application costs you more than the medical itself — it also makes you ineligible for BasicMed and for the sport pilot route that lets you fly on a driver's licence. A consultation with the AME first, with your records in hand, frequently converts what would have been a denial into a straightforward special issuance.