WARNING - Need for Consult or Careful Consideration
While many instructors still tell their student pilots that they should just go talk to the local AME and that "anyone with a pulse can get a medical", this is no longer good advice for most students. The aeromedical process has become increasingly complicated in the last decades and is now well described as a minefield of possible Catch-22s and gotchas.
When many current instructors were trained, the process of obtaining a medical certificate was simpler. The regulations requiring a medical certificate for even private (non-commercial) pilots historically evolved out of military screening for the best pilot candidates during World War I. Initially the requirements for a private pilot were fairly simple, but they have become much more tricky and intrusive over the years. This process was greatly accelerated by the GermanWings crash when a depressed pilot intentionally crashed and killed 144 passengers and 6 crew members. Now the FAA delves into all manner of possible medical and psychiatric illness which might impair a pilot's ability to fly.
The current FAA form 8500-8 to apply for a medical certificate asks about medical conditions as "Have you ever in your life...". There is no statute of limitations so a condition diagnosed as a young child, such as ADHD, must be reported. Any yes answer or use of serious medications can be hang-up and cause deferral of the application to further review or outright denial.
The good news is that with enough time and money for evaluations, most pilots that can reasonably safely fly can eventually obtain a medical certificate. But this requires careful consideration to avoid cutting off options for flying which do not require an FAA medical certicate. Many student pilots have inadventently simply filled out the form and gone to an aviation medical examiner (AME) without due consideration to a condition which no longer affects them and found themselves denied and cut off from ever being able to fly even lighter aircraft.
This page grew out of the experiences of many pilots on internet aviation forums, such as Flyers Forum, and discussions there. It will attempt to provide basic information on this page and answers to questions which have frequently arisen.
Types of FAA Medical Certificates
There are 3 classes of medical certificates issued by the FAA (see FAR 61.23).
- 3rd Class. This is the type of certificate allows a private pilot to exercise the privileges of a private pilot certificate and and allows flight instructors to instruct. The requirements are least stringent for this class and the certificate is valid for 5 years (60 calendar months) for those under 40 and 2 years (24 calendar months) for those over 40.
- 2nd Class. This type of certificate allows commercial pilots to exercise the privileges of a commercial pilot certificate. This means essentially being able to fly commercially for hire. The requirements are slightly more stringent than for a 3rd class and this certificate is valid for 1 year (12 calendar months).
- 1st Class. This type of certificate airline transport pilots to exercise the privileges of an airline transport certificate. This means essentially being able to fly scheduled air service, like that offered by Southwest or United Airlines. The requirements are the most stringent and this certificate is valid for 1 year (12 calendar months) for those under the age of 40 and 6 months for those 40 and older.
Process to Obtain an FAA Medical Certificate
There are 2 steps in the normal process of obtaining an FAA medical certificate:
- Fill out the medical form, which must now be done online at the MedXpress website.
- Visit an FAA designated aviation medical examiner (AME) for an exam appropriate to the class sought. Local flight instructors will normally have suggestions but the FAA maintains an amelocator to help find one.
There are 3 possible outcomes from that exam by the AME:
- Issued. This means that the AME found nothing to prevent the applicant from obtaining a certificate and that the certificate is issued in the office before the applicant leaves. This is the best outcome for the applicant.
- Deferred. This means the AME found conditions which do not allow him or her to issue the certificate immediately and the application must be forward to the examiners at the Civil Aerospace Medical Institute (CAMI) in Oklahoma City.
- Denied. This normally happens after a deferral and examination by CAMI, though can sometimes be the outcome determined by the AME in cases where the applicant clearly fails to meet the medical requirements.
It is very important to realize that once the medical reference number (or MID) at the bottom of the 8500-8 form is entered into the FAA system by the AME or his office staff, the application will eventually result in either issuance or denial.
Regular Versus Special Issuance
If an applicant meets all the requirements under the normal FAA regulations for issuance of a medical certificate, that is called a "regular issuance". If the applicant cannot meet all those requirements due to a past or current medical condition, the FAA can provide a "special issuance" (SI) certificate in many cases after appropriate testing and program participation. Such a certificate will usually have a set of restrictions on flying or ongoing testing or conditions the applicant must comply with to continue flying as a pilot.
An example of this would be a pilot who has had troubles with excessive alcohol consumption. By demonstrating through testing and the program participation that they are remaining sober, a pilot may obtain a SI certificate.
There are a large number of medical conditions, past or present, and/or current use of medications which can result in the FAA denying an application for a medical certificate. Given this, applicants who have any medical condition, or are taking any serious medication, or have to check "yes" to any box in section 18 of the form 8500-8, are advised to obtain a consultation with the AME prior to activating an actual formal application for a medical certificate.
Normally you will pay a small amount for the consultation, followed by the normal fee for the class of exam you are having. This is a small price to pay to avoid an unnecessary deferral or denial of your medical application.
To do this, follow the following steps:
- Confirm that the AME you are visiting is willing to do a consult. Most will these days, but some will refuse. If so, find another AME.
- Fill out the application for a medical certificate using MedXpress. Print out the form so you can take it with you.
- Cut off the confirmation number (MID) at the bottom of the form. Keep it in your pocket when you visit the AME. The reason to do this is that front office staff will often want to prepare your chart for the doctor using this information. But sometimes they "helpfully" enter the MID into the FAA system and that then means your application will end in either issuance or denial, cutting off some other options for flying.
- After the AME has assured you he can issue your certificate in the office, then provide the MID so he or she can do so.
If the AME says there are conditions that prevent issuance in the office, that is the time to explore what they are and ask for advise on how best to proceed. In many cases, the AME may be able to issue your certificate after further documentation of the conditions which are of concern, or it may require the help of specialized AMEs.
BasicMed is a program enacted in 2017 which acts like a somewhat restricted 3rd class medical. A pilot flying under the Basic Program can act as pilot in command (PIC) for a restricted set of aircraft in restricted conditions, though the restrictions are not very severe. The pilot does not have to have a current FAA medical certificate to do so. The basic requirements for BasicMed are:
- Have held an FAA medical certificate at any point after July 14, 2006 which was not denied, revoked or rescinded.
- Possess a U.S. driver's license.
- Complete a BasicMed medical education course online.
- Pass a physical examination with a state-licensed physician, using the Comprehensive Medical Examination Checklist
The regulations governing BasicMed are 14 CFR Part 68. More details about the program, courses, and checklists are available on the FAA's BasicMed page.
Ways to Fly Without a Medical
Not being able to obtain or maintain a medical does not mean one can never fly an aircraft. There are several ways to fly without a medical, though the types of aircraft and flights may be more restricted.
If you have held an FAA medical at any time after July 14, 2006, you may simply be able to use the BasicMed program. This is often an option for people who have had medical issues develop which, while not bad enough to endanger flight safety, would require an expensive and time-consuming special issuance. There is a list of conditions in 3 categories, mental, cardio, or neuro, that require an SI in any case however, but many conditions will not. Also note that a pilot flying under BasicMed must not know of or have reason to know of any medical condition which would prevent them from operating safely (14 CFR 61.53)
NOTE that if your last medical was denied, revoked, or rescinded, you cannot use BasicMed. Thus the importance of obtaining an AME Consult if there is any question about an medical application being issuable in the office.
Sport pilot is a special type of pilot certificate which allows the pilot to flight light sport airplanes (LSAs) by holding a driver's license so long as they do not know of or have reason to know of any medical condition which would prevent them from operating safely (which applies to all pilots in any case 14 CFR 61.53).
LSAs are lighter than many commonly used general aviation aircraft and are restricted to one passenger (see FAA Sport Pilot Rule for details.). Night and instrument operations are prohibited. Operations in some controlled airspace require separate endorsements. The rules and regulations covering sport pilot certification are covered in 14 CFR 61 Subpart J.
NOTE that if your last medical was denied, revoked, or rescinded, you cannot fly as a sport pilot. Thus the importance of obtaining an AME Consult if there is any question about an medical application being issuable in the office.
A person can fly gliders with a pilot certificate for gliders without holding an FAA medical certificate. As always, such a pilot may not fly as pilot in command if they know of or have reason to know of any medical condition which would prevent them from operating the aircraft in a safe manner 14 CFR 61.53.
While gliders are not powered aircraft, they are capable of soaring to great heights and distances using the thermal power of the atmosphere. It is a very elegant sport. Gliders are also an excellent way to start learning to fly as they really teach how a set of wings and controls behaves in the air. Indeed, this is how the Wright Brothers first taught themselves to fly. If you are anxious to start flying but have to wait on resolving your medical, you can start and solo in gliders before obtaining a medical.
There is also a sub-type of glider called a motor glider which, since it is classified by the FAA as a glider, does not require a medical. However, one type has a motor which is able to self-launch. Touring motor gliders can be used for flying cross-country and so these are another alternative for flying without a medical.
Balloons and ultra-light airplanes
Yet other ways to become airborne without an FAA medical are flying balloons, which float quite gracefully in the air, and ultra-light airplanes. While neither provide the flexible utility of normal certified airplanes, they do provide a very enjoyable experience of flying.
Senior and HIMS Aviation Medical Examiners
If there are any questions about an AME being able to issue an FAA medical in the office, one is well advised to obtain the advice of a senior AME or senior AME in the Human Intervention Motivation Study (HIMS). The latter especially applies if substance abuse or psychiatric issues are in the history "ever in your life".
The following is a very brief listing of some of the nationally recognized expert AMEs in dealing with specialized and difficult aeromedical cases. While such consultation will cost some money in fees and testing, it is well worth it to eventually obtain the lowest possible overall costs and time expended.