PILOT FAQ · FAA MEDICAL CERTIFICATION
Straight answers to common FAA medical questions.
Whether you’re scheduling your first FAA medical, renewing a certificate, taking a medication, managing a medical condition, or dealing with a deferral, start here. We’ve answered the questions pilots ask us most so you can understand what to expect, what to bring, and when it may help to speak with an AME before your exam.
FAA guidance can change, and every pilot’s situation is different. Always refer to the FAA and your Aviation Medical Examiner for the most current and definitive requirements.
43 questions shown
Before Your Appointment
How do I get an FAA medical certificate?
Choose an FAA-designated Aviation Medical Examiner, schedule an appointment, complete the FAA application in MedXPress, and undergo the required examination. If you meet the standards for the class requested, the AME may issue the certificate.
What is FAA MedXPress?
MedXPress is the FAA system pilots use to complete and submit the applicant portion of FAA Form 8500-8 before a medical examination.
How long is my MedXPress application active?
The FAA says you must complete the AME examination within 60 days after submitting the application. If an AME does not import it within that period, the application disappears from the system.
Why do I need my MedXPress confirmation number?
Your AME needs the confirmation number to import the submitted application. Save or print the application and bring the confirmation number to your appointment.
What should I bring to an FAA medical exam?
Bring government-issued identification, your MedXPress confirmation number, glasses or contact lenses if you use them, and any medical records or current detailed clinical progress notes requested for your history.
What happens during an FAA medical exam?
The office may collect height, weight, pulse, blood pressure, vision, hearing, and urine-test information, with an ECG when required. The AME reviews your history and performs the physical examination.
Is an After Visit Summary the same as a clinical progress note?
Not necessarily. The FAA explains that a patient-portal summary or After Visit Summary may omit information it needs. When requested, obtain the actual current, detailed clinical progress note from the treating clinician.
Do I need a HIMS AME for ADHD?
Not necessarily. ADHD does not automatically mean you need a HIMS AME. Fast Track involves a qualified doctoral-level psychologist or neuropsychologist and your AME. Standard Track requires an FAA HIMS-trained neuropsychologist for evaluation and testing. This is a different role from a HIMS AME. Additional conditions may introduce separate HIMS AME requirements.
A Senior AME is required for a First-Class exam. Read the ADHD examiner-role guide →
Certificate Classes
Which class of FAA medical certificate do I need?
First Class is generally associated with airline transport pilot privileges, Second Class with commercial pilot privileges, and Third Class with private or recreational pilot privileges. Confirm the certificate required for the operations you intend to perform.
What medical certificate does a student pilot need?
When a medical certificate is required, a Third Class certificate is generally sufficient for a student pilot, although a higher class can also satisfy that requirement.
Can I apply for a First Class medical before I am an airline pilot?
Yes. The FAA does not require a particular age, pilot certificate, or level of aviation experience before an otherwise qualified applicant may receive a medical certificate.
Examiner requirement: A First-Class examination must be performed by a Senior Aviation Medical Examiner. AMEs without the Senior designation perform Second- and Third-Class examinations. Both our Pilot Physician doctors are Senior AMEs.
How long does a First Class medical remain valid for First Class privileges?
For First Class operations, the certificate is generally valid for the remainder of the month of examination plus 12 calendar months if the applicant had not reached age 40, or 6 calendar months if age 40 or older.
How long does a Second Class medical remain valid for Second Class privileges?
For Second Class operations, the certificate is generally valid for the remainder of the month of examination plus 12 calendar months. It may continue to support certain Third Class operations for a longer period.
How long does a Third Class medical remain valid?
A Third Class certificate is generally valid for the remainder of the month of examination plus 60 calendar months if the applicant had not reached age 40, or 24 calendar months if age 40 or older.
When is an ECG required for a First Class medical?
FAA guidance requires an ECG at the first First Class application after reaching age 35 and annually after reaching age 40. An ECG is not routinely required for Second or Third Class examinations.
Can I meet the FAA vision standards while wearing glasses or contacts?
FAA vision standards may be met with or without correction. Bring the corrective lenses you use so the AME can test you appropriately and apply any required limitation.
Is there an age limit for receiving an FAA medical certificate?
The FAA states there is no age restriction for medical certification itself. Any applicant who meets the applicable medical standards may be issued the appropriate class.
Medical Conditions
Can a pilot with a history of ADHD qualify for an FAA medical certificate?
Potentially. The FAA currently provides Fast Track and Standard Track evaluation pathways for applicants with a history of ADHD or ADHD-medication use. The applicable pathway and documentation depend on the individual history.
What should I do before an exam if I have ADHD history?
Review the current FAA ADHD pathway and document checklist before the examination, and consider speaking with an AME before submitting MedXPress. Do not stop prescribed medication without guidance from the treating clinician.
Can a pilot with obstructive sleep apnea qualify?
Many treated applicants can qualify, but the FAA uses condition-specific protocols and may require evidence of effective treatment and compliance. Bring the current documentation required for your pathway.
Can high blood pressure be handled by the AME?
Some applicants with well-controlled hypertension may qualify through the FAA CACI process when all worksheet criteria and documentation requirements are met. Otherwise, the AME may need to defer.
Can a pilot with diabetes receive a medical certificate?
FAA pathways vary according to diabetes type, treatment, control, and complications. Review the current FAA protocol and medication guidance with your AME before the examination.
Does a mental-health diagnosis automatically disqualify a pilot?
No. The FAA says most treated mental-health conditions do not automatically disqualify a pilot, although the diagnosis, symptoms, treatment, medications, and stability determine the evaluation pathway.
Who you may need: Not every mental-health history requires a HIMS AME. Certain FAA pathways, including initial certification while continuing a qualifying antidepressant under the Antidepressant Protocol, require a HIMS AME. Psychiatric or neuropsychological evaluations are separate roles and may also be required. Your history and the applicable FAA protocol determine which professionals are needed. FAA Antidepressant Protocol ↗
How does the FAA evaluate kidney stones?
The pathway depends on whether stones are retained, symptomatic, recurrent, or associated with other findings. Some applicants may qualify under a CACI worksheet when every criterion is satisfied.
What if I have difficulty with FAA color-vision testing?
Color vision is evaluated against the FAA standard for safely performing airman duties.
Medications & Flying
Does the FAA publish a single list of approved medications?
No. FAA guidance explains that certification depends on both the medication and the underlying condition, including dosage, side effects, interactions, stability, and aviation-safety impact.
Are over-the-counter medications always safe for pilots?
No. Some nonprescription products can impair alertness or performance. Review the FAA over-the-counter guidance and ask an AME when you are uncertain.
Can I fly after taking a sedating antihistamine such as diphenhydramine?
FAA guidance identifies sedating first-generation antihistamines as aeromedically concerning and provides no-fly guidance. Do not rely on feeling alert; verify the current waiting period and your fitness to fly.
Can a pilot take an antidepressant and still qualify?
The FAA has pathways for certain conditions and conditionally acceptable antidepressants, but eligibility is case-specific and often requires documentation. Do not start, stop, or change treatment solely for certification without your treating clinician.
HIMS AME distinction: The FAA Antidepressant Protocol’s initial-certification pathway for continued qualifying medication use requires evaluation by a HIMS AME. A Senior AME designation alone does not establish HIMS qualification. Follow-up requirements depend on the applicable FAA authorization. FAA protocol and examiner requirements ↗
What should I do when starting a new medication?
Consider the medication, the condition being treated, side effects, and any FAA observation or no-fly period. Under 14 CFR 61.53, do not act as required flightcrew when a condition or treatment makes you unable to meet the applicable requirements.
Deferrals & Special Issuance
What does it mean when an AME defers an application?
A deferral means the AME did not issue a certificate at the examination and sent the application to the FAA for additional review. A deferral is not the same as a final denial.
What should I do after an FAA medical deferral?
Watch for the FAA letter, gather every requested record, and respond completely by the stated deadline. The FAA recommends actual current detailed clinical progress notes when those are requested.
What is a Special Issuance medical certificate?
Special Issuance is an FAA authorization pathway under 14 CFR 67.401 for some applicants who do not meet unrestricted standards. It commonly requires additional records, testing, follow-up, and a more limited authorization period.
Examiner and specialist roles: Special Issuance does not automatically require a HIMS AME. The condition-specific FAA protocol and authorization determine who must evaluate or monitor the pilot. FAA-directed HIMS pathways for certain substance-use or mental-health cases may require a HIMS AME; other conditions may need a different specialist. FAA substance-use and HIMS guidance ↗
What is CACI?
CACI means Conditions AMEs Can Issue. If the applicant meets every condition-specific worksheet criterion and is otherwise qualified, the AME may be able to issue without first contacting the FAA.
What if I do not meet all CACI worksheet criteria?
When required CACI criteria are not met, the AME generally must defer the application and send the supporting information to the FAA for review.
Can a denied FAA medical application be appealed?
A denial letter includes information about review or appeal rights. The FAA also notes that some denied applicants may still be eligible for certification through Special Issuance.
What is the fastest way to send requested medical records to the FAA?
FAA pilot guidance says taking requested documents to your AME for electronic addition to the record is generally the fastest method. Follow the instructions in your FAA letter.
After the Exam
When will I receive my medical certificate?
If the required documentation is present, the examination meets the standards, and no deferral is required, the AME may issue the certificate at the visit. Otherwise, FAA review may be necessary.
How do I replace a lost or destroyed medical certificate?
Copies are not valid substitutes. FAA guidance says a replacement for a lost or destroyed certificate must be issued by the FAA.
What if my health changes after the medical certificate is issued?
A current certificate does not override the pilot’s responsibility under 14 CFR 61.53. Do not serve as required flightcrew when you know or have reason to know a condition or treatment makes you medically unqualified.
Pilot Physician Services
Which services does Pilot Physician provide?
Pilot Physician provides First, Second, and Third Class FAA medical examinations, plus pilot consultations for certification questions, complex histories, medications, deferrals, and preparation.
Our designation: Dr. Gilberto Munoz and Dr. Teresa Cvengros are Senior Aviation Medical Examiners, authorized to perform First-, Second-, and Third-Class medical examinations. Senior AME is distinct from HIMS AME. A consultation does not replace a required HIMS AME assessment or specialist evaluation.
Does Pilot Physician provide BasicMed exams?
No. Pilot Physician does not provide BasicMed examinations. The practice offers First, Second, and Third Class FAA medical exams and consultations.
When should I schedule a consultation instead of an exam?
A consultation can be useful before submitting MedXPress when you have a complex diagnosis, medication, prior deferral or denial, Special Issuance question, or uncertainty about the records you may need.
Confirm the right provider: A consultation can help clarify the pathway but does not replace required specialist testing. ADHD Standard Track requires an FAA HIMS-trained neuropsychologist, not automatically a HIMS AME. Certain antidepressant and substance-use pathways may require a HIMS AME. Compare examiner and specialist roles →
Where is the Pilot Physician office?
Pilot Physician is located at 2845 N Sheridan Road, Suite 907, Chicago, Illinois 60657. Call 773-755-2600 for scheduling, parking, or transit questions.
We are conveniently located in Lincoln Park (blocks from the Zoo and Lakefront) between Fullerton and Belmont stops off Lake Shore Drive.
We are accessible via Red/Purple/Brown Lines. Blue Line trains must connect via Loop.