Careers Career Paths Aspiring Pilots and the Aviation Medical Exam Share PINTEREST Email Print Hero Images / Getty Images Career Paths Aviation Technology Careers Sports Careers Sales Project Management Professional Writer Music Careers Media Legal Careers US Military Careers Government Careers Finance Careers Fiction Writing Careers Entertainment Careers Criminology Careers Book Publishing Animal Careers Advertising Learn More By Sarina Houston Sarina Houston Twitter Commercial Pilot, Flight Instructor, Aviation Writer Embry-Riddle Aeronautical University Sarina Houston was the aviation expert for The Balance Careers. She is a commercial pilot and certified flight instructor. Learn about our Editorial Process Updated on 09/26/19 Most pilots require aviation medical certificates. Some pilots, such as sports pilots and balloon pilots, aren't required to obtain an aviation medical certificate. The rest of us, however, need to pass an aviation medical exam to legally utilize the privileges of our pilot certificates. Aviation medical exams can be a source of anxiety for many. Will you pass? What exactly is the examiner looking for? Is my eyesight good enough? Should I disclose certain health problems on the forms? What happens if I don’t pass? There are a lot of questions about the aviation medical exam. Even the healthiest of people get nervous before an exam. After all, a lot is at stake. The good news is that most applicants pass the exam—sometimes it just takes a while. Do Your Research If you’re perfectly fit and healthy, you have nothing to worry about. Most of us do have some minor health glitches, though. If you do, you should check up on whether any of these problems will disqualify you. Others may require you to get a special medical certificate. Getting one will give your doctor important information about your health. Are you concerned about a specific medical condition? Make sure you prepare yourself by doing some research before you show up for your appointment. The FAA's medical exam guide online has the information you can find about certain health problems. There are also a lot of other online resources available for free that can guide you in the right direction. If you need a special issuance medical exam, you'll probably need additional paperwork. Make sure you prepare these documents well in advance. Once gathered, send these to the FAA after your exam is complete. Or you might find that your condition is a non-issue after all. For example, mild depression that is stable or completely resolved isn't an issue. Major depression treated with medication will require a review by the FAA and a special issuance. What the Examiner Will Do Before you even show up, the examiner will have you register for an account with the FAA’s MedXPress system, which is an electronic form that will be reviewed by your medical examiner and submitted to the FAA upon completion of your exam. The examiner will verify your identity after your registration and forms are complete, and review information pertaining to your health history. He or she may also let you know if there are any details that may delay you from getting your medical certificate. The specific type of aviation medical certification you’re applying for will determine the intensity of the exam. Third-class medical exams are the least intrusive. First-class medical exams require a more in-depth exam. Types of Exams Applicants under 40 usually have to undergo the most basic, third-class medical exam. This entails checking your eyesight, including your peripheral vision, nearsightedness, farsightedness, and color vision. The examiner will also perform a hearing test to determine if you're able to hear at the most basic level. Prior to doing a general physical, the examiner will go over the following: Health issuesMedicationsSurgeries you've had in the pastPrevious doctor visits The examiner will also have a urinalysis done. This helps indicate any diseases, blood or proteins in the urine. Expect to have your blood pressure checked, as well as questions about your overall mental wellbeing. Some of the medical requirements (for example, vision and hearing standards) are different for first and second class medical certificates, but overall the exam for each class is pretty similar. First-class medical exams must be done more frequently and require the applicant to have an electrocardiogram (ECG) done annually if over age 40. At the end of the exam, the medical examiner has three choices: He or she can approve the application, deny it or defer it to the FAA for further processing. What Happens If You've Been Denied or Deferred Don’t panic. Just because your medical certificate application was denied or deferred to the FAA for further review does not mean that you’ll be grounded forever. First, know that aviation medical examiners (AMEs) rarely deny a certificate outright. Most of the time, they are encouraged and required to push it on to the FAA for review. But even if it is denied (if there’s no question that you clearly do not meet the requirements), you can appeal the decision with the FAA. A history of extreme substance abuse coupled with multiple arrests, for example, might require a denial on behalf of the examiner and/or FAA. But if you can prove that you've been to rehab and have been sober for at least 24 months, you may have a chance at an appeal. Most of the time, people with a health problem can successfully obtain a special issuance medical certificate after completing the deferment process with the FAA. Sometimes, you’ll need to switch medications to one that’s acceptable for flight. Sometimes you’ll need to wait until you’re symptom-free for a certain period of time. And many times, the FAA will approve your medical application with barely a question. For instance, people with hypothyroidism should have no problem flying, and usually, have their applications approved even though they’ll likely have to be deferred first. For most people, the aviation medical exam will be a piece of cake. For others, it can be frustrating to wait for the waiver process to be completed. But most of the time, the FAA will let you keep flying in the end.