Aspiring Pilots and the Aviation Medical Exam

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Aviation medical certificates are a requirement for most pilots. 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 surrounding 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 have some minor health glitches, though. Knowing which health problems will disqualify you or which will require a special issuance medical certificate will not only help calm your fears but will provide you with valuable information for your doctor.

You’ll want to show up prepared, so if you’re concerned about a certain medical condition, research it before your appointment. Check out the FAA medical exam guide online to find out about specific health problems. Also, there are a lot of other online resources available for free that can guide you in the right direction.

You might, for instance, determine that you’ll need a special issuance medical, which requires extra documentation. You can start gathering those documents ahead of time so that you’re prepared to send them to the FAA once your examiner completes your exam.

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.

When you’re registered and have completed the appropriate forms, your examiner will verify your identity with two forms of identification and initiate the exam. You’ll go over any health history that you included on your paperwork, and the examiner will point out any issues that might delay the processing of 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

For the most basic third-class medical exam for an applicant under the age of 40, the examiner will check your eyesight, including peripheral vision, nearsightedness, farsightedness, and color vision. A hearing test might be done, which will ensure you can at a minimum, hear at a conversational level.

The examiner will discuss any specific health issues and medications with you, review previous surgeries and doctor visits and complete a general physical exam. A urinalysis is done to check for blood or protein in the urine or other blatant signs of disease. Your blood pressure will be checked, and you’ll likely field some questions about your mental health.

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.