What to Expect at Your FAA Medical Exam
Every pilot who exercises most flight privileges needs an FAA medical certificate, and the only way to get one is through an Aviation Medical Examiner (AME) — a physician designated by the FAA to perform flight physicals. Knowing what happens before, during, and after the exam removes most of the stress and helps you avoid the delays that catch pilots off guard.
The three certificate classes
Which class you need depends on the privileges you exercise, not the certificate you hold.
- First class — required for airline transport pilot privileges. The most rigorous standards, including an ECG at age 35 and annually after 40.
- Second class — required for commercial privileges such as charter or agricultural flying.
- Third class — for private, recreational, and student pilots. The most common starting point.
Before the exam: MedXPress
Every FAA medical exam starts at home. You must complete FAA Form 8500-8 online through MedXPress before your appointment, and bring the confirmation number with you — the AME imports your application with it.
Answer the medical history questions carefully and honestly. Most delays are caused not by disqualifying conditions but by surprises: a condition or medication disclosed for the first time at the exam, with no supporting records on hand. If you have a history item, bring documentation from your treating physician.
What the AME checks
A routine exam usually takes 30–45 minutes. The AME reviews your MedXPress application and history, then performs the physical examination.
- Vision — distant and near acuity, and color vision screening.
- Hearing — conversational voice test or audiometry.
- Blood pressure and pulse.
- Urinalysis — screening for sugar and protein (not a drug test).
- Heart, lungs, neurological function, and general physical condition.
- ECG, when required for first class applicants.
Walking out with your certificate
In the large majority of exams, the AME issues your medical certificate on the spot. If something needs more review, the AME may request additional records before issuing, or defer the application to the FAA — which adds weeks to months.
The best way to avoid a deferral is preparation: review the MedXPress questions in advance, gather records for anything in your history, and if you have a known condition, call the AME’s office first. Many AMEs will tell you exactly what to bring so the exam can be issued same-day.
Choosing the right AME
AMEs vary in availability, pricing, and experience with complex cases. Pilots with straightforward histories mostly need convenience; pilots with medical history items benefit from an AME experienced with FAA special issuance procedures. Reading pilot reviews before booking helps on both counts.
Find an Aviation Medical Examiner near you
Search AMEs by location, certificate class, HIMS designation, and pilot reviews.
This guide is general information for pilots, not medical or legal advice. Requirements change — always confirm current FAA standards with your AME, your instructor, or the FAA directly.