What to Expect at Your FAA Medical Exam
Many pilot operations require an FAA medical certificate issued after an examination by an Aviation Medical Examiner (AME), a physician designated by the FAA. BasicMed, sport-pilot operations using a driver’s license, and certain glider or balloon operations follow different medical-qualification rules, so confirm which standard applies before scheduling.
Reviewed against FAA guidance: July 9, 2026
The three certificate classes
Which class you need depends on the privileges you exercise, not the certificate you hold.
- First class — required for the airline transport pilot and part 121 flightcrew operations specified in 14 CFR 61.23. An ECG is required at the first application for a first-class certificate after reaching age 35 and annually after reaching age 40.
- Second class — generally required for airline transport pilot second-in-command operations that do not require a first-class medical, commercial pilot privileges in aircraft other than balloons or gliders, and commercial balloon privileges for compensation or hire except qualifying flight instruction.
- Third class — generally used for private, recreational, and student pilot privileges when an FAA medical certificate is required.
Before the exam: MedXPress
Complete FAA Form 8500-8 through MedXPress and bring the confirmation number and government-issued identification to the appointment. The submitted application remains available for 60 days if an AME does not import it.
Answer every medical-history question accurately. If you have a current or past condition, medication, prior FAA letter, or special issuance, review the applicable FAA guidance and ask the AME what records are required. The FAA may require an actual clinical progress note rather than a patient-portal summary or a general physician letter.
What the AME checks
The AME reviews the MedXPress application and medical history, verifies testing performed by office staff, and personally completes the physical examination. Appointment length varies by office and medical history.
- 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
After the examination, the AME may issue the certificate, defer the application for FAA review, or deny it when the applicant is clearly ineligible under FAA standards. If required information is missing, the AME may allow a short period to provide it, but the examination must still be transmitted to the FAA within the required timeframe.
Preparation can reduce avoidable delays but cannot guarantee same-day issuance. Review the MedXPress questions, gather the records specified by current FAA guidance, and contact the AME before the examination when your history is complex.
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.
Related guides
Official sources
Find an Aviation Medical Examiner near you
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This guide provides general educational information, not medical or legal advice. FAA requirements and medical-certification guidance can change. Confirm the current requirements for your circumstances with the FAA and an appropriately qualified AME.