First, Second, and Third Class FAA Medical Exams
FAA medical-certificate requirements are tied to the operation and privileges being exercised, not simply the pilot certificate printed on your card. Age also affects how long a certificate satisfies first- or third-class requirements.
Reviewed against FAA guidance: July 9, 2026
First class medical
A first-class medical is required for the operations specified in 14 CFR 61.23, including pilot-in-command privileges of an airline transport pilot certificate, certain airline transport pilot second-in-command privileges, and service as a required pilot flightcrew member in part 121 after reaching age 60. For first-class operations, it is valid through the end of the 12th month after the examination month when the applicant was under 40, or the 6th month when the applicant was 40 or older.
An ECG is required at the first application for a first-class certificate after reaching age 35 and then annually after reaching age 40.
Second class medical
At least a second-class medical is generally required for airline transport pilot second-in-command privileges 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. It satisfies second-class operating requirements through the end of the 12th month after the examination month, regardless of age.
Third class medical
A third-class medical generally satisfies student, recreational, private pilot, and applicable flight-instructor medical requirements through the end of the 60th month after the examination month when the applicant was under 40, or the 24th month when the applicant was 40 or older.
A higher-class certificate can satisfy lower-class operations
A first- or second-class certificate does not physically change into another certificate. Instead, it may continue to satisfy lower-class operating requirements for a longer period. For example, a first-class certificate can continue to satisfy third-class requirements for 60 months when the pilot was under 40 at the examination, or 24 months when the pilot was 40 or older.
When an FAA medical certificate may not be required
BasicMed, eligible sport-pilot operations using a U.S. driver’s license, and certain glider or balloon operations have separate rules. Review the conditions and limitations before assuming that one of these alternatives applies.
Choosing an AME by class
When searching for an AME, filter by class if you know what you need. If you are unsure, ask your instructor, employer, or the AME office before the appointment.
Official sources
Find a first, second, or third class AME
Use the AME class filter to find Aviation Medical Examiners for the medical certificate you need.
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.