You can legally train on a third-class medical, and plenty of people do. But the first class is the strictest of the three, and it is the one an airline job requires. Sitting that exam first costs $100 to $200 and about half an hour, and it answers the one question that can end a pilot career before it starts.
The short version
| Figure | What it is | Source |
|---|---|---|
| $100 to $200, set by the examiner | Cost | |
| About half an hour | Time | |
| Same day, in most cases | Issued | |
| Your first solo, not your first lesson | Needed by |
Which class you need
It all comes down to what you want to do as a pilot.
| Class | Who it is for | Valid under 40 | 40 or older |
|---|---|---|---|
| First class Required to fly for an airline. The strictest standard, and the one your career plan depends on. |
Airline pilots | 12 months | 6 months |
| Second class The minimum the moment flying becomes your job: charter, banner towing, sightseeing. |
Commercial pilots | 12 months | 12 months |
| Third class Enough to solo and to carry passengers. Not enough to be paid to fly. |
Student and private pilots | 60 months | 24 months |
Calendar months from the exam. A first class does not expire, it steps down: second-class privileges for 12 months, then third class after that.
How to get one
About a week, most of it waiting for the appointment.
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Fill in MedXPress
Free, online at mymedxpress.faa.gov. Your medical history, then a confirmation number to bring to the exam.
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Find an AME
Only an FAA-designated Aviation Medical Examiner can issue it. Locator on faa.gov. Call ahead, not every AME does first class.
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Take the exam
About half an hour. Vision, hearing, blood pressure, a urine sample, your history. Bring photo ID.
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Walk out with it
Most people are issued the same day. $100 to $200 typically, set by the examiner. Anything deferred goes to the FAA, which is slower but not a no.
Before you submit anything
Talk to an AME before you submit
ADHD or ADHD medication, antidepressants, anxiety or depression treatment, sleep apnea, a DUI, a seizure, insulin, a heart condition: ask as a consultation first. A submitted application is on the record, a conversation is not.
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Glasses are fine
First and second class want distant vision correctable to 20/20 in each eye. Correctable is the word that matters.
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BasicMed is not a career route
BasicMed never allows flying for compensation or hire, so it does not cover commercial or airline flying.
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The medical is not the student certificate
Two separate pieces of paper. The student pilot certificate comes through IACRA and does not expire.
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You need it before you solo
Not before your first lesson with an instructor. Get the first class done early anyway.
A plain-English summary, not medical or legal advice. The rules live in 14 CFR 61.23 and 14 CFR part 67, and your Aviation Medical Examiner is the authority on your own case.
Questions
Which FAA medical do I need to become an airline pilot?
A first-class medical certificate. Airline pilots exercising airline transport pilot privileges must hold one, so it is the standard your career depends on. You can legally train on a third class, but the advice from everyone who has done this is to hold a first class before you spend money on training.
Do I need a medical certificate for my first flight lesson?
No. You need one before you fly solo, not before your first lesson with an instructor. That said, a career pilot should get the first-class exam done early, because it is the one thing that can end the plan.
How long is a first-class medical valid?
For airline transport pilot privileges, 12 calendar months if you were under 40 at the exam and 6 calendar months if you were 40 or older. After that it keeps working at lower privilege levels: second class for 12 calendar months from the exam, then third class for 60 calendar months if you were under 40, or 24 if you were 40 or older.
How much does an FAA medical exam cost?
The FAA does not set the price, the examiner does. A first-class exam commonly runs somewhere between $100 and $200. The MedXPress application itself is free.
Can I still fly professionally with a medical condition?
Often yes, through a special issuance, but it takes paperwork and time. If you have a history that could complicate things, talk to an Aviation Medical Examiner as a consultation before you submit anything, because a submitted application is on the record.
