A flight physical is a mandatory medical assessment required for all pilots and air traffic controllers to ensure they are physically and mentally fit to operate aircraft safely. This specialized examination verifies that no medical condition exists which could impair judgment or performance while flying. The primary purpose is to maintain the highest safety standards within the aviation system. This medical clearance confirms the pilot meets established aeromedical standards.
Understanding Physical Certification Levels
Not all flight physicals are identical, as the required medical standards depend on the level of flying privileges sought. The Federal Aviation Administration (FAA) in the United States uses a tiered system of medical certificates, each with distinct requirements. The specific class determines the depth of the examination and the frequency of renewal.
The highest level is the Class 1 Medical Certificate, which is mandated for Airline Transport Pilots (ATPs) who fly for major carriers. The Class 2 Medical Certificate is required for commercial pilots who fly for hire, such as charter pilots, flight instructors, or corporate aviators. The Class 3 Medical Certificate is the minimum requirement for student pilots, private pilots, and recreational flyers who are not flying for compensation or hire.
The Standardized Examination Components
Every flight physical, regardless of class, begins with a detailed review of the applicant’s medical history, followed by a standardized physical examination performed by an FAA-designated Aviation Medical Examiner (AME).
Vision and Hearing Assessment
A core component involves a thorough vision assessment, testing distance, near, and color vision. For a Class 3 certificate, the minimum acceptable distant visual acuity is 20/40 in each eye, with or without corrective lenses, while Class 1 requires 20/20 distant vision with correction. Color vision testing ensures the pilot can accurately perceive the colors necessary to distinguish between airport lights, weather maps, and cockpit instrumentation. Hearing is also tested to ensure effective communication, often through a conversational voice test performed at a six-foot distance. If the applicant cannot pass this test, they may be required to undergo formal audiometry.
General Physical Examination
The general physical examination includes recording height and weight, and measuring blood pressure and pulse rate. Federal standards generally require blood pressure to be below 155/95 mmHg, and the pulse must be regular and within a normal range. A comprehensive physical check of major organ systems, including the heart, lungs, and neurological function, is also performed.
Urinalysis
A mandatory urine specimen is collected during the examination for routine urinalysis. This test checks for the presence of protein, which can indicate kidney issues, and glucose, which suggests diabetes. The sample may also be used for drug screening, especially for pilots in certain employment categories, ensuring compliance with federal substance abuse regulations.
Systemic Health Requirements and Review
Beyond the immediate physical tests, the flight physical involves a deep review of a pilot’s long-term and systemic health status, focusing on chronic conditions that could lead to sudden incapacitation. Cardiovascular health is highly scrutinized, with a history of conditions like myocardial infarction (heart attack), angina pectoris, or the presence of a permanent cardiac pacemaker being automatically disqualifying without further review. Applicants for a Class 1 certificate are required to have an electrocardiogram (EKG) at age 35 and annually after age 40 to assess cardiac rhythm and function.
Neurological conditions, such as a history of epilepsy or unexplained loss of consciousness, are also disqualifying due to the risk of in-flight impairment. These conditions, along with severe mental health diagnoses like psychosis, bipolar disorder, or a history of substance dependence, require extensive documentation and specialized authorization. Diabetes mellitus that requires insulin or certain oral hypoglycemic medications is also initially disqualifying.
For many of these conditions, outright denial is not the final outcome. Instead, the applicant’s file is deferred to the federal authority for a determination of eligibility. A pilot can receive a medical certificate through a process known as Special Issuance, or a waiver, if they can provide comprehensive medical records demonstrating the condition is stable, well-managed, and does not pose an undue safety risk. This often requires regular monitoring and specific follow-up testing to maintain the certificate.
Certification Outcomes and Renewal Cycles
Upon completion of the physical examination, the Aviation Medical Examiner (AME) makes one of three determinations: issuance, deferral, or denial. If all standards are met, the AME issues the medical certificate immediately. If a potentially disqualifying condition is present, the AME must defer the application to the central regulatory office for a final decision. Denial occurs only if the applicant clearly fails to meet the minimum standards and the condition cannot be mitigated through a Special Issuance.
The validity period of the medical certificate depends on the class and the pilot’s age. A Class 1 certificate is valid for six calendar months for pilots aged 40 and older, and twelve calendar months for pilots under age 40. The Class 2 certificate is valid for twelve calendar months for commercial operations regardless of the pilot’s age. A Class 3 certificate lasts 60 calendar months for pilots under age 40, and 24 calendar months for pilots aged 40 and older. The process begins with the pilot completing an online application through the MedXPress system, which the AME reviews and submits electronically after the examination.