How Do I Pass the Medical Pilot Test?

Most pilots require aviation medical certificates to prove that they are fit and healthy enough to fly. Sports pilots and balloon pilots do not require an aviation medical certificate, however.

It can be a very stressful test for even the fittest and healthiest pilot as their dreams can usually depend on a medical pilot test result.

However, if you’re perfectly fit and healthy, you shouldn’t have anything to worry about. To pass the medical, we should look at what would make you fail it first. Avoiding these should see you pass with flying colors.

Some medical conditions will automatically mean you can not become a pilot such as bipolar disorder or poor eyesight. However, even medical conditions that you may think are benign can affect your medical results.

Here is a list of some conditions and other factors that the FAA has labeled as disqualifying medical conditions.

  • Bipolar disorder
  • Angina pectoris
  • Cardiac valve replacement
  • Epilepsy
  • Heart replacement
  • Diabetes mellitus which requires hypoglycemic medications
  • Coronary heart disease
  • Myocardial infarction
  • Severe personality disorder
  • A permanent cardiac pacemaker
  • Psychosis
  • Substance abuse and dependence

To pass your medical test, get fit and healthy with a workout routine long before the test day and check with your doctor beforehand to see if you have any underlying conditions.

What does a pilot medical consist of?

The initial medical exam for commercial pilots is rather extensive. Although the tests are in constant motion every year, you can expect some basics.

The medical will take one full day where you would see different specialists who all assess your health, ailments, and the possible effects these could cause in the cockpit.

The test day usually looks like this:

  • Complete a general health declaration - This has several questions about your’s, as well as any relative’s health status. These questions are generally simple such as whether you have high blood pressure or take any medication.
  • The general health exam - A doctor looks through your answers and asks some follow-up questions and does a basic examination of you. This includes testing your reflexes and listening to your heart and lungs.
  • ECG - Your heart will get checked with an ECG/EKG. Electrodes are fitted to your upper body for the doctor to measure your heart’s electrical activity. Your blood pressure will also get measured here.
  • Lung function test - Your lung functionality and capacity will be tested. This is measured with you exhaling forcefully through a narrow pipe.
  • Blood and urine samples - Normal blood and urine samples are taken for a general health examination.
  • Vision test - Asked to read a number of letters on a board. An optician may examine your eyes afterward to determine if your vision is good enough for piloting.
  • Color blindness test - You will complete an Ishihara test to see if you are color blind or not.
  • Hearing test - Inside a sound-proofed chamber, you will wear a pair of headphones. When you hear a certain tone, you press a button.

How do I prepare for the FAA medical exam?

Before your medical examination, there are many things you can do to improve your chances of passing. Here is a list of the most important ones:

  • You must get plenty of rest and sleep.
  • Drink a plentiful supply of water on the day of the exam
  • Avoid food or drinks with caffeine, sodium, carbohydrates, or sugar for at least 8 hours before the exam
  • Do not eat anything for at least 4 hours prior to the exam

For vision testing during the exam, prepare by:

  • Bringing glasses or contacts to the exam
  • Pre-test for color blindness
  • Pre-test for distant vision
  • Pre-test for near vision

For your blood pressure:

  • Pre-test your blood pressure with your physician
  • Ask the nurse if you can sit without talking for a few minutes while your blood pressure is tested

For the hearing test:

  • Get a hearing evaluation from your physician or Otolaryngologist before the test. Most pilots can still use a headset as amplification if their hearing is a little impaired

For the electrocardiogram:

  • Pre-test your EKG with your private physician to see if you have any abnormalities. If anything is found, complete an evaluation and attain documentation on the issue. Then, contact the FAA immediately


  • If you have had to visit your doctor for anything other than a routine check-up or general counseling over the past three years, you should take documentation with you to the FAA test

Alcohol and substance problems:

  • If you have had issues with alcohol or substance abuse, the FAA will require extensive paperwork

Changed medical condition:

  • If your medical condition has changed since your last exam, you will need to bring additional documentation

Vitamins, food supplements, and herbal preparations:

  • Some vitamins, food supplements, and herbal preparations can have a serious effect on your FAA medical exam. Contact Pilot Medical Solutions for more advice

What do they check for in a first class medical?

For pilots to exercise Airline Transport Pilot (ATP) privileges, they need to acquire a first-class medical certificate.

During the medical examination, you would be checked over by professionals so they can determine how healthy and fit you are.

Here is what the FAA check in the first-class medical:

  • Distant vision - This has to be 20/20 or better in each eye separately, with or without correction.
  • Near vision - This must be 20/40 or better in each eye separately as measured at 16 inches.
  • Intermediate vision - Has to be 20/40 0r better in each eye separately at age 50 and over, measured at 32 inches.
  • Color vision - Need to have to ability to perceive colors that are necessary for safe piloting duties.
  • Hearing - Need to prove you can hear an average conversational voice in a quiet room with both ears at 6 feet while your back is turned to the examine.r 
  • Audiology - Have to score at least 70% reception in one ear with no greater intensity than 65 dB in the Audiometric Speech Discrimination Test.
  • Pulse - Determines your cardiac system status and responsiveness.
  • Blood pressure - Maximum level is 155/95.
  • Electrocardiogram (ECG) - Taken at age 35 and then annually after the age of 40
  • Mental health - Can’t have psychosis, bipolar disorder, or severe personality disorders
  • Substance dependence and substance abuse - Check your history for any substance dependence and the last two years for substance abuse.

What happens if you fail the FAA medical?

This won’t mean that you will be grounded forever. If you are denied or your results are deferred to the FAA for review, you can appeal the decision with the FAA. This should only be done once an outright decision has been made after a referral.

If you are denied because of substance abuse and you can prove that you have been to rehab and have been sober for at least 24 months, you can appeal. 

If you failed on health problems, you can usually obtain a special issuance medical certificate after the deferment process with the FAA is completed. You may need to change some medications to FAA-approved ones on occasions and wait until you are symptom-free over a period of time.

Most of the time, the FAA will allow you to fly if you are relatively healthy and fit. If you believe the results are wrong, challenge the decision.

What is the 1st, 2nd, and 3rd class FAA medical?

These are medicals you have to go through before taking to the air as a pilot. You have to complete and pass each test to obtain a medical certificate.

These are designated as 1st class, 2nd class, and 3rd class. Generally, 1st class certificates are for an airline transport pilot, a 2nd class is for commercial pilots, and 3rd class examinations are taken by students or recreational and private pilots. 

You need these certificates before flying solo in an airplane, helicopter, airship, or gyroplane. These are taken to alert you and the FAA of any conditions that could prevent you from becoming a pilot. 

What is a Medical Class 3 pilot?

A Medical Class 3 pilot has a 3rd class medical certificate. This is to exercise the privileges of a private pilot license as well as any lower pilot certification level (not the FAA’s sport pilot certificate).

A 3rd class medical expires after 60 months in the US for people under the age of forty or 24 calendar months for those over forty. 

Medical Class 3 pilots are generally students, private pilots, or recreational pilots. Class 1 and 2 pilots require 1st class and 2nd class medical certificates.