A first class medical certificate is required to exercise the privileges of an airline transport pilot license – and therefore act as pilot in command of a scheduled air carriers’ aircraft.

A first class medical certificate is either good for 6 months or 12 months, depending on if the pilot is aged 40 or older.

How Long is a First Class Medical Good For?

If You’re Under 40

If younger than 40, you are required to renew your first class medical certificate every 12 months.

After 12 months, a first-class medical certificates lapses to a third class certificate.

If You’re 40 or Older

If you’re 40 or older, you are required to renew your first class medical certificate every 6 months.

What Happens When Your First Class Medical Expires?

If you’re 40 or older and your first class medical certificate expires, privileges will change to that of a second-class medical certificate for 6 months, until being downgraded to the privileges of a third-class medical certificate.

If you’re younger than 40 and don’t renew your first class medical certificate after 12 months, it will lapse to a third class certificate.

It’s important to note that the duration is calculated according to the month of the examination, not the day of the examination.

First Class Medical Certificate Requirements

First class medical certificate requirements include:

Vision

  • Distant Vision: Distant vision must be correctable to 20/20 or better in each eye
  • Near Vision: Near vision must be correctable to 20/40 or better in each eye, as measured at 16 inches
  • Intermediate Vision: If aged 50 or over, intermediate vision must be correctable to 20/40 or better in each year, as measured at 32 inches
  • Color Vision: The FAA state that it is necessary to possess the “ability to perceive those colors necessary for safe performance of airman duties”

Hearing

You must “demonstrate hearing of an average conversational voice in a quiet room, using both ears at 6 feet, with the back turned to the examiner or pass one of the audiometric tests”.

This test can either be an audiometric speech discrimination test (a score of at least 70% reception in one ear is required), or a pure tone audiometric test.

ENT, Pulse, and Blood Pressure

  • ENT: You must not suffer from any ear, nose, or throat condition that interferes with, or could be aggravated by flying, including the interference of clear communication, or is manifested by vertigo or a disturbance of equilibrium
  • Pulse: Not disqualifying per se. Used to determine cardiac system status and responsiveness
  • Blood Pressure: While no specified values are stated in the standards, the current guideline maximum value is 155/95

Electro-Cardiogram

An Electro-Cardiogram (EKG) is required at age 35 and annually after age 40.

Mental Health

You must not have a diagnosis of psychosis, bipolar disorder, or severe personality disorders.

Substance Dependence and Abuse

A diagnosis or medical history of substance dependence is disqualifying unless there is established clinical evidence of recovery, including abstinence of at least 2 years. A history of substance abuse within the past 2 years is disqualifying.

Disqualifying Conditions

Besides substance use and dependence, and the mental health conditions listed above, medical disqualifying conditions include:

  • Angina pectoris
  • Bipolar disease
  • Cardiac valve replacement
  • Coronary heart disease that has been treated or, if untreated, that has been symptomatic or clinically significant
  • Diabetes mellitus requiring hypoglycemic medications
  • Disturbance of consciousness without satisfactory explanation of the cause
  • Epilepsy
  • Heart replacement
  • Myocardial infarction
  • Permanent cardiac pacemaker
  • Transient loss of control of nervous system function(s) without a satisfactory explanation of the cause

What Happens If You Fail Your First Class Medical Exam?

If you fail your first class medical exam, the first thing you should do is find out why you failed.

Sometimes the reason for failing a medical exam can easily be solved through medication, or perhaps a little longer through nutrition and exercise.

If you fail your first class medical exam, the privileges that come with the certificate will no longer be applicable, which means that you will no longer be able to continue in the capacity of a captain if you fly for an airline, though a special issuance can be issued.

As long as you meet the requirements to obtain a second class medical certificate, you can still fulfill second-in-command duties.

How Long is a Second Class Medical Good For?

A second-class medical certificate is good for 12 months for operations requiring a second class medical certificate.

How Long is a Third Class Medical Good For?

As specified in FAR 61.23, a third-class medical certificate is good for 5 years (60 months) if you are younger than 40 years old, and 2 years (24 months) if you are aged 40 or older.

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