The FAA ensures pilots are safe to operate aircraft by requiring them to maintain a valid medical certificate.
A medical certificate may only be obtained by visiting an AME (Aviation Medical Examiner). AMEs are doctors specifically authorized by the FAA to issue flight medicals.
The medical is one of the documents you must carry on board as a student while flying solo (without your instructor).
If you are training towards a Sport Pilot Certificate you may not need a medical, however for the rest of us this is a requirement in order to obtain your pilot certificate.
The catch to the Sport Pilot rule is you cannot have applied for and been denied a medical and you cannot have previously held a medical which was suspended or revoked.
Therefore, if you don’t believe you will qualify for a medical certificate and would like to fly for fun and recreation you SHOULD NOT apply for one.
Instead look into getting certified as a Sport Pilot rather than a private pilot and fly using a valid drivers license in lieu of a medical.
To operate as a Sport Pilot without a medical certificate you must hold a valid driver’s license and comply with any limitations on your driver’s license.You also must not have any medical condition that would make you unable to operate an aircraft in a safe manner.
However, just because you have a potentially disqualifying condition does not necessarily mean you will never be able to fly for hire or for an airline.
There is a process which may allow you to be approved for a flight medical after an initial disqualification referred to as a Special Issuance. You can learn more about special issuances here: https://www.faa.gov/ame_guide/app_process/general/si
Disqualifying Conditions
The following conditions are listed in the regulations as disqualifying medical conditions; however, in many cases when the condition is adequately controlled, the FAA will issue medical certification contingent on periodic reports.
- 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 cause
- Epilepsy
- Heart replacement
- Myocardial infarction
- Permanent cardiac pacemaker
- Personality disorder that is severe enough to have repeatedly manifested itself by overt acts
- Psychosis
- Substance abuse
- Substance dependence
- Transient loss of control of nervous system function(s) without satisfactory explanation of cause.
Other conditions not specifically listed in the regulations may also be disqualifying. If you have a condition that you are concerned about this best option is to speak directly to an AME (Aviation Medical Examiner).
Medications That Prevent Issuance of an Aviation Medical Certificate
ANGINA MEDICATIONS
- nitrates (nitroglycerin, isosorbide dinitrate [Imdur])
- ranolazine (Ranexa)
ANTICHOLINERGICS (ORAL)
- atropine
- Over-active bladder (OAB) medications with tertiary structure that carry strong warnings about potential for sedation and impaired cognition:
- tolterodine (Detrol)
- oxybutynin (Ditropan)
- solifenacin (Vesicare)
- Parkinsonism
- benztropine (Cogentin)
CANCER TREATMENTS
- Including many chemotherapy, radiation therapy, and immunotherapy medications, whether used for induction, maintenance, or suppressive therapy.
CONTROLLED SUBSTANCES (SCHEDULES I – V)
- Including medical marijuana, even if legally allowed or prescribed under state law.
- Any open prescription for chronic use of any drug or substance with no
resolution. (If short-term use, see “pain medication” and “anti-anxiety” in DNF
section.)
DIABETIC MEDICATION
- pramlintide (Symlin)
- Most diabetes medications are allowed. See Acceptable Combinations of Diabetes Medications.
DOPAMINE AGONISTS
- Used for Parkinson’s disease or other medical conditions:
- bromocriptine (Cycloset, Parlodel)
- pramipexole (Mirapex), ropinirole (Requip)
- rotigotine (NeuPro)
HYPERTENSIVE (CENTRALLY ACTING)
- Including but not limited to:
- o clonidine
- guanabenz, methyldopa, reserpine
MALARIA MEDICATION
- mefloquine (Lariam)
- Most other malaria medications are allowed.
PSYCHIATRIC OR PSYCHOTROPIC MEDICATIONS
- Even when used for conditions other than mental health. Including but not limited to:
- Antidepressants (some are allowed – see SSRI guidance)
- Anti-anxiety (some are DNF – see that section)
- Antipsychotics
- Attention deficit disorder (ADD) or attention deficit hyperactivity disorder
- (ADHD) medications
- Mood stabilizers
- Stimulants
- Tranquilizers
SEIZURE MEDICATIONS
- Even if used for non-seizure conditions (e.g., migraines)
STEROIDS, HIGH DOSE
- Greater than 20 mg prednisone or prednisone equivalent per day.
WEIGHT LOSS
- Sympathomimetic (such as phentermine [Adipex])
- bupropion + naltrexone (Contrave)
Other conditions that may be disqualifying include drug or alcohol related offenses.
Knowing there are some disqualifying conditions that may preclude you from receiving a valid medical certificate you can see why it is so important to get this completed prior to starting your training.
The last thing we want to see is someone come and spend thousands of dollars to get up to the solo phase of flight training just to find out they cannot acquire a medical certificate.
Basic Med
You may have heard about this thing called Basic Med. Basic Med allows pilots to fly without a medical certificate by meeting alternative requirements with additional limitations placed on them.
There are many benefits to going Basic Med and I encourage many people to do so as it may save your ability to keep flying in the event of developing a condition that would be disqualifying otherwise.
However, in order to qualify for Basic Med you must have held a valid FAA Medical Certificate after July 14, 2006.
Steps To Aquire Your Medical Certificate
Step 1 Submit Your Medical Application
Please keep in mind the technical stuff will change over time. We will attempt to keep this updated through future updates, however from time to time the exact steps may be slightly different.
- Request an account and follow the instructions to get logged in at: https://medxpress.faa.gov
- If you want more information on medXpress you can read this: https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/medxpress.pdf
To select the correct class of medical consider the following:
- 1st Class is required by airline pilots and charter pilots operating under an ATP (Airline Transport Pilot) Certificate. If your goal is to ultimately become an airline or charter pilot flying jets it is a good idea to go ahead and apply for 1st Class now to know you are able to obtain it later when you will be required to have it.
- 2nd Class is required for those operating under a commercial pilot certificate such as smaller charter flights, pipeline patrol, and other entry level pilot jobs. If you are leaning this direction you might as well apply for 1st class.
- 3rd Class is for recreational and private pilots. If you only intend to fly for yourself and don’t intend to ever fly for hire this option is for you.
- After selecting the class click the “Next” button. Enter in your information for each step as applicable.
After submitting your medical application you will be issued a confirmation number.
This confirmation number is important and will be required to schedule your appointment with an AME (Aviation Medical Examiners)..
Step 2 Schedule Your Appointment with an AME
After submitting your medical application you have 60 days to complete a medical evaluation by an AME.
Except to pay Anywhere from $250 – $300 for this exam. Unfortunately it is not typically covered by insurance.
If you are local to the Des Moines area you can find a List of Our recommended AME’s Here.
If you are not local to Des Moines find an AME near you here: https://designee.faa.gov/designeeLocator
- Select “AME” from the dropdown and input the necessary fields until you find an AME near you.
If you don’t get any results you may have to broaden your search.
The FAA is supposed to keep this list up to date, however at times there may be a lot of AMEs on the list that are retired or no longer doing medicals.
Be patient and keep trying, or contact your local flight school to see who they recommend for acquiring medicals.
Step 3 Show Up to Your Appointment
Next just show up to your appointment. The process is quite similar to a routine physical. If you don’t take any prescription meds and are in decent health it should go pretty quickly. After the exam you should leave with your medical certificate in hand. If not and your AME tells you that you will need a special issuance, now is the time to ask questions about the process.
