Pilot Medical Exams: What You Need to Know – Requirements and Common Disqualifiers

If you're planning to become a pilot, passing a medical exam is one of the very first hurdles you'll face. Whether you're aiming for a Private Pilot Licence (PPL), Commercial Pilot Licence (CPL), or even an Airline Transport Pilot Licence (ATPL), a valid aviation medical certificate is non-negotiable. This post will walk you through the different types of medicals, what to expect during the process, and which conditions might keep you grounded.

Types of Aviation Medical Certificates

There are three main classes of aviation medical certificates, depending on the type of licence you're pursuing:

✅ Class 1 Medical Certificate

• Required for: Commercial Pilots (CPL) and Airline Transport Pilots (ATPL)

• Validity:

  • Under 40 years: 12 months

  • 40 years and over: 6 months

• Includes: ECG, hearing test, vision assessment, blood tests, lung function, urine test, and a full physical exam.

✅ Class 2 Medical Certificate

• Required for: Private Pilots (PPL)

• Validity:

  • Under 40 years: 60 months

  • 40 years and over: 24 months

• Less stringent than Class 1, but still requires vision, hearing, and general health checks.

✅ Class 3 Medical Certificate

• Required for: Air traffic controllers (not pilots)

• Included here for completeness.

What to Expect During the Medical Exam

Your aviation medical exam will be conducted by a Designated Aviation Medical Examiner (DAME) approved by your national aviation authority (e.g., the SACAA in South Africa). Here's what usually happens:

• Medical History Review: Includes previous illnesses, medications, surgeries, and family history.

• Vision Test: Both corrected (with glasses or contacts) and uncorrected vision are assessed. Depth perception, color vision, and peripheral vision are checked.

• Hearing Test: You need to be able to hear a normal conversation at 2 meters, or pass an audiometry test.

• Cardiovascular Check: For Class 1 exams, this includes an ECG (especially if you're over 40).

• Lung Function Test: Spirometry is used to evaluate respiratory health.

• Blood and Urine Tests: To screen for diabetes, kidney issues, and other hidden conditions.

• Physical Exam: General health check including BMI, blood pressure, and neurological function.

Common Disqualifiers

While many conditions won’t automatically disqualify you from flying, certain medical issues can raise red flags. Here's what might prevent you from passing a medical exam:

❌ Vision Problems

• Severe uncorrected vision issues

• Poor color vision (some licenses allow restrictions if you fail the Ishihara test)

❌ Hearing Loss

• Significant hearing loss that impairs radio communication

❌ Heart Conditions

• History of heart attacks, arrhythmias, or uncontrolled high blood pressure

❌ Neurological Disorders

• Epilepsy, seizures, or a history of strokes

❌ Mental Health Conditions

• Severe anxiety, depression, bipolar disorder, or any psychiatric condition that affects decision-making

❌ Diabetes Requiring Insulin

• In most jurisdictions, insulin-dependent diabetes can be disqualifying (exceptions exist under strict protocols)

❌ Substance Abuse

• History of alcohol or drug abuse, or a positive test result

Can You Reapply if You’re Disqualified?

In many cases, yes. If you're denied a medical certificate, don't give up. You may be eligible for a special issuance or a waiver depending on the condition and how well it's managed. You’ll need to provide additional documentation and undergo further evaluations, but it's often worth the effort.

Tips to Pass Your Medical

• Be honest on your medical history form. Dishonesty can lead to long-term consequences.

• Manage your health well before applying. Eat right, exercise, and get enough sleep.

• Bring your glasses or contacts, if you use them.

• Avoid caffeine or stress before the exam, especially if you’re concerned about blood pressure.

Final Thoughts

A pilot medical exam isn’t something to fear—it’s a safeguard to ensure you're fit to fly safely. If you're healthy and proactive, you’ll likely have no issues. But even if you do face a challenge, the aviation medical system often allows for second chances.

Ready to take flight? Make your appointment with an Aviation Medical Examiner and take that next step toward the skies!