First Class Medical Certificate
This is the certificate an airline transport pilot must hold to command an airplane, and sitting for it is the quickest way to learn whether a professional route is open to you at all. It costs a small fraction of one training phase. It can also close the route on the spot, which is precisely why it belongs at the beginning.
What Is A First Class Medical Certificate?
It is the highest of three classes of FAA airman medical certificate, issued under subpart B of part 67, and 61.23(a)(1) makes it a requirement for exercising the pilot-in-command privileges of an airline transport pilot certificate. Eight sections set the standards, running from 67.101 through 67.115. Only an Aviation Medical Examiner may issue one. A flight school cannot, and neither can the physician who knows you best.
The reason to sit it early is structural rather than medical. Nothing in a training syllabus asks for this certificate until the far end of a professional route, so it is entirely possible to spend two years and a great deal of money before anybody checks whether you can hold one. That ordering is backwards, and it is the most expensive avoidable error available in this subject.
The examination itself is unremarkable for most people. Sight and hearing, blood pressure, the usual systems looked over, a sample, and a history-taking that is longer and a good deal more specific than the one your own physician conducts. Past a certain age it adds a heart tracing. Healthy adults mostly walk out holding a certificate.
What catches people is history rather than present health. A diagnosis written down a decade ago, a medication stopped years back, one episode nobody thought of as medical at the time — those are what produce a deferral, and a deferral is a delay counted in months rather than days.
One thing this page refuses to do is predict whether a certificate will be issued to you. Nobody who has not examined you can know that, and a school reassuring you about it is guessing with something that matters. What follows is the text of the standards, where each one lives, and what the words in it mean.
Who Actually Needs A First Class Medical Certificate?
14 CFR 61.23(a)(1) names three situations and no others. Exercising the pilot-in-command privileges of an airline transport pilot certificate is the first. The second is second-in-command privileges of an airline transport pilot certificate in a flag or supplemental part 121 operation requiring three or more pilots. The third catches people out: serving as a required pilot flightcrew member in any part 121 operation once the sixtieth birthday has passed, whichever seat you occupy.
Everything below that is served by a lower class. Commercial pilot privileges in an airplane need at least a second class under 61.23(a)(2)(ii). Private, recreational and student privileges need at least a third class under 61.23(a)(3)(i), or nothing at all from part 67 if you qualify to operate within the conditions and limitations at 61.113(i).
So most people reading this page do not yet need a first class certificate and will not need one for years. The argument for sitting the examination anyway is not that the rule demands it. It is that a first class examination answers a larger question for one appointment, and the certificate then steps down through the lower privileges rather than being wasted.
What Are The First Class Medical Standards?
Subpart B of part 67 holds eight sections. 67.101 is eligibility, 67.103 the eye, 67.105 ear, nose, throat and equilibrium, 67.107 mental, 67.109 neurologic, 67.111 cardiovascular, 67.113 the general medical condition and 67.115 the discretionary route. Below is what each governs and the figures inside it.
67.103 — Eye
Distant acuity has to reach 20/20 or better, eye by eye, under 67.103(a), with lenses or without them. Where lenses are what get you there, the certificate is issued on the condition that you wear them. Near vision under 67.103(b) has to reach 20/40 or better, Snellen equivalent, at sixteen inches, again eye by eye.
From the fiftieth birthday, 67.103(b) runs that near check at two distances rather than one: sixteen inches and thirty-two inches. This is the paragraph that surprises people. It surprises them again when they discover the second-class standard at 67.203(b) says exactly the same thing, and that the third-class standard at 67.303 says neither. Reading glasses that solve the close range can leave the middle one short, and the usual answer to that is a different prescription rather than a different career.
The section also requires colour perception sufficient for airman duties, normal fields of vision, and freedom from eye conditions that interfere with function or would be aggravated by flying. 67.103(f) adds a fusion test that is only run where specific prism-diopter thresholds are exceeded.
- 20/20 at distance, each eye separately
- 20/40 near at sixteen inches, each eye separately
- From fifty, that near check runs at sixteen and at thirty-two inches
- Colour perception sufficient for airman duties
- Normal fields of vision
67.111 — Cardiovascular, And The Heart Tracing
Here the first class parts company with the other two, and this is the single practical difference between the classes. 67.111(a) rules out an established medical history or clinical diagnosis in six areas: heart attack, angina pectoris, coronary heart disease that has needed treatment or been symptomatic or clinically significant untreated, cardiac valve replacement, permanent pacemaker implantation, and heart replacement.
Then 67.111(b) adds something the other classes never ask for. A person applying for first-class certification must show no heart attack and no other clinically significant abnormality on an electrocardiographic examination, first at the first application after the thirty-fifth birthday and then annually after the fortieth. 67.111(c) will not accept a tracing dated more than sixty days before the application it accompanies.
The second-class equivalent at 67.211 lists the same six conditions as lettered paragraphs and then stops. There is no electrocardiogram paragraph in it at any age. If you are over forty and weighing the two classes against each other, that is the difference, and it is essentially the whole of the difference.
- Six cardiovascular conditions listed at 67.111(a)
- A tracing at the first application once thirty-five has passed
- A tracing every year once forty has passed
- Nothing older than sixty days at application
- 67.211 asks for no tracing at all, at any age
67.107 And 67.109 — Mental And Neurologic
These two are worth reading before you book, because they are written around diagnoses and treatment histories rather than around something you pass or fail on the day. 67.107(a) names a severe personality disorder repeatedly shown in overt acts, a psychosis as the section defines it, a bipolar disorder, and substance dependence except where clinical evidence shows recovery including complete abstinence across at least the preceding two years. 67.107(b) covers substance abuse within the preceding two years.
67.109(a) names three things: epilepsy; a disturbance of consciousness for which no satisfactory medical explanation exists; and a transient loss of control over nervous system functions, again where the cause is medically unexplained. Both sections then close with a broader clause allowing the Federal Air Surgeon to consider any other condition of that kind on its facts.
If either section is likely to touch you, a paid consultation with an Aviation Medical Examiner before you apply is worth considering, because an examiner can tell you what evidence the FAA is likely to look for. We will not tell you what such a conversation is likely to produce, because we do not know, and pages that promise a particular outcome from it are describing something they cannot see.
- 67.107 is written around diagnoses and histories
- Substance dependence requires two years of documented abstinence
- 67.109 names epilepsy and unexplained disturbances of consciousness
- Both sections end with a broader discretionary clause
67.105 And 67.113 — Hearing, And The General Condition
67.105(a) accepts any one of three hearing demonstrations. Hearing a conversational voice, at ordinary volume, in a quiet room with both ears at six feet while the examiner faces away. Or a speech discrimination score of at least seventy percent in one ear or in a sound field. Or pure tone audiometry falling within the published table of worst acceptable thresholds. The rest of the section covers ear, nose, throat and equilibrium conditions, and vertigo.
67.113 is the catch-all. Paragraph (a) rules out an established history or clinical diagnosis of diabetes mellitus requiring insulin or another hypoglycaemic drug for control. Paragraphs (b) and (c) allow the Federal Air Surgeon to consider any other disease, defect or limitation, and any medication or treatment, that would make you unable to exercise the privileges safely.
- Three alternative hearing demonstrations at 67.105(a)
- Seventy percent is the speech discrimination threshold
- 67.113(a) addresses insulin-requiring diabetes specifically
- Medication and treatment are considered under 67.113(c)
67.115 — The Discretionary Route
67.115 sends anybody failing 67.103 through 67.113 to 67.401. Under that section an Authorization for Special Issuance, valid for a stated period, may be granted at the discretion of the Federal Air Surgeon where the applicant shows the duties of the class applied for can be performed without endangering public safety. 67.401(a) also allows a special medical flight test, practical test or medical evaluation for that purpose.
67.401(b) offers a second route where a disqualifying condition is static or nonprogressive: a Statement of Demonstrated Ability. It carries no expiry, and it lets a designated examiner issue a certificate of the specified class provided the condition described on its face has not adversely changed.
This route is real and it is used. It is also not something to build a plan around, because it runs on the discretion of the Federal Air Surgeon on the evidence in front of him, and neither we nor anybody else can tell you in advance how that will land.
- 67.115 points at 67.401
- An Authorization is valid for a specified period
- A Statement of Demonstrated Ability does not expire
- Both are discretionary, and neither is a plan
When Is An ECG Required For First Class Certification?
At the first application after your thirty-fifth birthday, and then every year after your fortieth. That is 67.111(b), and it is the only place in part 67 where an electrocardiogram is required by the standard rather than requested on the facts of a particular case.
67.111(c) adds a timing constraint that is easy to fall foul of. A tracing satisfies the requirement only where it is dated no earlier than sixty days before the date of the application it accompanies, and where it was performed and transmitted according to acceptable standards and techniques. An older tracing taken for another purpose does not carry over, so the sequencing of the appointment matters.
The practical effect for anybody over forty holding a first class certificate is an annual heart tracing for the rest of a professional flying career. That is administration rather than an obstacle for most people. It is also, precisely, the reason many working pilots who do not need airline transport command privileges renew at second class instead: 67.211 asks for none of it.
How Should You Prepare For The Examination?
Four things, none of which is medical advice and all of which reduce the chance of an avoidable delay. The order is deliberate.
Assemble Your Own History First
Diagnoses, dates, medications past and present, surgeries, and anything a physician wrote down that you might not think of as aviation-relevant. The history-taking on this examination is more specific than the one you are used to, and arriving with the dates already in hand is the single most useful preparation there is.
Decide Which Class You Are Sitting
Sitting first class answers the larger question and the certificate steps down through the lower privileges afterwards. Sitting second or third class answers a smaller question with fewer items attached. Which is right for you depends on whether a professional route is genuinely in view, and it is worth settling before the appointment rather than during it.
Consider A Consultation If Anything Is Complex
Where something in your history is likely to be difficult, a paid consultation with an Aviation Medical Examiner before you apply lets you find out what evidence is likely to be wanted. What such a conversation produces is not something we can predict, and this page will not pretend otherwise.
Get The Sequencing Right
If a tracing is required, 67.111(c) will not accept one dated more than sixty days before the application it accompanies. Bring the reading prescription you actually use, particularly if you are fifty or older and the near check will be run at two distances.
How Long Does A First Class Medical Certificate Last?
Longer than most people assume, because one certificate runs three separate clocks. The duration table at 14 CFR 61.23(d) uses your age on the date of examination, not your age today, and it stops supporting airline transport privileges a long time before it stops supporting private ones.
Airline Transport Pilot Privileges
The short clock, and the one a professional career is scheduled around. It halves across the fortieth birthday, which is worth putting into a renewal plan a year ahead.
- Under 40 At Examination12 calendar months
- 40 Or Older6 calendar months
- Rule14 CFR 61.23(d)(1)
Commercial Pilot Privileges
Once the first-class window shuts, the same piece of paper still supports commercial privileges out to twelve months at any age. This is why a first class examination is rarely money wasted.
- Any Age12 calendar months
- Also Met ByA second class certificate
- Rule14 CFR 61.23(d)(1)(iii)
Private, Student And Instructor Privileges
The long tail. The certificate keeps supporting these for years after it has stopped supporting anything you could be paid for.
- Under 40 At Examination60 calendar months
- 40 Or Older24 calendar months
- Rule14 CFR 61.23(d)(1)
What Happens If You Do Not Meet One Of The Standards?
The route is 67.115, which points at 67.401, and the outcome is a matter for the Federal Air Surgeon rather than for the examiner in the room. An Authorization for Special Issuance may be granted for a stated period where you show that the duties of the class applied for can be performed without endangering public safety, and 67.401(a) allows a special medical flight test or evaluation to be authorised as part of establishing that.
Where the condition is static or nonprogressive, 67.401(b) allows a Statement of Demonstrated Ability instead. That does not expire, and it authorises a designated examiner to issue a certificate of the specified class provided the condition on its face has not adversely changed. 67.401(d) lets the Federal Air Surgeon limit duration, condition renewal on further testing, and state operational limitations on the face of the certificate.
We are not going to characterise your chances. That would require knowing your history, and the honest position of a flight school is that this conversation belongs entirely to you and an Aviation Medical Examiner. What we will say is that the process exists, that it is used regularly, and that starting it earlier is uniformly less costly than starting it after two years of training spend.
One more thing belongs here rather than buried at the foot of the page. Acting as pilot in command, or as a required crewmember, is prohibited by 61.53 while you know or have reason to know of a medical condition that would stop you meeting the requirements for the certificate that operation needs, or while taking medication or treatment with that effect. A valid certificate in your pocket is not the whole of the duty.
What Does The Training Behind This Certificate Cost?
The medical examination is not one of these figures and never reaches an invoice from us; it is settled directly with the examiner. What is priced here is the flying, phase by phase, fixed at the point you enrol.
Private Pilot — Comprehensive
Sixty logged hours rather than the regulatory forty, which is the shape most adult students actually finish in.
- ✓60 hours logged, 55 of them airborne
- ✓50 hours flown with an instructor beside you
- ✓5 simulator sessions and 10 hours of ground school
- ✓Books and training materials inside the price
Instrument Rating
The rating that stops weather from deciding your calendar, and the second phase of any professional route.
- ✓Flown in the same airplanes you learned in
- ✓Redbird sessions used for procedures and scan
- ✓Fixed at the figure you enrolled at
Multi-Engine Add-On
A class rating flown in the Piper Seminole, bought as a rating rather than by the hour.
- ✓No hour floor written into the class rating
- ✓Ten to fifteen hours is the usual shape
- ✓Priced as a rating, never as a rental
Airline Career Track
No logged time at the start, a commercial certificate and an instructor rating at the end, under one figure agreed on day one.
- ✓Five phases beneath a single number
- ✓Payment arrangements from $2,500 down
- ✓Nothing repriced when a phase ends
- ✓Part 61 throughout
Six Things Worth Knowing Before The Appointment
None of these is medical advice. All of them are things people tell us afterwards that they wished they had known beforehand.
History Beats Fitness
What causes delay is almost never present health. It is a diagnosis recorded years ago, or a medication stopped and forgotten. Bring the dates.
Only An AME Can Issue
Not your own physician, not a specialist, not us. The examination has to be conducted by an Aviation Medical Examiner, and only an examiner can issue what comes out of it.
Bring The Glasses You Actually Use
From fifty, 67.103(b) runs the near check at sixteen inches and at thirty-two. A prescription tuned for reading can meet one distance and not the other.
Watch The Sixty-Day Window
67.111(c) will not accept a heart tracing dated more than sixty days before the application it goes with. Sequence the tracing and the appointment accordingly.
Note The Duration Rule Uses Your Age At Examination
61.23(d) counts from your age on the examination date rather than from your age when the certificate gets used. Sitting shortly before a fortieth birthday is therefore worth a moment of thought.
A Certificate Is Not A Permission Slip
61.53 stops you flying when you know of a condition that would prevent you meeting the standard, whatever the paper in your pocket says. That duty is continuous.
Is BasicMed An Alternative To A First Class Medical Certificate?
No, and the reason is worth stating precisely. The route at 14 CFR 61.113(i) lets a private pilot act as pilot in command without a part 67 certificate, given a valid U.S. driver’s licence and everything 61.23(c)(3) requires. 61.23(c)(1) lists where that route reaches: student, recreational and private privileges, flight instructor duties and examiner duties. Commercial and airline transport privileges are not among them.
There is also a gate on entry that catches career changers. 61.23(c)(3)(i)(B) requires that a medical certificate issued under part 67 was held by you at some time after 14 July 2006. Somebody who has never held one cannot start there, which is another reason the examination belongs at the beginning of a plan.
And one correction that matters more than any of the above, because it has been published wrongly and people have planned around it. Under 68.9(a)(3) the cardiovascular list is limited to one special issuance per diagnosis, and that list holds four items: heart attack, coronary heart disease that has required treatment, valve replacement and heart replacement. Mental health works differently, and so does neurology. 68.9(c)(2) obliges somebody with a clinically diagnosed mental health condition to certify, every two years and alongside the certification at 68.3(b)(3), that a State-licensed specialist is still treating them for it. The neurological paragraph at (d)(2) says the same thing about a neurological condition.
Anybody writing that BasicMed turns every special issuance into a single event has read 68.9(a)(3) and stopped reading. That wording appears in that paragraph and in no other, and the difference is a recurring two-yearly obligation rather than a footnote.
First Class Or Second Class — Which Should You Sit?
The standards are word-for-word identical except in one section. Knowing which section that is settles the choice for most people in about a minute.
Sit First Class
One appointment establishes whether the top of a professional route is medically open to you, and the certificate then steps down through commercial and private privileges rather than being wasted.
Best foranybody whose plan includes an airline transport pilot certificate
- Cardiovascular Section67.111, with an ECG
- Eye Section67.103
- ATP Command Validity12 months, or 6 from age 40
- Steps Down ToCommercial, then private
Sit Second Class
Everything a commercial pilot certificate permits, on a twelve-month clock that does not shorten with age, and with no electrocardiogram in the standard at all.
Best forsomebody being paid to fly who does not need airline transport command privileges
- Cardiovascular Section67.211, with no ECG
- Eye Section67.203, worded identically to 67.103
- Commercial Validity12 months at any age
- Steps Down ToPrivate
Side By Side
| First Class | Second Class | |
|---|---|---|
| Governing Subpart | Part 67, subpart B | Part 67, subpart C |
| Distance Vision | 20/20 each eye | 20/20 each eye |
| Near Check At 32 Inches From 50 | Yes | Yes |
| Electrocardiogram | From 35, then annually from 40 | None at any age |
| ATP Command Privileges | 12 or 6 calendar months | Not supported |
| Commercial Privileges | 12 calendar months | 12 calendar months |
What Can You Verify About This School?
Five statements about the operation, each independently checkable. Nothing on this site is a rating, a quoted customer or a graduate count, and no claim is made anywhere about medical outcomes.
Airframe Types Owned Rather Than Leased In
You will fly Cessna 162 Skycatcher, Piper Warrior, Piper Arrow II, Diamond DA20, Cirrus SR22 Turbo and Piper Seminole. Every one of them belongs to the operation, which is why the maintenance schedule is set here.
Maintained under 14 CFR 91.409(b)Instructors On The Roster
Each of them carries a commercial certificate or an airline transport pilot certificate underneath, an instructor certificate on top, and a medical in date. Your instructor holds pilot-in-command authority for every lesson you fly.
14 CFR 61.23 · 61.183 · 61.195Days A Year The Weather Allows Training
Counted from NOAA ASOS observations across the twelve months to 1 August 2026, admitting a day only where the ceiling held at 3,000 feet with five miles of visibility, for four qualifying daylight hours. Method and limitations are published beside the figure.
NOAA ASOS observations via the Iowa Environmental MesonetOne Session In The Full-Motion Simulator
A Redbird MCX, full-motion and fully enclosed. Two of those sessions are inside the Standard and the Premium private pilot programs, five inside the Comprehensive, and no session is ever lost to weather. It is very good for procedures and instrument scan and poor for landings, which we would rather say than sell it as a substitute for the airplane.
Printed on the site, not quoted on requestProgram Prices Hidden Behind An Enquiry Form
Nothing is withheld. Every program figure is on the page, no figure is offered as a spread, and what you sign for is what you read.
Every figure is on the page you are readingFirst Class Medical Questions
The highest of the three classes of FAA airman medical certificate, issued under subpart B of 14 CFR part 67 and required by 61.23(a)(1) for exercising the pilot-in-command privileges of an airline transport pilot certificate. Eight sections set the standards, 67.101 through 67.115, and only an Aviation Medical Examiner may issue one.
Three different periods from one certificate, under the table at 61.23(d)(1), based on your age on the date of examination. Airline transport command privileges: twelve calendar months under forty, six from forty. Commercial privileges: twelve calendar months at any age. Private, student and instructor privileges: sixty calendar months under forty, twenty-four from forty.
67.111(b) requires an electrocardiographic examination showing no heart attack and no other clinically significant abnormality at the first application after your thirty-fifth birthday, and annually after your fortieth. 67.111(c) will not accept a tracing dated more than sixty days before the application it accompanies.
Under 67.103, distant acuity must reach 20/20 or better in each eye, corrected or not, and near vision must reach 20/40 at sixteen inches, eye by eye. From age fifty the near check runs at thirty-two inches as well. Colour perception sufficient for airman duties and normal fields of vision are also required.
No. 67.203 reproduces 67.103 word for word, including the intermediate check at thirty-two inches from age fifty. The easier standard is the third class one at 67.303, which requires 20/40 at distance rather than 20/20 and has no second near distance and no age condition in it at all.
The electrocardiogram. 67.111(b) requires one for first class certification from the thirty-fifth birthday and annually from the fortieth. 67.211 lists six cardiovascular conditions and stops, with no tracing required at any age. The eye, mental, neurologic, ear and general condition sections are otherwise materially the same across the two subparts.
67.115 points at 67.401, under which an Authorization for Special Issuance may be granted for a stated period at the discretion of the Federal Air Surgeon, or a Statement of Demonstrated Ability where the condition is static or nonprogressive. Both are discretionary and both turn on your own evidence. Whether either applies to you is a question for an Aviation Medical Examiner and not for a flight school.
Not for commercial or airline transport privileges. The route at 61.113(i) reaches student, recreational and private privileges plus instructor and examiner duties, as listed at 61.23(c)(1), and no further. It also requires under 61.23(c)(3)(i)(B) that you held a part 67 certificate at some time after 14 July 2006, so somebody who has never held one cannot begin there.
Only for the cardiovascular conditions. 68.9(a)(3) limits those to one special issuance per diagnosis, covering heart attack, coronary heart disease that has required treatment, valve replacement and heart replacement. For a mental health condition, 68.9(c)(2) requires certification every two years that a State-licensed specialist is still treating you, and 68.9(d)(2) requires the same for a neurological condition.
It is the sequence we recommend and the reasoning is arithmetic rather than medical. The examination costs a small fraction of any training phase and it is the only item that can close a professional route outright. Whether you will be issued a certificate is not something we can tell you, which is exactly why finding out early costs so much less than finding out late.
What This Page Is And Is Not
This page is a description of published federal standards with a citation beside each one. It is not medical advice, it is not a prediction, and nothing on it should be read as an indication of whether you personally will be issued a certificate. That question can only be answered by an Aviation Medical Examiner who has examined you and reviewed your history, and it is between the two of you. Airline Pilot Flight School neither issues medical certificates nor influences their issue, and no consultation, conversation or preparation offered by anybody here changes an outcome determined under part 67.
Every regulation cited on this page was read at source before publication and checked against a second independent copy of the same text. Airline Pilot Flight School trains under part 61 of 14 CFR at Van Nuys Airport; it is not an airline, is not owned by one, and holds no cadet program, pathway agreement or hiring arrangement with any carrier. No employment or salary outcome is promised anywhere on this site, and no pass rate or graduate count is published, because this operation is new and any such number would rest on a sample too small to carry meaning.
Book The Examination First, Then Come And Fly
An assessment flight is an ordinary first lesson rather than a sightseeing trip: you do the flying, an hour of instruction received goes into your logbook, and $229 is deducted from any program you enrol in within a day.
Sitting the examination costs a small fraction of a training phase and settles the one question that can close a route. Once that is answered, an hour at the controls will settle the other one, and the two together are a far better basis for a decision than either alone.
One Hour, Hands On The Controls
Your instructor holds pilot-in-command authority for the flight and will take the airplane where that is sensible, but the flying itself is yours.
Deducted If You Enrol
Enrol within a day of landing and every dollar of the $229 is taken off the program. Decline, and you still keep an hour of logged instruction.
A Straight Conversation Afterwards
Bring the arithmetic at the top of this page and somebody here will work through it beside you, including the version where the sensible answer is not yet.
Find Out What You Can Hold Before You Spend
One examination establishes whether the top of a professional route is medically open to you. It costs a fraction of a training phase and it is the only item on the list that can end the plan outright.
Keep Reading
Fly The Aeroplane Once, Then Decide
The assessment flight is the first hour of the syllabus and a two-way evaluation. You fly it from the left seat with an instructor beside you, they write down what they saw, and you get an honest read on whether the plan is realistic. It is loggable, and it is credited in full against enrolment if you enroll within 24 hours.
What happens on an assessment flight →