What Is a Third Class Medical Certificate for Pilots?

A third class medical certificate is the FAA’s baseline health credential for pilots who fly recreationally or personally. You need one to fly solo as a student pilot, to exercise the privileges of a recreational or private pilot certificate, and to take the practical test for most pilot certificates. An Aviation Medical Examiner (AME) issues it after checking your vision, hearing, cardiovascular health, neurological function, and mental fitness. It stays valid for five years if you’re under 40 at the time of your exam and two years if you’re 40 or older.1eCFR. 14 CFR 61.23 – Medical Certificates: Requirement and Duration

Who Needs One

Federal regulations require at least a third class medical when you exercise the privileges of a private, recreational, or student pilot certificate. Flight instructors acting as pilot in command or as a required crew member need one too. So does anyone taking the practical test for a recreational, private, commercial, or airline transport pilot certificate, or for a flight instructor certificate.1eCFR. 14 CFR 61.23 – Medical Certificates: Requirement and Duration

Commercial and airline transport pilots hold higher-class medicals (second and first class), which apply stricter standards. Third class is the entry point for personal flying and training.

When BasicMed Is an Alternative

Since 2017, many private pilots have been able to fly without a current FAA medical certificate under BasicMed. To qualify, you need a valid U.S. driver’s license, a completed medical examination checklist from a state-licensed physician, and a certificate of completion from an FAA-approved online medical education course.2eCFR. 14 CFR 61.113 – Private Pilot Privileges and Limitations: Pilot in Command

BasicMed carries limits. The aircraft can have no more than seven seats and a maximum takeoff weight of 12,500 pounds. You can carry no more than six passengers. You cannot fly above 18,000 feet, exceed 250 knots indicated airspeed, or leave the United States unless the destination country authorizes it.2eCFR. 14 CFR 61.113 – Private Pilot Privileges and Limitations: Pilot in Command

If you fly larger aircraft, want to go higher than 18,000 feet, or expect to pursue a commercial or airline transport certificate later, the third class medical is the route to stay on.

Medical Standards

Vision and Hearing

Distant vision must be 20/40 or better in each eye, with or without correction. If you need glasses or contacts to reach 20/40, your certificate will carry a limitation requiring you to wear them while flying. Near vision must also be 20/40 or better at 16 inches in each eye.3eCFR. 14 CFR 67.303 – Eye

For hearing, the FAA accepts any one of three tests. The most common is the conversational voice test: you stand six feet from the examiner with your back turned and must hear an average conversational voice using both ears. Alternatives are an audiometric speech discrimination test with a score of at least 70 percent, or specified pure tone audiometric thresholds.4eCFR. 14 CFR 67.305 – Ear, Nose, Throat, and Equilibrium

Mental Health and Neurological Conditions

A clinical diagnosis of psychosis, bipolar disorder, or a severe personality disorder that has manifested in overt acts is disqualifying. So is substance dependence on alcohol, opioids, stimulants, cannabis, or other psychoactive substances, though the FAA will consider evidence of recovery if you can show at least two years of sustained total abstinence. Substance abuse within the preceding two years is separately disqualifying.5eCFR. 14 CFR 67.307 – Mental

On the neurological side, epilepsy, any unexplained disturbance of consciousness, and any unexplained transient loss of nervous system function are disqualifying. The FAA can also deny certification for any other seizure disorder or neurological condition that, in the Federal Air Surgeon’s judgment, would prevent safe performance of pilot duties.6eCFR. 14 CFR Part 67 Subpart D – Third-Class Airman Medical Certificate

General Health

Diabetes that requires insulin or any other hypoglycemic drug for control is specifically disqualifying. Beyond that, any disease, defect, or limitation the Federal Air Surgeon finds would prevent safe performance of pilot duties, or could reasonably be expected to do so during the certificate’s validity period, is disqualifying. The same standard applies to medications and treatments.7eCFR. 14 CFR 67.313 – General Medical Condition

That catch-all gives the FAA considerable discretion. Conditions such as obstructive sleep apnea, certain cardiac arrhythmias, or a history of organ transplant aren’t on a fixed list of automatic disqualifiers, but they can still lead to a deferral or denial depending on severity and treatment.

Medications That Can Block Issuance

Even when an underlying condition isn’t disqualifying, the medication treating it can be. The FAA maintains a “Do Not Issue” list of drugs and drug classes that prevent an AME from issuing your certificate. Common categories include:

  • Psychiatric medications: antidepressants, anti-anxiety drugs, antipsychotics, ADHD medications, mood stabilizers, and tranquilizers, even when prescribed for non-psychiatric conditions.
  • Anticonvulsants, even if prescribed for migraines rather than seizures.
  • Controlled substances (Schedules I through V), including medical marijuana regardless of state law.
  • Cancer treatments such as chemotherapy, radiation therapy, and immunotherapy drugs.
  • Certain cardiovascular drugs, including nitrates for angina and centrally acting blood pressure medications like clonidine and methyldopa.
  • Weight-loss sympathomimetics like phentermine.

If you’re taking anything on the Do Not Issue list, the AME must defer your application rather than issue the certificate.8Federal Aviation Administration. Do Not Issue and Do Not Fly Medications

A separate “Do Not Fly” list covers medications that won’t block certification but that you cannot take within a certain window before flying. Tell your AME about every medication you take, including over-the-counter drugs and supplements.

How to Get the Certificate

The process starts online. Create an account at FAA MedXPress and complete the electronic version of FAA Form 8500-8, which collects your personal information and full medical history. You’ll get a confirmation number by email once you submit.9Federal Aviation Administration. Medical Certification

Next, schedule an appointment with an AME. AMEs are physicians the FAA designates to conduct these exams; you can find one through the FAA’s AME locator. The AME sets the fee, not the FAA, and it typically runs somewhere around $100 to $175. The visit usually takes 20 to 30 minutes.

At the appointment, the AME pulls up your MedXPress application, reviews your history, and performs the physical exam covering vision, hearing, blood pressure, and a general assessment. If you meet all the standards, the AME issues your third class medical certificate in the office.10Federal Aviation Administration. Instructions for Completion of the Application for Airman Medical Certificate

If the AME Can’t Issue on the Spot

Not every exam ends with a certificate in hand. If you disclose a condition that needs further review, take a medication on the Do Not Issue list, or have a history outside the AME’s authority to approve, the AME defers your application to the FAA’s Aerospace Medical Certification Division in Oklahoma City. Some deferred applications take many months to resolve.

For conditions that would normally disqualify you, the Federal Air Surgeon can grant a Special Issuance authorization. You’ll need supporting medical documentation showing you can safely perform pilot duties despite the condition. A Special Issuance typically comes with a limited validity period and may require periodic medical reports to stay active.11eCFR. 14 CFR 67.401 – Special Issuance of Medical Certificates Some later renewals can be handled through the AME Assisted Special Issuance process, letting your AME reissue the certificate under the existing authorization without another trip through Oklahoma City.12Federal Aviation Administration. Guide for Aviation Medical Examiners – Special Issuance

If the FAA denies your certificate, you can appeal to the National Transportation Safety Board within 60 days of the denial. The petition must explain why the denial was wrong and include a copy of the denial letter. An administrative law judge holds a hearing where both you and the FAA present evidence, and you can bring an attorney.13National Transportation Safety Board. How to File a Petition for Review of a Certificate Denial

How Long It Lasts and How to Renew

The validity period depends on your age at the exam:

The clock starts from the month of the exam, not the date the certificate lands in your hands. An exam on March 15 for a 35-year-old runs through the last day of March five years later. To renew, you repeat the MedXPress-and-AME process before the current certificate expires. There’s no separate renewal form.

Duties After You’re Certified

The certificate doesn’t excuse you from paying attention to your health between exams. Two ongoing rules catch pilots off guard.

Self-Grounding

You cannot fly as pilot in command or as a required crew member if you know, or have reason to know, of any medical condition that would make you unable to meet the requirements for your medical certificate. The same applies if a medication or treatment you’re taking would have that effect. It’s a continuing obligation. Develop a new condition, start a new medication, or have a health event between exams, and you must ground yourself until it’s resolved.14eCFR. 14 CFR 61.53 – Prohibition on Operations During Medical Deficiency

Reporting DUIs and License Actions

If you’re convicted of driving under the influence of alcohol or drugs, or your driver’s license is suspended, canceled, or revoked for those reasons, you must report it in writing to the FAA within 60 days. The 60-day clock starts from the effective date of the administrative action or conviction, not the arrest. The report goes to the FAA Civil Aviation Security Division and must include your name, address, date of birth, airman certificate number, the type of violation, the date of the action, and the state that holds the record.15eCFR. 14 CFR 61.15 – Offenses Involving Alcohol or Drugs

Failing to report is itself grounds for denial of any certificate application for up to a year, or suspension or revocation of certificates you already hold. Two or more alcohol or drug-related motor vehicle convictions within a three-year period can independently trigger certificate action, whether or not the underlying conditions affect your ability to fly.