To get an FAA Third Class Medical Certificate, you complete the MedXPress online application, book an appointment with an FAA-designated Aviation Medical Examiner (AME), and pass a short in-office physical. Most applicants finish the exam in under an hour and leave with the certificate in hand the same day. The parts that trip people up are on the paperwork side, not the medical side, so the work you do before the appointment matters more than what happens in the exam room.
Who Needs a Third Class Certificate
The Third Class certificate is the FAA’s baseline medical qualification for non-commercial flying. You need one to exercise the privileges of a student pilot certificate, a recreational pilot certificate, or a private pilot certificate.1eCFR. 14 CFR 61.23 – Medical Certificates: Requirement and Duration Student pilots cannot fly solo without it. Flight instructors acting as pilot in command need at least a Third Class certificate as well.
The certificate confirms you meet minimum standards for vision, hearing, cardiovascular health, neurological function, and mental fitness. It does not qualify you for commercial flying, which requires a Second or First Class certificate under stricter standards.
One boundary worth knowing up front: many private pilots eventually fly under BasicMed instead of renewing a Third Class certificate, but BasicMed requires that you have already held an FAA medical certificate of some class issued after July 14, 2006.2Federal Aviation Administration. AC 68-1A – BasicMed First-time applicants have to go through the Third Class process at least once before BasicMed is an option.
Step 1: File the MedXPress Application
Start with FAA Form 8500-8, filed online through MedXPress at medxpress.faa.gov. The FAA requires you to submit it before your exam appointment.3Federal Aviation Administration. FAA MedXPress Program for Pilots – Your Express Lane to Medical Certification You’ll create an account, complete the medical history questionnaire, and submit. MedXPress issues a confirmation number that your AME needs to pull up your file at the appointment.
The form asks about every medical condition you have ever had, every surgery, every current medication, every visit to a health professional, and any history of substance use or mental health treatment. Answer everything honestly and completely. The FAA cross-references your answers against outside databases, and an omission that surfaces later is a much bigger problem than the underlying condition would have been. Controlled high blood pressure on medication, for example, is usually workable. Failing to disclose it is not.
Medications to Check Before You Apply
Some medications are flatly incompatible with flying, and others require a specific approval pathway. Tricyclic antidepressants and MAO inhibitors are unacceptable across the board, and certain SSRIs are also disqualifying, while several common SSRIs and SNRIs are conditionally acceptable when used alone and when the applicant is otherwise qualified.4Federal Aviation Administration. Antidepressant Medications
If you take any prescription drug, check the FAA’s medication guidance before your appointment. Showing up on a disqualifying medication does more than get you denied. It starts a paper trail that complicates every future application. A phone call to your AME beforehand, or to a pilot medical services line, is worth making before anything goes on the record.
Reporting DUIs and Alcohol-Related Incidents
Any alcohol- or drug-related motor vehicle action, whether a conviction or an administrative license suspension, must be reported to the FAA in writing within 60 days of the action.5eCFR. 14 CFR 61.15 – Offenses Involving Alcohol or Drugs This is a separate obligation from your medical application, and the clock starts when the action happens, not when you apply. Missing the deadline is an independent violation that can affect all your pilot certificates.
Step 2: Find an Aviation Medical Examiner
Only Aviation Medical Examiners, physicians the FAA has specifically designated, can perform the exam and issue the certificate. The FAA’s online Designee Locator searches by zip code or city. Volume varies; an AME who regularly performs pilot exams is a better choice if your history has anything that will need careful evaluation.
AME fees are not set by the FAA. Expect somewhere between $75 and $200 for a Third Class exam, with higher prices common in metropolitan areas. Call the office to confirm the fee and ask whether they need anything beyond your MedXPress confirmation number.
Step 3: The Physical Exam
At the appointment, the AME pulls up your MedXPress application using your confirmation number and reviews your history with you. Then comes the physical, which covers several systems but is less involved than most applicants expect.
Vision testing checks distant acuity (20/40 or better in each eye, with or without correction), near vision (20/40 or better at 16 inches), and color perception sufficient for safe flight.6eCFR. 14 CFR Part 67 – Medical Standards and Certification If you need glasses or contacts to hit 20/40, you’ll get the certificate with a limitation requiring corrective lenses while flying.
Hearing is tested by whether you can hear a conversational voice from six feet away with your back turned to the examiner, though some AMEs use an audiometer instead.6eCFR. 14 CFR Part 67 – Medical Standards and Certification The AME also checks blood pressure, pulse, heart and lung sounds, basic neurological function, and takes a urine sample to screen for conditions like diabetes.
Conditions That Can Disqualify You
A short list of conditions is automatically disqualifying unless the FAA grants a waiver. Cardiovascular disqualifiers include a history of heart attack, angina, coronary disease requiring treatment, cardiac valve replacement, permanent pacemaker, and heart replacement.6eCFR. 14 CFR Part 67 – Medical Standards and Certification
Neurological disqualifiers include epilepsy, unexplained loss of consciousness, and unexplained loss of nervous system function. Mental health disqualifiers include psychosis, bipolar disorder, severe personality disorders with a history of overt acts, and substance dependence without at least two years of sustained total abstinence and satisfactory clinical evidence of recovery.6eCFR. 14 CFR Part 67 – Medical Standards and Certification Diabetes requiring insulin or other hypoglycemic drugs is also disqualifying under the general standards.
A disqualifying condition does not necessarily end your flying. Many pilots with these conditions fly under Special Issuance authorizations, described below. Walking into the exam without knowing where you stand on this list, though, is how applicants create problems that take months to unwind.
Getting the Certificate and How Long It Lasts
If you meet the standards, the AME issues your Third Class Medical Certificate at the end of the appointment. It is valid for 60 calendar months if you are under 40 at the time of the exam, or 24 calendar months if you are 40 or older.1eCFR. 14 CFR 61.23 – Medical Certificates: Requirement and Duration The clock runs from the last day of the month you took the exam, not the exam date itself.
Age matters for planning. Someone at 38 gets five years. Someone at 42 gets two. The regulation keys off your age at the exam, so timing an exam just before your fortieth birthday can genuinely extend your validity.
If the AME Can’t Issue on the Spot
When the AME cannot determine on their own whether you meet the standards, the examiner defers your application to the FAA’s Aerospace Medical Certification Division instead of issuing or denying it.7Federal Aviation Administration. Application Review – Item 62 A deferral is not a denial. It means the FAA needs more information. Recent FAA data indicates that straightforward deferred cases with complete documentation are averaging under 20 days to a decision, though complex cases involving substance testing or neuropsychological evaluation take longer.
For many common conditions, including controlled hypertension, treated hypothyroidism, and certain cardiac procedures, the FAA has set up streamlined pathways called Conditions AMEs Can Issue (CACI). Under CACI, your examiner follows a worksheet for the specific condition and, if you meet the criteria and bring the right documentation, issues your certificate without deferring to the FAA. Knowing whether your condition qualifies for CACI before the appointment, and arriving with the required records, is the single biggest time-saver in the process.
Special Issuance and SODA
If you have a disqualifying condition, the Federal Air Surgeon can grant an Authorization for Special Issuance. You have to show you can safely perform pilot duties despite the condition, and the FAA may require a special medical flight test or additional evaluation.8eCFR. 14 CFR 67.401 – Special Issuance of Medical Certificates The authorization has a set validity period, and you re-demonstrate fitness when it expires. The FAA can also attach operational limitations.
For static conditions that are not expected to worsen, such as the loss of an eye or a limb, the FAA may grant a Statement of Demonstrated Ability (SODA) instead. A SODA does not expire. Your AME confirms at each exam that the condition has not changed, then issues the certificate based on the existing SODA.8eCFR. 14 CFR 67.401 – Special Issuance of Medical Certificates Both an Authorization and a SODA can be withdrawn if the condition worsens or the pilot does not follow the FAA’s limitations.
If You Are Denied
If the FAA denies your medical certificate after review, you can appeal to the National Transportation Safety Board. The petition for review must be filed within 60 days of the date the FAA serves its denial.9National Transportation Safety Board. How to File a Petition for Review of a Certificate Denial The petition identifies the specific denial action and explains why you believe it was wrong. Include the denial letter and submit everything as a single PDF to the NTSB’s Office of Administrative Law Judges by email. Pilots do prevail in some appeals, but the process is a legal proceeding, and most applicants benefit from consulting an aviation medical attorney before filing, particularly when the denial turns on a contested reading of medical evidence.