What Is a Second Class Medical Certificate?

A Second Class Medical Certificate is the FAA medical clearance you need to exercise commercial pilot privileges, and it’s valid for commercial flying for 12 months from the date of your exam.¹ The certificate confirms you meet FAA health standards for vision, hearing, cardiovascular function, neurological fitness, and mental health. You get it by filing an application through the FAA’s MedXPress system and passing an exam with an FAA-designated Aviation Medical Examiner.

Who Needs One

You need at least a Second Class certificate to exercise the privileges of a commercial pilot certificate in any powered aircraft. Any flying-for-hire work falls under this requirement.¹ The same class is required if you serve as second-in-command under an airline transport pilot certificate in Part 121 airline operations, work as a flight engineer or flight navigator, or serve as an air traffic control tower operator.² Balloon pilots exercising commercial privileges are also covered.

Airline captains exercising ATP privileges need a First Class certificate instead. Private and recreational pilots can operate on a Third Class or, in many cases, under BasicMed.

The Medical Standards

The health criteria are set out in 14 CFR Part 67, Subpart C. Your AME checks each area against defined benchmarks.

Vision

Distant visual acuity must be 20/20 or better in each eye, tested separately, with or without corrective lenses. If you need glasses or contacts to reach 20/20, the FAA adds a limitation to your certificate requiring you to wear them in flight.³ Near vision must be 20/40 or better in each eye at 16 inches. At age 50 and older, you also need 20/40 intermediate vision at 32 inches.⁴

Color vision is a separate test. If you fail the approved screening, the AME can only issue a Third Class certificate with a “day VFR only” limitation. Lifting that restriction for a Second Class requires an appeal to the Federal Air Surgeon. Color-correcting lenses like X-Chrom are not accepted.⁵

Hearing

You have to demonstrate acceptable hearing by at least one approved method. The simplest is hearing an average conversational voice in a quiet room at 6 feet, using both ears, with your back to the examiner. An audiometric exam is the alternative.

Cardiovascular

The regulations disqualify anyone with a clinical diagnosis or established history of a heart attack, angina, coronary heart disease that required treatment or was symptomatic, cardiac valve replacement, permanent pacemaker implantation, or heart replacement.⁶ Hypertension is not an automatic bar, but elevated readings may cause the AME to defer your application to the FAA’s Aerospace Medical Certification Division.

Neurological

You cannot hold a Second Class certificate if you have a history of epilepsy, an unexplained disturbance of consciousness, or an unexplained transient loss of nervous system function. The Federal Air Surgeon can also disqualify any other neurological condition that, in qualified medical judgment, makes safe flight unlikely during the certificate’s validity period.⁷

Mental Health and Substance Use

A clinical diagnosis of psychosis, bipolar disorder, or a severe personality disorder that has manifested through overt acts is disqualifying. So is substance dependence. These conditions don’t permanently lock you out of flying, but you’ll need a special issuance from the Federal Air Surgeon before you can be certified, with documentation that the condition is well-managed.

How to Apply

File Through MedXPress

The process starts online. You complete FAA Form 8500-8 in the MedXPress system at medxpress.faa.gov, entering your personal information and full medical history.⁸ Be thorough and honest. Intentionally false statements violate 14 CFR 67.403 and can trigger both certificate revocation and federal criminal prosecution under 18 U.S.C. § 1001, which carries fines up to $250,000 and up to five years in prison. Administrative certificate action and criminal prosecution are separate tracks, and you can face both.

Watch the timing. Once you create an application in MedXPress, you have 30 days to submit it. After submission, you must complete your exam within 60 days or the application is automatically deleted and you’ll have to start over.⁹

See an AME

You can only get the certificate through an FAA-designated Aviation Medical Examiner. The FAA’s locator tool at designee.faa.gov/designeeLocator lets you search by location.¹⁰ If you have a history involving alcohol, substance use, or certain mental health conditions, look specifically for a HIMS (Human Intervention Motivation Study) AME, who is trained to evaluate and sponsor monitoring for those situations.

The AME pulls up your MedXPress application using your confirmation number, reviews your history, and runs the physical exam. If you meet all the standards, the AME issues the certificate on the spot. The FAA does not set exam fees; AMEs charge independently, typically in the $100 to $200 range for a standard Second Class exam.

If You Don’t Meet a Standard

Falling short on a standard at the exam does not necessarily end your path to certification. What happens next depends on the condition.

Conditions AMEs Can Issue

For a long list of common conditions, the FAA has published worksheets that let the AME issue your certificate in the office, as long as you meet the specified criteria. These CACI conditions include hypertension, asthma, hypothyroidism, migraines, glaucoma, sleep apnea, and many others.¹¹ Meet the worksheet criteria and the AME can issue without deferring to the FAA.

Deferral to the FAA

If no CACI path applies and the AME cannot issue, the application is deferred to the FAA’s Aerospace Medical Certification Division (AMCD) in Oklahoma City. That is not a denial. The AMCD reviews your file, may request additional records or testing, and makes a determination. If the AMCD declines, you can request reconsideration by the Federal Air Surgeon.¹²

Special Issuance and SODAh3>

If you have a disqualifying condition but can show you can still fly safely, the Federal Air Surgeon may grant an Authorization for Special Issuance. This is a time-limited authorization that lets the AME issue a certificate for a specified period, often with conditions like periodic medical reports or follow-up testing. You reapply when it expires.¹³

For stable conditions that won’t change over time, the Federal Air Surgeon can instead issue a Statement of Demonstrated Ability (SODA). A SODA doesn’t expire. It authorizes any AME to issue your medical certificate going forward, as long as the condition described on the SODA hasn’t worsened.¹³

Appealing a Denial

If the FAA ultimately denies your certificate after reconsideration, you can petition the National Transportation Safety Board for review. The petition must be filed within 60 days of the denial and must include a concise explanation of why you believe the denial was wrong. The NTSB assigns the case to an administrative law judge, who holds a hearing where both you and the FAA present evidence, then issues a decision.¹⁴

How Long It Lasts

A Second Class Medical Certificate is valid for commercial pilot privileges through the last day of the 12th month after your exam date, regardless of your age. An exam on March 15 gives you commercial privileges through March 31 of the following year.¹

After the 12-month commercial window ends, the same certificate continues to function as a Third Class for private flying. How long depends on your age at the time of the exam:

Under 40: private pilot privileges continue through the 60th month after the exam date, giving you an additional 48 months of private flying after the commercial period ends.
40 or older: private pilot privileges continue through the 24th month after the exam date, giving you 12 additional months of private flying beyond the commercial period.

To keep commercial privileges without a gap, schedule a new exam before your current 12-month window closes and submit a fresh MedXPress application.¹

Your Obligations Between Exams

Holding a medical certificate comes with duties that extend well beyond the exam room. These catch pilots off guard more often than the exam itself does.

Grounding Yourself When You’re Unfit

Under 14 CFR 61.53, you cannot act as pilot in command or as a required flight crewmember if you know or have reason to know of any medical condition that would prevent you from meeting the standards for your certificate. The same rule applies if you’re taking any medication or receiving treatment that makes you unable to meet those standards.¹⁵ This is a self-assessment obligation. Nobody checks on you daily. The FAA expects you to ground yourself when something’s wrong.

For short-term problems that resolve on their own, like a bad cold or a minor injury, stay on the ground until you recover and report the condition on your next MedXPress application. For anything chronic or requiring ongoing treatment, talk to an AME about whether you need a new evaluation before returning to the cockpit.

Reporting DUIs and Related License Actions

This one blindsides pilots who assume their driving record stays separate from their flying privileges. Under 14 CFR 61.15, if you’re convicted of driving under the influence of alcohol or drugs, or if your driver’s license is suspended, canceled, or revoked for refusing or failing a breath or blood test, you must notify the FAA in writing within 60 days. The clock starts on the effective date of the license action, not the arrest date or court date.¹⁶

The written report goes to the FAA Civil Aviation Security Division (AMC-700), P.O. Box 25810, Oklahoma City, OK 73125. Include your name, address, date of birth, certificate number, the type of violation, the date of conviction or administrative action, and the state that holds the record. Send it by certified mail or fax to keep proof of delivery. Missing the 60-day deadline can lead the FAA to deny any certificate application for up to a year or to suspend or revoke certificates you already hold.¹⁶

Cannabis

Whatever your state allows, the FAA maintains a zero-tolerance policy on cannabis use for all certificate holders. Marijuana remains a Schedule I substance under federal law, and a positive drug test or disclosed use will trigger certificate action. The same applies to CBD products that may contain trace amounts of THC.

A Note on BasicMed

BasicMed lets some private pilots skip the traditional medical certificate process, using a physical from any state-licensed physician on FAA Form 8700-2 plus a free online course from AOPA or Mayo Clinic.¹⁷ It is not an option for commercial work. You cannot fly for compensation or hire under BasicMed, so for the operations that require a Second Class certificate, there is no BasicMed shortcut.¹⁸

1
eCFR. 14 CFR 61.23 – Medical Certificates: Requirement and Duration
2
Federal Aviation Administration. Classes of Medical Certificates
3
eCFR. 14 CFR 67.203 – Eye
4
Federal Aviation Administration. Synopsis of Medical Standards
5
Federal Aviation Administration. Guide for Aviation Medical Examiners: Aerospace Medical Dispositions Item 52 – Color Vision
6
eCFR. 14 CFR 67.211 – Cardiovascular
7
eCFR. 14 CFR 67.209 – Neurologic
8
Federal Aviation Administration. Medical Certification
9
Federal Aviation Administration. How Long Will My Application Remain in the MedXPress System?
10
Federal Aviation Administration. Find an Aviation Medical Examiner (AME)
11
Federal Aviation Administration. Guide for Aviation Medical Examiners
12
Federal Aviation Administration. Guide for Aviation Medical Examiners – Reconsideration
13
eCFR. 14 CFR 67.401 – Special Issuance of Medical Certificates
14
National Transportation Safety Board. How to File a Petition for Review of a Certificate Denial
15
eCFR. 14 CFR 61.53 – Prohibition on Operations During Medical Deficiency
16
eCFR. 14 CFR 61.15 – Offenses Involving Alcohol or Drugs
17
Federal Aviation Administration. BasicMed
18
Federal Aviation Administration. FAA Updates BasicMed Program