Receiving Your First Medical Certificate

An Article by Dr. Larry Diamond, Pharm.D. CFII for AV8 Prep December, 2024

On June 19th, 2024, I received my twentieth FAA Medical Certificate. I have had nineteen third-class medicals and one second-class medical. Ninety-nine percent of my medicals were received in Michigan, and one percent in Florida. I received my first medical certificate in 1984.

I am a pharmacist with a research background. I did not have Google to help me find an aviation medical examiner (AME). I trained at KONZ, Grosse Isle Municipal Airport, Grosse Isle, Michigan. I went to the flight training manager and asked who does flight physicals in the area.

My next step was to go to our local Flight Standards District Office (FSDO) in Ypsilanti, Michigan. I was handed a booklet with all the physicians available to do flight physicals in the state. I also was able to see if the AME was a pilot.

The importance for me, as a flight student and pharmacist, is I want the AME to be familiar with the pilot mindset. I need to know if the AME will understand the concerns, decision-making, and cognitive skills required to pursue the private pilot's certificate. If the medical examiner is one of us or has a history of flight instruction, the AME may better relate to the pilot's mindset when doing the flight physical. When choosing an AME, I recommend you visit a couple of AME websites to check out the AME's appointment times and days of availability.

The applicant will first visit the FAA MedXPress website (https://medxpress.faa.gov/MedXpress/) to make a physical flight appointment. You will proceed to the new user tab and sign up for a new account. In the request an account section, you will fill in your name and email address in the appropriate boxes. The MedXPress completes the initial portion of the application. You will fill out an 8500-8 form, which includes your age, weight, height, eye color, what class of medical certificate you are applying for, medical conditions, and any medications or over-the-counter medications you have or are taking regularly.

The next step is to find and schedule an appointment with an AME in your area. The easiest way to find an AME is to ask your flight instructor who they see for their medical certificates. If you want more choices, go to the FAA website, www.faa.gov, and do a Designee Locator Search. Select the type of designee tab. You, as the applicant, will select AME in the dropdown box. I recommend going into Locator search. This option will allow you to choose the state in which you reside. I have found that putting in a city and a state will give more negative than positive results. For instance, I choose Michigan and can see all the cities where an AME is available. The following prompt is to select what type of medical certificate the AMEs do. The third-class medical certificate is the most commonly chosen type of medical for a student pilot.

The third-class medical is active for five years if under 40 and two years for over 40. The third-class medical is for student and private pilots, the second-class medical is for commercial pilots, and the first-class medical certificate is for airline pilots.

The health standards for the medical certificate include 20/20 distant vision, with or without correction. You must be able to hear a conversation six feet away with or without hearing aids.

Disqualifying medical conditions

You cannot have any disqualifying medical conditions. Examples of disqualifying medical conditions include severe mental conditions like bipolar disease, seizure disorders, Parkinson's disease, dementia, and disabling strokes. Suppose you are taking or have taken any chronic over-the-counter or prescription medications (including any herbal supplements) regularly in the past or present. In that case, each medication must be added to the application.

The medication section is essential as there is a list of "can fly or no-fly" medications. The no-fly medications will disqualify the applicant from getting a medical certificate. Membership to the Airline Owners and Pilots Association (AOPA) includes a valuable resource listing the no-fly and can-fly medications. This list enables the first-time applicant to find the medication they are taking in the FAA Safe Medication list and see if the FAA approves it as a safe-to-fly drug. I have recently published my second book, Aviate and Medicate, by Larry M. Diamond, PharmD., CFI, CFII, which will allow you to see which medications are deemed safe to fly while taking. Anti-anxiety, tranquilizers, and anti-seizure medications are prohibited.

You can buy the book on Amazon at: https://www.amazon.com/Aviate-Medicate-Compendium-FAA-Approved-Medication/dp/B0DDCX6V8S

Sedating antihistamines cannot be taken before flight as this type of medication is very sedating. The bottom line is that if a medication causes sedation or any other cognitive change in the pilot, there must be a waiting period after the last dose before the flight.

There are also disease states like diabetes and depression where the pilot will receive a Special Issuance medical certificate. A Special Issuance of a Medical Certificate (SI) is a time-limited medical certification from the Federal Aviation Administration (FAA) that allows pilots to exercise the privileges of a first, second, or third-class medical certificate, even if they have a disqualifying medical condition.

There are three possible outcomes of an FAA medical certificate application. Issuance is when the pilot is issued a medical certificate and can fly. However, the certificate may have restrictions, such as a time limit, vision correction requirements, or an altitude limit. Deferral of a pilot's exam is deferred to the FAA for further review. Deferral of a medical certificate can happen if the AME has concerns about the pilot's medical history or eligibility. Denial is where a pilot is denied a medical certificate. Denial can occur if the pilot doesn't meet the FAA's medical standards. However, a denial isn't necessarily permanent. The pilot may be able to get the certificate reissued if they can show that their medical condition has improved or is being treated safely.

I hope this article has helped clarify the path to receiving your first and many more FAA medical certificates. The whole process usually takes about twenty to thirty minutes. You will be weighed, get a urinalysis to check for sugar or protein (not a drug test), vision check, color blindness test, blood pressure and hearing test, heart and lung check, reflex check, and balance test while standing. The average cost for a third-class medical certificate is between $100 -$180.00. Your goal is to be a safe and healthy pilot. Enjoy

A new version of Dr. Larry's Aviate & Medicate will be released in 2025, the current edition was published by 107 School in 2024, and is still available on Amazon. You can see more of Dr. Larry's writing on AOPA's website. AV8 Prep acquired 107 School in 2024.

Larry M. Diamond, PharmD, CFII

Larry Diamond has a Doctor of Pharmacy Degree and has been a pharmacist for 37 years. Larry’s pharmacy practice has been as a Clinical Pharmacy Specialist in Cardiology, Orthopedic Surgery Specialist and most recently Clinical Pharmacy Coordinator.