How often must a military/commercial/private pilot submit to a medical exam to prove his/her fitness for flight?
Don’t know about military, but for the rest:
Airline pilot: every six months
Other commercial pilot: once a year
Private pilot: every three years when under 40, every two years 40 and above.
Sport pilots, ultralight pilots, glider pilots (US): no FAA physical required.
There may be circumstances requiring individuals have examinations more often than otherwise. For example, I knew a pilot in her 90’s who still held and used a commercial certificate. After a certain point (I forget, exactly, but certainly by her mid-90’s) the FAA was requiring her to have a medical exam every 6 months. That would be on a case-by-case basis.
FAA medical reform has been passed into law (although awaiting regulatory implementation). This states licensed pilots with a valid 3rd class medical never again need to take a medical exam if flying certain classes of planes:
This means an 80-yr-old retired physician can keep flying his high-performance twin-engine Beech Baron G58 without fear of failing a medical:
However a 30-yr-old person in good health except for a disqualifying condition on the FAA’s long list of conditions cannot reliably get a 3rd class medical. This could be something as minor as haven taken Prozac 10 years ago or use a CPAP machine for sleep apnea.
Every past doctor’s visit must be reported (under penalty of perjury), even seeing the family Dr for a runny nose.
The applicant can pursue “special issuance” which is seeking a waiver for their disqualifying condition but this is uncertain and often expensive.
If an applicant ever fails a 3rd class medical or seeks special issuance and is denied, they are prohibited from even flying a Light Sport Aircraft (e.g. Piper Cub-class planes), which normally does not require a medical exam under Sport Pilot provisions. So the current regulatory system encourages not reporting medical conditions or approaching an aeromedical examiner if the slightest possibility exists they might not pass the test or might not be granted special issuance.
In the US perhaps, it’s not standard worldwide though. I have annual medicals on an ATPL in Australia. I can’t recall what age we go to 6 monthly, might be 60.
Geez, Joema, paint a bleak picture why don’t ya…
No, actually, they don’t require you to report every single doctor’s visit in your life. They do require you to go down a checklist and if you mark “yes” to anything they have to ask further questions.
And sometimes it’s routine and cheap. I “flunked” the vision portion of the FAA physical due to colorblindness and was issued a limited license until I could take an additional test, which cost me nothing (other than time to go to the FSDO). I was told, based on the color perception issues I had, that I would almost certainly pass the additional test with no problems, which I did.
The main thing they’re looking for are on-going, chronic problems that could endanger others. So… you took valium the week your spouse died, your house burned down, your dog ran away, and you lost your job due to extreme transitory stress, but it was a brief, temporary thing 10 years ago and within a couple months you picked up the pieces and were functioning again? OK, no problem Febrile seizure at 6 months of age but you’re 40 now and haven’t had a seizure since and haven’t required medication for it? Probably not a problem. High blood pressure? Get it under control and come back in X months.
Now, some things ARE going to be a problem - if you had a major depressive episode that lasted two years, yes, you are going to have a problem with that. You currently have epilepsy? Nope, you are not going to be able to get that license, sorry.
That’s based on your most recent attempt at a medical, not any ever. I’ve known several people who failed a 3rd class medical, resolved the problem, then were issued clearance and went on flying. Beware of blanket statements.
I should also point out that even pilots not currently required to get a medical exam still have to “self-certify” prior to flight - if you take off knowing you have a forbidden condition you can still be severely penalized for it. Pilots are expected to ground themselves if they’re sick or having an issue potentially hazardous towards others.
It’s not nearly as bad as it used to be.
Here’s what you do if you have a potential problem: you contact an aeromedical examiner BEFORE you take the official exam to discuss your concerns. The doc will be able to tell you what tests and/or documentation will be required in order to either pass or get special issuance. Or, if there really is no chance you can pass, you can find that out, too.
For the insanely determined there are always Part 103 ultralights in the US. Very limited single-seaters, but hey, if you absolutely MUST fly… follow the regs and you’ll only put yourself at risk. Yeah, I’ve known a few of those guys, too, mostly older guys with severe heart problems. At least one of them that I knew had his massive heart attack while airborne, but at least no one else go hurt and only his ultralight got broke.
Apparently, reporting every Dr. visit is required, under penalty of perjury. FAA aviation medical expert Dr. Charlton Stanley describes it here:
That may been the original goal, but in actual practice they are looking for any item whatsoever on a long list of items that would disqualify you – regardless of whether there is significant risk it might endanger others.
It is far from “no problem”. Lots of people have been denied because of a prior condition years ago which no longer exists. This doesn’t mean they can never get a 3rd class medical, only they must often jump through hoops and run the risk of being denied. If that happens they can’t even fly a light sport plane.
In the comments here you can see some generally benign conditions pilots have been denied 3rd class medicals over: Flying With A Medical Condition - PilotWorkshops
By “ever fails” I meant if after passing a series of medicals they ever fail or if they fail on the initial attempt they are denied. I did not mean and did not say they are perpetually denied.
Yes that is a good idea. As you said things are better than they used to be.
I am not a current or past pilot and have never taken an aeromedical exam, but I did work at an aerospace university for 10 years.
- hand raised from back of room *
Private pilot, I get, I suppose. What’s a Sport Pilot?
A Piper Cub is a Light Sport? Cool, last time I flew a Cub I don’t think the LSA category existed.
Edit: Wiki suggests the PA-18 Cub is too heavy for the LSA category. I know there is replica Cub that fits into the LSA category though, the Cub Crafters Sports Cub and Carbon Cub, also the old J-3 is light enough as well.
Light Sport Aircraft have a gross take-off weight of 560kg or less (600 kg for a float-plane). They come under a different rule set regarding certification, maintenance, and pilot licensing. You don’t need a private pilot licence to fly one for example.
It appears you are correct. I suspect it may be in response to the Germanwings suicide, though I don’t see how it will solve the problem, pilots will just be discouraged from seeing someone about mental issues. Having to report every visit for a head cold would be an annoyance but that is all. You get used to keeping track of your Dr. visits I guess.
Horses mouth information here: https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/app_history/item19/
BTW the disqualifying conditions seem reasonable to me:
Angina pectoris
Bipolar disease
Cardiac valve replacement
Coronary heart disease that has been treated or, if untreated, that has been symptomatic or clinically significant
Diabetes mellitus requiring hypoglycemic medications
Disturbance of consciousness without satisfactory explanation of cause
Epilepsy
Heart replacement
Myocardial infarction
Permanent cardiac pacemaker
Personality disorder that is severe enough to have repeatedly manifested itself by overt acts
Psychosis
Substance abuse
Substance dependence
Transient loss of control of nervous system function(s) without satisfactory explanation of cause.
https://www.faa.gov/licenses_certificates/medical_certification/faq/response6/
As it happens, I am a private pilot and I’ve submitted to half a dozen FAA medical exams. I also hold a Statement of Demonstrated Ability which indicates to anyone with knowledge of these things that I have some personal experience with hoop-jumping.
Yes, some “minor” things can trip you up - but some things that are minor on the ground are not-so-minor in the air. There has been considerable progress in the 20 years since I took my first flight lesson in modernizing at least the US medical regulations.
Anyone past the age of 18 who isn’t in absolutely perfect health, I’d recommend they consult with an FAA medical examiner first, prior to getting the official exam. Also prior to when you’re prepping to solo if you’re already taking lessons.
I should mention that some of the above can still get issuance at least as a 3rd class medical. Granted, that would screw over a professional pilot, but it’s less of a concern for us private types.
The FAA examiner I took my checkride with, who was required to hold a second class medical, happened to have Type II diabetes but was able to get a special issuance to keep his required privileges. Never asked the details of it, but he was one of the go-to guys for folks with medical concerns in my area. Plenty of former alcoholics are flying, but they have to demonstrate/prove sobriety for a considerable period of time.
The cardiac stuff is definitely of some concern - even a lowly private pilot is expected demonstrate turning maneuvers of up to 2g’s, which does impose and additional burdens on your heart. You don’t want the pilot to pass out because their heart isn’t strong enough to keep their brain oxygenated during a turn, or precipitate a cardiac emergency. I was quite surprised to read a study once that looked at the average heart rate of a pilot during a normal, routine, uneventful landing - spikes to 160 or 170 beats per minute were quite common. There are some pretty sound reasons for the FAA’s deep concern over any sort of heart, blood pressure, or circulatory problems. The problems are common enough that there are actually some pretty reliable guidelines for special issuance, the major concern being whether or not the pilot is at risk for suddenly dropping dead at the stick.
I’ve also heard complaints about the FAA disapproving of certain common cold medications. Well, first of all, if you’re having a lot of sinus or other congestion pressure changes can feel like your head is being slapped by a sledgehammer, which isn’t really good for your concentration and alertness. Some of those medications can impair your reaction time which is not a good thing when mixed with aviation. Others can increase your blood pressure and heart rate, which, added to the normal burden piloting imposes on your system, is a potentially very bad thing. Pseudoephedrine can contribute to vertigo (about 20% of the population is affected), which is a condition that can kill pilots. And everyone else on board. And maybe people on the ground, too. So, yeah, pilots are supposed to self-ground if they have a head cold and not take OTC meds, but it’s not because the FAA are meanies it’s because there are actual reasons behind the prohibitions.
There’s also the flip side that if you have a chronic but treatable condition the FAA may require you to take your meds and forbid you from flying without them “on board”, just like they require people with less than perfect vision to wear their “corrective lenses” (glasses or contacts) while flying.
can’t say for sure now but 80-85 I flew Hueys in the Army and it was every year then.
Heart problems is actually one thing where it can be more lenient if you are doing multi-crew airline flying. I know a few guys who have a medical that restricts them to only flying multi-crew and only with another pilot who doesn’t have the same medical restriction. A bit of a rostering nightmare if you have a small base filled with old fogies with heart problems.
After your post above, I’m considering wearing my heart rate monitor tonight, just to see what it says.
I would really be interested in this. 
Actually, so would I - I mean sure, I read that stat and the source seemed reliable but it would be interesting to get some data on our own.
I’m wearing it. One sector in to a three sector night. Recording the data with my cycling GPS.
I’m afraid it is not very interesting.
We operated three sectors with the first being flown by the first officer and the second and third being flown by me.
For the night I recorded an average heart rate of 77 bpm and a max of 113.
Sector one maximum was 102 bpm at top of climb when I got up and made us a cup of coffee. Approach and landing HR was in the mid 70s. HR peaked again at 101 bpm during my walk around.
Sector two maximum was mid 80s and the approach and landing, flown by me, was in the mid 70s with a couple of peaks in the low 80s. I recorded another ~100 bpm peak during the walk around.
Sector three had some peaks in the mid 80s during approach and reached 91 during landing. This one seemed to have the most obvious rise during the landing which is probably because it was a relatively high workload approach.
All in all the data suggests that I had a cruisy night. Maybe if I was trying to land an F-14 Tomcat on a pitching deck at night after a couple of bolters with only enough fuel remaining for one last approach it would have been a different story.
For reference my resting HR is ~70 bpm and max is 183 bpm.
A link to a HR vs altitude graph: https://dl.dropboxusercontent.com/u/57942579/Screenshot%202016-08-26%2004.43.37.png
Altitude is cabin altitude and the three segments represent the climb cruise and descent of each flight.
Time between flights is the turn around time. Spikes in HR generally being associated with mild physical activity such as a walk around. Dead areas in the HR are when I got too far from the recording device.
The little blip in the cabin altitude at the end of each flight is the cabin depressurising on landing.
EDIT: Sorry for the hijack OP, it didn’t seem worthy of a separate thread.
ISTR that standard based on one of my troops a few years back who was a qualified Blackhawk pilot who wanted to maintain his medical qualifications even though we weren’t an aviation unit. I looked as far as this. It references the reg if anyone wants to dig deeper.
From that link
To be at least Class B (A is more serious) the standard is at least $500k in property damage, at least one injury causing permanent partial disability, or three or more personnel hospitalized for in patient treatment.
Probably the other useful thing for those noting it seems less intrusive than the civilian standard is that people bearing the title Commander have more power than a civilian boss with regards to medical information. A Commander observing a possible medical or mental health issue can lawfully order a medical evaluation. Commanders also have an exception that allows them to access what civilian side is considered Protected Health Information under HIPAA. Think of it in terms of your civilian boss being authorized to require you go to the doctor and then they can discuss the diagnosis one on one with the doctor afterwards, whether you consent or not.
I flew USAF fixed wing in the same time frame. Annual was their standard then too.