What happens during a pilot medical?
While check flights and simulator assessments test flying skills, a medical determines something far more fundamental: whether a pilot is legally fit to fly at all.
What are the different types of pilot medical certificates?
In the UK and across Europe, aviation medical certification is split into two main categories: Class 1 and Class 2.
A Class 1 medical is required for professional pilots holding an Airline Transport Pilot Licence (ATPL), Commercial Pilot Licence (CPL) or Multi-Crew Pilot Licence (MPL).
A Class 2 medical applies to private pilots, including those with a Private Pilot Licence (PPL) or equivalent light aircraft qualifications.
While the UK and Europe use this two-tier system, other countries do things differently. In the United States, for example, the Federal Aviation Administration (FAA) uses a three-class medical system covering both private and commercial pilots.
How long does a pilot medical certificate stay valid for?
In the UK, a pilot medical is usually valid for 12 months for a Class 1 certificate. However, this is reduced to 6 months for pilots aged 60 and over, and for those aged 40 or above involved in single-pilot commercial operations.
A Class 2 medical for private pilots is generally valid for up to 60 months for younger pilots, with shorter renewal periods as age increases. Exact validity depends on the pilot’s age and the type of flying they do.
What happens during a pilot medical examination?
Medical examinations are carried out by approved Aviation Medical Examiners (AMEs) and are far more comprehensive than a routine visit to a family doctor.
The process begins with a detailed review of medical history before moving on to a series of physical and diagnostic assessments. These include:
Eyesight and vision testing
Vision is one of the most closely assessed parts of a pilot medical. Pilots undergo eyesight and colour vision tests, checks of eye muscle function, and measurements of intraocular pressure, with some also needing a specialist eye examination.
Wearing glasses or contact lenses isn’t a barrier to flying, but pilots must carry a spare pair of corrective lenses while on duty.
Hearing, heart and general health checks
The examination also includes checks of height, weight, blood pressure, reflexes, thyroid function and general physical health.
Hearing is assessed through an audiogram, while lung function is evaluated through a respiratory examination.
Heart health is another major focus, with electrocardiograms (ECGs) required at regular intervals. For many professional pilots, these become annual after the age of 40 and more frequent beyond 60.
Blood tests, mental health and substance screening
Blood and urine tests are a routine part of a pilot medical, helping to pick up things like infections, anaemia, cholesterol levels and other underlying health issues.
In recent years, there’s also been a much greater focus on psychological wellbeing, alongside regular drug and alcohol screening, reflecting how important overall mental and physical health is in aviation.
Which medical conditions can stop a pilot flying?
Certain medical conditions can prevent a pilot from obtaining or keeping certification. These include serious cardiovascular disease, uncontrolled diabetes and epilepsy.
Cancer does not automatically end a flying career, however. In some cases, pilots may continue flying if treatment has been successful and the condition is stable or in remission.
How aviation medical rules continue to evolve
Regulations continue to be evaluated. For example, in 2022, the UK Civil Aviation Authority made a landmark change allowing pilots living with HIV to fly commercially as long as their condition is stable and well-controlled on antiretroviral therapy. There must also be no clear risk of transmission or significant complications.
Other than HIV, for any conditions where there is a small but acceptable risk of incapacitation, pilots may be issued a Class 1 medical with an Operational Multi-Crew Limitation (OMCL). This means they must always fly alongside a fully qualified co-pilot who doesn’t have an OMCL.
What happens if a pilot fails their medical examination?
This really depends on what the reason is.
Losing a medical certificate doesn’t always mean the end of a flying career. Often it just means time away from the cockpit until a condition is resolved or managed.
Many professional pilots also have loss-of-licence insurance to help support them during that period.
In some cases, pilots even return to flying after major procedures, including heart surgery, once they’re cleared to do so.
What about medicals for air traffic controllers and cabin crew?
It’s not just pilots who are medically assessed. Air traffic controllers must also meet strict medical standards, and some airlines require cabin crew to undergo checks similar to a Class 2 medical.
Across the industry, the principle stays the same: making sure everyone responsible for safety in the air is fit to do their job. It’s a less obvious part of aviation, but an essential one all the same.
Featured image: stock.adobe.com
