Every pilot holds an airman medical certificate that’s either valid or invalid. Those of us who actively fly make the pilgrimage to the AME’s office on a regular basis—the frequency depending on the class of medical certificate we hold. Each class of medical certification comes with a strict set of compliance guidelines—and there’s no glory in holding a higher certificate level than you need. In fact, doing so often bites in the end.
The underlying premise for assigning classes to medical certificates is based on the FAA’s assessment of the risk of incapacitation while a pilot is flying an aircraft. This may be oversimplified, but the FAA bases its risk assessment in part on whether the pilot is carrying passengers for hire. A Private pilot is allowed a relatively higher risk with a given medical condition than a Commercial or ATP-rated pilot conducting passenger-carrying revenue flights. According to Gary Crump, AOPA’s Director of Medical Certification Services, “The FAA as a regulatory agency, practices evidence-based medicine, and makes certification policy based upon the best available medical data regarding incapacitation risk.”
The airman medical standards are minimum standards. There is no practical way for all possible medical conditions to be considered in a regulatory standard. For that reason, the FAA develops certification policies that include baselines for different medical conditions that are weighed against the risk of incapacitation associated with that condition. That way, every applicant for a medical certificate who has a medical condition that requires review will receive consideration that is measured against the medical policy and on the merits of the individual’s medical case history.
Based on this thinking, the FAA designates three levels of airman certification:
There’s no advantage to carrying a higher level of certificate than is needed. Many pilots, however, do just that and it eventually can create unnecessary certification problems. The staff in AOPA’s Medical Certification Department sees this routinely and the advice always is—if possible, drop to a lower certificate level. In many circumstances, the problem disappears.
For instance, some pilots hold a first class certificate but their employers only require a second. There is wisdom in dropping to a second class certificate, especially from age 40 and older when an annual ECG (electrocardiogram) is required to maintain a first class certificate. ECGs are not required by regulation for a second class certificate. Of course, we’re not suggesting that you shouldn’t see your doctor if you suspect a heart-related problem—but many “abnormal” ECGs don’t indicate a disqualifying medical condition, but an unnecessary, mildly abnormal ECG could result in a question about the validity of your current medical certificate, or prevent your AME from issuing you a new one. Here’s another example—the distance vision standard for first and second class medicals is 20/20 in each eye separately, with or without correction. As the years go by, many pilots don’t quite reach that standard— and even with corrective lenses are only able to achieve 20/30 or 20/40 in one or both eyes. The solution—unless your employment prohibits it—is to drop to third class certificate standards, which are 20/40 in each eye, corrected or uncorrected.
CFIs, you deserve a special mention. You can instruct primary and advanced students with a third class medical certificate. And, if the pilot qualifies and agrees to act as pilot in command, you can give advanced instruction with no medical certificate at all. Just be sure the instruction does not require a two-pilot crew (ie: instrument student under the hood and CFI as safety pilot).
Bottom line: Make it easy on yourself and hold only the medical certificate level you really need.
Have a medical question? Give AOPA’s airman medical certification staff a call, 800-USA-AOPA (872-2672) Monday through Friday, 8:30—6 Eastern Time.