You have choices
What class medical do you really need?
Life is nice when we have choices. Most of the time. Making decisions about what restaurant to try on weekends, where we grocery shop, what insurance we want to cover the airplane all require some amount of investigation before we decide. Hopefully, the decision is a good one that works to our benefit.
With the current and anticipated global pilot shortage, many new student pilots, and current pilots who might be looking at a career change to fly for hire, are faced with a decision about what medical class they will need to pursue. FAR Part 67 says that many of the medical certification standards are identical for first, second, and third class medical certification. However, one significant area of Subpart E, 67.401(e) says: “In determining whether an Authorization or SODA [statement of demonstrated ability] should be granted to an applicant for a third class medical certificate, the Federal Air Surgeon considers the freedom of an airman, exercising the privileges of a private pilot certificate, to accept reasonable risks to his or her person and property that are not acceptable in the exercise of commercial or airline transport pilot privileges, and, at the same time, considers the need to protect the safety of persons and property in other aircraft and on the ground.”
That means the FAA is willing to allow a somewhat higher threshold of “risk assessment” to a person who is exercising only private pilot privileges that don’t include carrying passengers for compensation or hire. So, the class of medical applied for has a bearing in how the FAA will handle a medical application that includes significant medical history that requires a higher level of review for special issuance consideration.
This subtle understanding of Part 67 can create issues for a student pilot with zero flight hours who attends a Part 141 university program that requires a first class medical to begin training. The school is trying to have some assurance that the student can qualify for a first class as an 18-year-old student, but that doesn’t necessarily assure that the same student will qualify for a first class after school when they start applying for a flying job.
I suggest that pilots apply only for the lowest class of medical needed for the privileges being exercised, especially if there is a medical history that will require a special issuance authorization. Keep in mind that any checkride for a pilot certificate can be done with a minimum of a third class medical (FAR 61.23 (3) (iii)) or under BasicMed. Although you’re acting as pilot in command, you’re not exercising the privilege of an airline transport pilot or other airman certificate for the purpose of that checkride. 
Gary Crump is the director of medical certification in the AOPA Pilot Information Center.
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