Class 1 Pilot Medical Requirements & Exam! Read this before you start your flight training!

In order to become a pilot, you must first pass the medical examination. It can seem a bit daunting at first, but the Your Pilot Academy team has worked diligently to lay out the process in the simplest terms so that you can go into your medical exam confidently!

Can you fly if you are colorblind? What happens if you have a chronic health condition like diabetes? Will you be rejected if you wear glasses? Keep reading to find out all these answers and much more about the Class 1 Pilot Medical Requirements & Exam.

It’s important to note that the information presented in this article is based upon EASA and FAA regulations. While airlines and flight schools are not permitted to relax any medical requirements, they can be more restrictive than the set regulations.

Disclaimer: We do not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purpose only. No material on this website is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. 

To avoid any confusion, it’s always wise to send an e-mail or call an aviation medical center or the flight school you are interested in. Then, they can answer any specific or nuanced questions you may have and advise you on the best course of action moving forward.

By the way, if you are still hunting for the perfect flight school, make sure you check out our database of over 200 flight schools around the world.

Why is the pilot medical examination necessary?

In order for you to operate an aircraft legally (and we hope this is your goal), you must hold a current medical certificate. There are no exceptions to this rule. To get the medical certificate, you have to go through… drumroll… the pilot medical examination.

Basically, the pilot medical examination is how you can prove you are still in good physical health and can safety perform all your duties as a pilot. There are three different classes, or levels, of medical certificates. Which certificate you need depends on your role.

  • Class 1 Medical: this is for commercial pilots who hold, or are candidates for, a CPL(A) or ATPL(A).
  • Class 2 Medical: this is for private pilots (PPL), sailplane pilots (SPL), and balloonists (BPL).
  • Class 3 Medical: this is for air traffic controllers (ATC).

The Class 1 Pilot Medical

In this article, the primary focus will be the Class 1 Medical. The Class 1 Medical certificate is required for anyone who wishes to use their CPL, MPL or ATPL in order to fly commercially. You must complete a medical examination annually, or once every year, in order to keep your medical certificate current. The exam consists of several parts, which will be described below.

Make sure you read through each item carefully so you are aware of any issues which may arise that could potentially hinder you from becoming a pilot. If you have any concerns about a specific requirement after reading this article, your next step should be to contact an aviation medical center.

It’s best to do this before you apply to a flight school, so that you can avoid paying for a course you may not be able to complete. If everything you read below seems fine for you, you will not have to worry about the medical examination until after you have passed the flight school selection process.

Blood test

During your medical examination, a small amount of blood will be drawn in order to determine the level of hemoglobin in your blood. Hemoglobin is a protein which is responsible for transporting oxygenated blood throughout your body. If hemoglobin is too low, this can be indicative of anemia or other serious health conditions.

In addition, your total cholesterol will be checked during your initial examination and again when you turn 40 years old. This test can help to determine your risk for acute conditions such as heart attack and stroke.

Urine test

At each medical examination, you will be asked to produce a urine sample on site. It will be checked for the presence of blood, glucose (sugars) and proteins. There are many reasons for the urine test, but one of which is to test for signs of diabetes mellitus.

Class 1 Pilot Medical - Your Pilot Academy

Vision test

As you may expect, your vision is vital to your ability to fly an airplane. While you are flying, there will be situations where you encounter a reduction in vision or visual processing ability, such as in the case of low oxygen levels at high altitudes, night flights, or fatigue.

Every time you go in for a medical examination, your eyesight will be tested in a vision screener from distances of about 30-50 centimeters (12-18 inches), 1 meter (3 feet) and 5 meters (20 feet). If you wear contacts or glasses, the examiner will take measurements without correction and again with your corrective lenses/contacts on.

In order to pass and be awarded the medical certificate, your visual acuity must be 0.7 (6/9) or better in each eye. If your country or region uses the Snellen chart to measure visual acuity, it should be 20/20 or better in each eye for distance vision and 20/40 or better in each eye for near vision. The visual acuity in both eyes should be 1.0 (6/6) or better. The Snellen acuity in both eyes should be 20/20 or better for distance vision and 20/40 or better for near vision.

Wearing glasses does not mean you are unable to pass the vision test. In fact, many successful pilots wear glasses every day!

Color vision test

One of the most common questions we encounter is, “can I still become an airline pilot even if I am colorblind?” Well, the short answer is yes! There are actually tons of people who are colorblind and don’t even realize it.

There are numerous tests out there which check for various types of colorblindness, but one of the most widely-used red-green colorblindness tests is the Ishihara test. This test consists of 24-38 pictures of dotted plates, or Ishihara plates, with numbers inside. If you can identify the correct numbers for the first 15 pictures, which will be presented to you in a random order, then you have passed the test.

Maybe now you are thinking to yourself, “why is it that important to see colors anyway?” If you think about it, almost everything in the aviation world is color-coded. Also, when you can easily differentiate between colors, this improves your depth perception.

For instance, a PAPI, or Precision Approach Path Indicator, consists of a set of lights that can either be seen as white or red, depending on the angle at which you are viewing them. This serves as an indicator for the pilots to determine their approach path. Two red and two white lights mean the approach path is correct. More red lights? The aircraft is below the approach path. More white lights? The aircraft is above the approach path. So what happens if you can’t see the difference between white and red? You might end up in a really bad situation, for starters.

Physical examination

Another important phase of the medical examination is the physical exam. The doctor or nurse will test many things, including your mobility, balance and coordination. Your eyes, ears, heart and lungs will be checked for possible defects as well.

Electrocardiogram (ECG/EKG)

An electrocardiogram is performed in order to understand how your heart muscle is functioning. The test is done by attaching electrodes to your chest, wrists and ankles. The test is painless. You will have an ECG at your initial examination, then once every 5 years until you turn 30. Until age 40, you need an ECG every other year. After 40, your examiner will perform an ECG annually.

Lung function examination (Spirometry)

The lung function exam aims to test the capacity and contents of your lungs. To do this, you will usually be asked to insert a mouthpiece between your lips and perform a variety of breathing exercises, such as inhaling and exhaling as fast as you can, or exhaling for as long as you can. This exam will be performed every so often, unless there is a medical indication which warrants an earlier test.

Hearing test (Audiometry)

Your hearing will be tested by pure tone audiometry during your initial medical examination. You will be seated in a soundproof cabin and asked to put on headphones, through which you will hear sounds at varying frequencies and intensities. If there is some degree of hearing loss present in either ear, it should not exceed 35 dB at any of the following frequencies: 500, 1000 or 2000 Hz. Additionally, hearing loss shall not exceed 50 dB at 3000 Hz in either ear.

Following the initial examination, you can expect to have a hearing test every 5 years until you reach age 40. After that, you’ll need to go in for a hearing test every two years.

Eyeball pressure measurement (Tonometry)

Excess pressure behind your eyeballs can serve as an indication of several serious health conditions. Also, it can increase your risk of permanent nerve damage. Therefore, your eyeball pressure will be measured during your initial examination and upon indication that something is amiss. The test is simple, as you will only feel a sudden, small puff of air blow into your eye.


For the purposes of obtaining a Class 1 medical certificate, there is no limitation regarding height. However, since you obviously need to be able to fly a plane without any troubles caused by your height, most flight schools and airlines do impose their own minimum and maximum height.

Normally, the minimum height requirement is approximately 157.5 cm (5 feet, 2 inches) and the maximum is roughly 203 cm (6 feet, 8 inches). These limitations are due to the limited amount of space in the cockpit and the seat/rudder pedal adjustments.


There are no limitation on body weight, except when a person’s Body Mass Index (BMI) is greater than 35. If the BMI exceeds 35, extra tests and risk assessments need to be done to rule out issues with the cardiovascular system, as well as other systems which may be negatively impacted by the high BMI. This is one of the many reasons why exercise and healthy eating are important for pilots.

Diabetes Mellitus

Aspiring pilots who have been diagnosed with Diabetes Mellitus should consult an aviation medical center in your area, as guidelines can vary greatly by country. For instance, commercial pilots in the Netherlands with diabetes mellitus and requiring insulin are assessed as unfit and are therefore not able to fly. Even if the pilot does not require insulin, they are normally assessed as unfit unless there is evidence that their condition is controlled and blood sugar is stable with no instances of hypoglycemia.

In Ireland, England and Canada, however, pilots who take anti-diabetes medications may be assessed as fit to fly, unless these medications are likely to cause hypoglycemic episodes. Furthermore, those who require insulin may also be determined as fit in certain, although very limited, cases.

In the U.S., FAA regulations state that when there is no glycosuria and the pilot has a normal HbA1c, a license and/or medical certificate can be issued normally. However, in most cases when a pilot is diagnosed with diabetes mellitus, a bit of fact-finding and a unique decision will be made on a case-by-case basis regarding if the pilot is deemed fit or unfit to fly. More info about Diabetes can be found here (

Additional Research

Either during your initial medical exam or at certain intervals throughout your career as a pilot, additional research or tests will be necessary to ensure you are in peak physical shape. The kinds of tests that are needed will depend on several factors, such as your age, familial risk factors, or if there was a medical indication of an underlying health issue. Examples of additional tests which may be necessary are an electrocardiogram or audiometry.

Other health conditions

There are additional health conditions which may impact your ability to receive a medical certificate, such as epilepsy, Attention-Deficit/Hyperactivity Disorder (AD/HD) or any unexplained disturbances to consciousness. Since the above list is not exhaustive and flight schools, airlines or countries can change their guidelines at any time, it is always best to consult an aviation medical center.

If you are unsure about whether a condition will lead to you being deemed unfit to fly, they will be able to offer specific guidance and suggestions. Some other great resources are this Guide for Aviation Medical Examiners and Guidance for medical certification of EASA pilots by condition. Before you embark on a selection process for a flight school, give those a read!

We hope this article gave you a bit more insight into the class 1 medical requirements and examination process. The class 1 medical is the most restrictive of all classes. Therefore, even if it is determined that you are unfit for a class 1 medical certificate, you could potentially still apply for one of the less restrictive classes. A class 2 medical certificate, for example, would allow you to fly privately.

As always, feel free to add any discussion points or ask questions by leaving a comment. If you are taking steps to become a pilot, don’t forget to check out the Become an Airline Pilot eBook for tons of information and tips.

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