Medical For Pilots

Medical For Pilots – The Requirements

Medical for pilots and the requirements. Height requirements, weight requirements, wearing glasses, being color blind or having diabetes. In this article, I discuss what a Class 1 medical consists of and cover all of the medical requirements to become a commercial (airline) pilot.

This article is based on the EASA and FAA regulations. Keep in mind that any flight school or company has the right to restrict these regulations further. Therefore, I highly suggest you call or send an e-mail to an aviation medical centre or the flight school you have in mind, in case of any doubts about the requirements. On a side note, if you are still looking for the perfect flight school, you might find my eBook “Become An Airline Pilot” useful.

Why do pilots have to pass a medical?

In order to legally operate an aircraft, all pilots have to hold a current medical certificate. This certificate is obtained by going through a medical examination. The medical examination is necessary in order to make sure that the holder of a pilot license is (still) in a sufficient state of health to properly operate an aircraft.

There are 3 classes and they are categorized as follows:

  • Class 1 medical – Commercial pilots (CPL (A), ATPL (A))
  • Class 2 medical – Private Pilots (PPL),  Sailplane Pilots (SPL) or Balloonists (BPL)
  • Class 3 medical – Air Traffic Controllers

Class 1 Medical

The Class 1 medical certificate is required for all pilots that use their CPL, MPL or ATPL license in a commercial way.

The annual medical check is a complete body check that consists of the following items. Make sure you go through them and check whether you are aware of something that might stop you from becoming a pilot. If that is the case, it is wise to do a medical check at an aviation medical center before applying at a flight school. In all other cases, a medical check usually takes place after you passed the flight school selection process.

Blood Test

A bit of blood is taken to determine the hemoglobin level in your blood. The total cholesterol is determined at the initial examination and at the age of 40.

Urine Test

During each examination your urine, that you produce on site, is examined for glucose, blood and proteins.

Vision Test

Of course, your eyesight is of vital importance. As an airline pilot, you will have to deal with factors that can influence vision and your interpretation. Examples are reduced oxygen at high altitudes, night flights and fatigue.

At each inspection, your eyesight is tested in the vision screener at 30-50 cm, 1 meter and 5 meters. If you wear glasses, the doctor or nurse will first measure without and then with your corrective glasses/contact lenses. For the medical certificate, your visual acuity should be 0.7 (6/9) or better in each eye. The visual acuity of both eyes should be 1.0 (6/6) or better.

Wearing glasses doesn’t mean you are unable to pass the examination. A lot of pilots wear them so don’t worry.

Color Vision Test

Can you become a pilot if you are bit color blind? Yes! Actually, many people are color blind without being aware that they are. There are specific tests to check the amount of color blindness, but the most common one is the Ishihara test. The Ishihara test with 24 different pictures is considered passed if the first 15 pictures, presented in a random order, are identified correctly.

You might ask yourself, why is it important to see colors? It’s because everything in aviation is color coded and being able to discriminate between colors results in a better depth perception. For example, a PAPI or Precision Approach Path Indicator, consists of a set of lights that can either be seen as white or red. The color is determined by the angle at which they are looked at and they serve 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? I guess you get the point.


Class 1 medical for pilots

Physical Examination

You will be physically examined on the basis of your medical certificate. In addition to the mobility, coordination, balance of your body, your eyes, ears, heart and lungs are also examined for possible defects.

Additional Research

Additional research is necessary at certain intervals. These intervals depend on your age and whether you have a medical indication. Examples are an ECG and audiometry.

Electrocardiogram (ECG)

The purpose of the ECG is to obtain information about the functioning of your heart muscle. This is achieved by placing electrodes on your chest, wrists and ankles. The ECG is taken at your initial medical examination and then every 5 years until the age of 30. After that every 2 years up to the age of 40 and annually up to the age of 50.

Lung Function Examination (Spirometry)

During the lung function examination, the doctor will assess the function and content of your lungs. In most cases you are asked to insert a mouthpiece between your lips after which you breathe in and exhale as fast as you can.

Hearing Test (Audiometry)

Your hearing will be tested by pure tone audiometry during the first examination. You will hear sounds through headphones at different frequencies and intensities. The hearing loss shouldn’t be in excess of 35 dB at any of the following frequencies 500, 100 or 2000 Hz or more than 50 dB at 3000 Hz in each ear. This test is carried out up to the age of 40 every 5 years and every 2 years thereafter. The hearing test is taken in a soundproof cabin.

Eyeball Pressure Measurement (Tonometry)

The pressure in your eyeball will be measured by a sudden puff of air. The research is done during your initial inspection and on indication that something is not as it should be.


In the Class 1 medical there is no limitation regarding height. Of course you have to be able to fly an airplane without any troubles caused by your length. That is why most flight schools and companies take a minimum length requirement of 157.5 cm and a maximum length of 203 cm. This is due to the space in the cockpit and the possible seat and/or rudder pedal adjustments.


The only limitation regarding body weight is the Body Mass Index when it is equal or greater than 35. When passing a BMI of 35, extra risk assessments need to be done regarding the cardiovascular system and other systems which might be at greater risk due to the high BMI.

Diabetes Mellitus

Unfortunately, commercial pilots in the Netherlands with diabetes mellitus requiring insulin are examined as unfit and therefore not able to fly. Pilots with diabetes mellitus not requiring insulin are also examined as unfit unless it can be demonstrated that blood sugar control has been achieved and they are stable without any hypoglycemic episodes.

Pilots with diabetes mellitus who do not require medication, may be assessed as fit to fly when the use of anti diabetic medications are not likely to cause hypoglycemia. In Ireland, England and Canada, it is possible to fly when insulin is required, but only under very strict conditions. Regarding the FAA regulations ,whenever there is no glycosuria and the pilot has a normal HbA1c, the license can be issued normally. However, in most cases regarding diabetes mellitus a personal FAA decision needs to be made in order to check whether the pilot is fit or unfit to fly. More info about Diabetes can be found here (

There are other health conditions which might lead to being examined as unfit. Not all are mentioned above as regulations per country , medical institute, company or flight school can change at any time. In case you are still in doubt about your health and whether it will affect the outcome of a medical examination, it is always wise to contact an aviation medical centre or check out these (Guide for Aviation Medical ExaminersGuidance for medical certification of EASA pilots by condition) sources before a selection process.

I hope this article gave you more insight in the medical requirements for a class 1 medical. The class 1 medical is the most restrictive class. If you are considered unfit for a class 1 medical you can still apply for a less restrictive class 2 medical and still fly privately.

Please comment below if you think something should be added to this list! For everyone who is taking steps to become a pilot, you can take a look at my app for pilots called ‘Preflight by DutchPilotGirl’. Have a great day guys and I hope to see you soon!

12 thoughts on “Medical For Pilots – The Requirements

  1. Thank you Michelle for sharing your wealth of aviation knowledge and experience! 😍

  2. Sorry for bothering but I was asking the weight required for an Commercial Airline Pilot

  3. I just want to know that i have gotten a leg surgery in my childhood which leaves a scar on my leg but there is no problem in any activity due to this.
    Can i get the EASA medical class 1 certificate?

  4. Hello Michelle, your infos are priceless! I have a question. Don’t mind to be brutal, just give me your opinion, as frank as it is: when I was a kid I had an accident while squba diving. The timpanus of my right ear has been severely damaged. I think much more than those 35 dB reported in your article. My left ear, on the contrary, is perfect. Any chance for me to become a pilot ? Thanks a lot. A lovely hug!!!

  5. Ahh.. these r the basic tests.. we learned how to perform them in 1st year of medical school.
    One more check done

  6. I thought the medical exam for pilots will be a lot harder. Thanks at least now i can look after my dream after having my online selection process in february.

  7. Even though I can never be a pilot (vision) I have always wanted to know what was on the medical. Thank YOu

  8. Hi Michelle, thanks for your articles. I have a question about the colourblind. I have received the medical class 1 even if i can not see the numbers on the Ishihara test. I had to do a special colour test. At the moment I’m on my ppl and next year I’m planning to start with the cpl, atpl school. Do you think I could have problems later to get a job because of my problem with colours?
    Greetings Markus

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