FAA Medical Certificates Explained: Third Class, BasicMed, and What Student Pilots Need
- Nathan Hodell
- Jun 11
- 4 min read
Few topics generate more confusion — and more anxiety — for new student pilots than the FAA medical certificate. Here's the plain-English version of what you need, when you need it, and how to avoid the one mistake that derails training before it starts.
Do You Need a Medical to Start Flight Training?
No. You can take lessons with an instructor without any medical certificate at all. You need a medical (and a student pilot certificate) before your first solo flight. That said, get your medical early — for one critical reason covered below.
The Three Classes
First class: Required to exercise ATP privileges — airline captains. The most stringent standards and the most frequent renewals.
Second class: Required to exercise commercial privileges — flying for compensation.
Third class: What student, private, and recreational pilots need. For pilots under 40, it's valid for 60 calendar months; 40 and over, 24 calendar months.
If you're a career-track student, consider getting a first-class medical for your very first exam even though you only need a third class. If something in your medical history is going to be a problem for an airline career, you want to know before you spend $80,000 on training — not after.
What Happens at the Exam
You'll see an Aviation Medical Examiner (AME) — a regular physician with FAA certification. The exam covers vision (20/40 correctable for third class — glasses are fine), hearing, blood pressure, urinalysis, and a medical history review. Most exams take 30–45 minutes and cost $100–$200.
Before the appointment, you'll complete an application in MedXPress, the FAA's online system. This is where the stakes are.
The Mistake That Grounds Students: Walking In Unprepared
The single most expensive medical mistake is showing up to an AME with a complicating history — ADHD (or even childhood ADHD medication), depression or anxiety treatment, DUI, sleep apnea, certain heart conditions, diabetes — without preparation. Once you submit MedXPress and the AME defers your application to the FAA, you're in a months-long (sometimes years-long) review process you can't take back.
If anything in your history might be an issue, do a consultation first: talk to an AME informally before submitting anything, or contact AOPA's medical certification specialists. Many conditions are certifiable with proper documentation — the difference between approval and an 18-month deferral is often just walking in with the right records on day one.
BasicMed: The Alternative That Keeps Pilots Flying
BasicMed, created in 2017, lets many pilots fly without holding a current FAA medical. To qualify, you must have held a valid FAA medical certificate at some point after July 14, 2006. Then, instead of seeing an AME, you complete a physical with any state-licensed physician every 48 months and an online medical education course every 24 months.
The 2024 expansion made BasicMed dramatically more useful. Under the FAA Reauthorization Act provisions effective in late 2024, BasicMed pilots can now operate aircraft up to 12,500 pounds maximum certificated takeoff weight (up from 6,000) carrying up to six passengers (up from five), and BasicMed can now be used for certain examiner and safety pilot functions. Limits remain: below 18,000 feet MSL, at or below 250 knots, not for compensation or hire, and within the United States (plus countries that accept BasicMed, like the Bahamas and Mexico under their conditions).
The catch for new students: BasicMed requires having held a medical after July 2006. Brand-new pilots still need to get a regular FAA medical at least once. That first third-class exam is your gateway — after it, BasicMed can carry you for the rest of a recreational flying career.
What About Sport Pilot and MOSAIC?
Sport pilots have long flown light-sport aircraft with just a driver's license, no FAA medical required (as long as you've never been denied one). With the FAA's MOSAIC rule expanding the definition of light-sport-eligible aircraft, this path now covers significantly more capable airplanes — making it a legitimate option for pilots who can't or don't want to pursue an FAA medical. One critical warning applies here too: a denied medical application locks you out of the driver's-license pathway, which is one more reason never to submit MedXPress without knowing you'll pass.
The Bottom Line
Get your medical early in training — before you've invested heavily.
If your history is complicated, consult before you apply. Never let an unprepared application turn into a deferral or denial.
Career-track? Test yourself against first-class standards from day one.
Recreational flyer? One medical now, BasicMed for life afterward.
Questions about medical requirements come up on every private pilot checkride oral, too — class durations, required documents, and BasicMed limitations are all fair game. The wifiCFI ground school covers the regulations the way your DPE will ask about them.
Study Full Aviation Courses:
wifiCFI's full suite of aviation courses has everything you need to go from brand new to flight instructor and airline pilot! Check out any of the courses below for free:
Study Courses:
Checkride Lesson Plans:
Teaching Courses:
Author: Nathan Hodell
CFI, CFII, MEI, ATP, Creator and CEO
Nathan is an aviation enthusiast that has thousands of hours of flying and flight instruction over the past 15+ years. Through his aviation career he has been able to earn his ATP, fly as an airline pilot, create a flight school with over 80 students, 12 airplanes, and 2 locations, and create and host wifiCFI.