Core takeaways: (1) the second-class exam applies discrete Part 67 standards to eyes, ears, heart, mind, and nerves, not a single fitness verdict; (2) second-class distant vision is 20/40 in each eye with or without correction, near is 20/40 at 16 inches, and intermediate applies at age 50 and over; (3) hearing passes by conversational voice or audiometric thresholds; (4) outcomes are issued, deferred, or denied, with special issuance as the recovery route; (5) a second-class certificate lasts 12 calendar months for second-class operations, and your documentation, not your fitness, decides how smooth the visit is.
What the exam is and how the application starts
You apply through MedXPress, see an Aviation Medical Examiner within 60 days, and the AME performs the physical against Form 8500-8.
Start by creating an account in MedXPress, the FAA's online application system, and answer the medical history questions there. Submit the application, then schedule an appointment with an Aviation Medical Examiner (AME), a physician trained to perform FAA exams. The application stays active for 60 days; if the AME has not uploaded it by then, it disappears from the system.
On exam day you bring your MedXPress confirmation number and a government-issued photo ID. The AME's staff collect your vitals, test your eyes, perform a hearing test, and collect a urine sample; an EKG is done only if required. The AME must then personally review your medical history with you and perform the physical examination, covering eyes, ears, nose, throat, heart, lungs, abdomen, extremities, skin, neurologic screening, and a general psychiatric impression.
The written backbone is FAA Form 8500-8, the Application for Airman Medical Certificate. You complete the history page yourself in your own handwriting, and the AME completes the examination items, numbered 21 through 58, covering each body system from head and sinuses through vision, heart, and ECG.
Official sources: How do I get a Medical Certificate and what to expect during the AME examination | Federal Aviation Administration — FAA medical certification process page, last updated May 14, 2026; Guide for Aviation Medical Examiners - Application Process for Medical Certification | Federal Aviation Administration — Exam Techniques and Criteria for Qualification, Form 8500-8 items
Issued, deferred, or denied: the three outcome paths
If everything meets the Part 67 standards, the AME issues the certificate on the spot. Otherwise the exam is deferred to the FAA, or in rare cases denied.
Deferral is not denial. When a condition or missing paperwork prevents an immediate decision, the AME sends the exam to the FAA for review, and you receive a letter listing what to provide, usually medical records. Documents go to your AME, who attaches them electronically to your file; that is the fastest route.
A denial means you did not meet the unrestricted standards in 14 CFR Part 67, and it applies to specifically disqualifying conditions. If you disagree, you can appeal, and the FAA explains how in the letter. In many cases a denied applicant can still fly under Special Issuance, an authorization under 14 CFR 67.401 that lets the FAA certify you with extra monitoring. A special-issuance certificate usually demands more medical documentation, expires sooner, but generally lets you operate the same way an unrestricted certificate does.
Official sources: How do I get a Medical Certificate and what to expect during the AME examination | Federal Aviation Administration — FAA medical certification process page, last updated May 14, 2026; Guide for Aviation Medical Examiners | Federal Aviation Administration — Summary of Medical Standards synopsis
Vision is four separate standards, not one eye chart
Second-class applicants need 20/40 distant acuity in each eye with or without correction, 20/40 near at 16 inches, 20/40 intermediate at 32 inches from age 50, and adequate color perception.
Distant visual acuity for second class is 20/40 or better in each eye separately, with or without correction. Wearing glasses or contacts is fully acceptable, so corrected vision inside the limit is a clean pass; bring your correction to the exam.
Near vision must reach 20/40 or better in each eye at 16 inches. The intermediate standard, 20/40 at 32 inches, applies once you are age 50 or over, which is why older applicants see an extra mid-range test. Color vision is judged by your ability to perceive the colors necessary for safe performance of airman duties.
| Vision element | First class | Second class | Third class |
|---|---|---|---|
| Distant acuity (each eye) | 20/20 or better | 20/40 or better | 20/40 or better |
| Near acuity at 16 inches | 20/40 or better | 20/40 or better | 20/40 or better |
| Intermediate at 32 inches | Required at age 50 and over | Required at age 50 and over | No requirement |
| Color vision | Colors needed for safe airman duties | Colors needed for safe airman duties | Colors needed for safe airman duties |
Official sources: Guide for Aviation Medical Examiners | Federal Aviation Administration — Summary of Medical Standards synopsis
Hearing and ear, nose, and throat standards
You meet the hearing standard by hearing an average conversational voice at 6 feet with your back turned, or by passing an audiometric test.
The regulation gives two routes. The simpler one is functional: hear an average conversational voice in a quiet room using both ears at 6 feet, with your back to the examiner. If that does not work, the AME turns to audiometry, either a speech discrimination score of at least 70 percent in one ear at no more than 65 dB, or pure-tone thresholds within the limits in the table below.
The ENT standard also covers balance and disease, not just acuity. It prohibits ear disease or a condition manifested by vertigo or a disturbance of speech or equilibrium, so a dizziness history is evaluated on separate grounds from pure hearing loss.
| Pure-tone limit (unaided) | 500 Hz | 1,000 Hz | 2,000 Hz | 3,000 Hz |
|---|---|---|---|---|
| Better ear | 35 dB | 30 dB | 30 dB | 40 dB |
| Worse ear | 35 dB | 50 dB | 50 dB | 60 dB |
Official sources: Guide for Aviation Medical Examiners | Federal Aviation Administration — Summary of Medical Standards synopsis
Heart, blood pressure, mental, and neurological rules
Pulse and blood pressure are screening signals, an ECG is not routine for second class, and a defined list of conditions must be denied or deferred.
Your pulse is not disqualifying by itself; the AME uses it to judge cardiac status and responsiveness. Blood pressure has no fixed regulatory value, but the current guideline maximum is 155/95. An electrocardiogram is not routinely required for second- or third-class applicants; routine ECG schedules attach to first-class certification at age 35 and annually after 40.
The mental standard excludes a diagnosis of psychosis, bipolar disorder, or severe personality disorders. Substance rules are explicit: substance dependence is disqualifying unless the Federal Air Surgeon accepts clinical evidence of recovery with sustained total abstinence for at least the preceding two years, and substance abuse within the preceding two years is disqualifying. Substances include alcohol and drugs such as cocaine, opioids, amphetamines, marijuana, and sedatives.
A short list of conditions forces the AME to deny or defer unless the FAA directs otherwise: diabetes requiring hypoglycemic medication, angina, treated or symptomatic coronary heart disease, myocardial infarction, cardiac valve replacement, a permanent pacemaker, heart replacement, psychosis, bipolar disorder, severe personality disorder with overt acts, substance dependence, substance abuse, epilepsy, unexplained disturbance of consciousness, and unexplained transient loss of control of nervous system function. Neurologic screening checks cranial nerves and reflexes, and the psychiatric element is the AME's general impression of cognition and mental wellness.
Official sources: Guide for Aviation Medical Examiners | Federal Aviation Administration — Summary of Medical Standards synopsis
How long a second-class certificate stays valid
A second-class certificate is valid for the rest of the month of issue plus 12 calendar months for second-class operations, and it keeps working for third-class operations for 24 or 60 months depending on age.
For operations requiring a second-class medical certificate, the certificate is valid through the remainder of the month of issue plus 12 calendar months, regardless of age. It does not stop there: for operations requiring only a third-class certificate, it remains valid for 24 more calendar months if you were 40 or over on the exam date, or 60 calendar months if you were under 40.
A replacement for a lost certificate must come from the FAA; copies are not valid, and the AME issues only one originally signed certificate.
Work through the arithmetic yourself with the exercise below, because the month-of-issue anchor trips up applicants who count from the exam day.
Practice exercise
A pilot who is 43 years old receives a second-class medical certificate issued on March 5, 2026. What is the last day it is valid for operations requiring a second-class medical certificate, and the last day for operations requiring only a third-class certificate?
Show answer
March 31, 2027 for second-class operations, and March 31, 2028 for third-class operations.
The validity clock starts at the month of issue, not the day. For second-class operations, add 12 calendar months to March 2026, landing in March 2027, and the certificate runs to the end of that month: March 31, 2027. For third-class operations, the pilot was over 40 on the exam date, so the 24-month period applies: 24 months from March 2026 ends in March 2028, again through the end of the month, March 31, 2028. The common error is anchoring on March 5 and computing March 4 of the following year.
Official sources: Guide for Aviation Medical Examiners | Federal Aviation Administration — General Information - Validity of Medical Certificates
Documents to gather before your appointment
If you have a current or past condition or take medication, research the requirements in the AME Guide and bring a current, detailed Clinical Progress Note, not a patient-portal summary.
For many conditions the FAA wants medical information in the form of a detailed Clinical Progress Note from a clinic visit no more than 90 days before your AME exam. The notes or After Visit Summary you can print from a patient portal are usually not sufficient, because they may contain only some of what the FAA needs; ask your physician's office for the actual progress note. A letter is usually not required, the note itself is.
With the correct documentation in hand, your AME may be able to issue the certificate immediately at the visit. Without it, certification can be delayed while records are collected, and a failure to provide requested information can delay issuance or lead to denial. Research the relevant standards in the Guide for Aviation Medical Examiners before your appointment; it is written for physicians, but it tells you and your care providers exactly what to collect.
- Complete MedXPress and schedule the AME visit within the 60-day application window.
- Request a current Clinical Progress Note dated no more than 90 days before the exam for any active condition.
- Bring your confirmation number, government-issued photo ID, corrective lenses, and copies of all medical records.
Final checklist before you go
Confirm the logistics, reconcile your history against your records, and know which outcome path your answers start.
A simple history needs little lead time; a condition with past deferrals deserves several weeks so documents arrive before the visit, not after. The checklist below condenses the sourced rules above into the day-of essentials.
- MedXPress submitted and an AME appointment booked inside the 60-day window.
- Confirmation number and government-issued photo ID in hand.
- Corrective lenses packed, since corrected vision within the limits is fully acceptable.
- Clinical Progress Notes within 90 days for every active condition or medication.
- Your Form 8500-8 history matches your pharmacy printout and medical records exactly.
Official sources
Fact-checked against FAA.gov:
- How do I get a Medical Certificate and what to expect during the AME examination | Federal Aviation Administration
- Guide for Aviation Medical Examiners | Federal Aviation Administration
- Guide for Aviation Medical Examiners - Application Process for Medical Certification | Federal Aviation Administration
- Guide for Aviation Medical Examiners | Federal Aviation Administration