The Category 1 medical examination is an in-person physical assessment by a Civil Aviation Medical Examiner (CAME), judged against Standard 424 of the Canadian Aviation Regulations. There is no written test and no pass mark. Prepare by booking with a CAME early, bringing photo ID, your complete medication list, lens prescription and medical history, and confirming your telemedicine eligibility before any renewal. If a standard is not met, flexibility, reconsideration and appeal routes exist, and each is time-sensitive in its own way.
What the Category 1 examination actually is
Category 1 is the medical category for professional flying in Canada, and the examination is a physical assessment by a Transport Canada-designated physician, not a written test.
Standard 424 defines Category 1 as the medical category covering all licences that involve flying for hire and reward, and describes it as essentially the standard for the professional pilot. A Category 1 holder is considered fit for any licence for the certificate's validity period unless something is specified otherwise.
The examination itself is conducted by a Civil Aviation Medical Examiner, or CAME: a physician appointed by the Minister of Transport to examine medical fitness for pilot and civil aviation personnel licences. Only a physician designated as a CAME may perform the official exam, unless you are outside Canada.
It helps to be clear about format before you study anything. This is not a knowledge exam with questions, a score or a syllabus. The examiner checks your physical and mental fitness against the standards in Standard 424 and records the result on a medical examination report.
Sources: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V; content last revised 2008/06/30, page updated 2026-01-08; How to apply – Apply for or manage an aviation medical certificate (Transport Canada) — Initial certificates, renewals, telemedicine, extensions; page updated 2026-06-26
Booking the appointment and what to bring
Contact a CAME directly to book; the examiner sets the exam fee, and a specific list of documents and information should come with you.
Search Transport Canada's list of approved CAMEs to find a physician near you and make an appointment. The CAME charges a fee for the medical exam and will tell you the cost. Transport Canada does not set these fees.
Separately, Transport Canada may invoice you a processing fee once your medical label has been processed. That fee is distinct from what the examiner charges, and you pay it through the online invoice payment form using your customer number, invoice number and payment amount.
Arrive prepared. The application guidance lists the documents and information you should bring or be ready to answer questions about, so gather them before the appointment rather than reconstructing them in the exam room.
- Photo identification
- List of all medications with dosage and frequency
- Copy of your lens prescription, if you wear glasses or contacts
- Name and phone number of your family doctor
- Current pilot permit or licence number, if you have one
- For pilots, your total flight time over the last 12 months
- Your past medical history, including diagnoses, treatments, and past exam reports, audiograms or electrocardiograms submitted for licensing
- Information about your family medical history
During the exam and how the report is assessed
You sign a declaration, answer the examiner's questions, authorize disclosure of medical information and take any required tests; the CAME reports to Transport Canada, which issues the certificate if you are fit.
At the examination, Standard 424 requires every applicant to sign a declaration about previous licensing medical exams, answer all of the CAME's questions relevant to the assessment, give written authorization to disclose medical information to a physician you name, and undergo any other tests the CAME requires.
The examiner records the findings on the Civil Aviation Medical Examination Report, Transport Canada Form 26-0010, which both you and the CAME sign. The report goes to the appropriate regional office for assessment by Civil Aviation Medicine Division medical staff.
Both the CAME and the Regional Aviation Medical Officer or Aviation Medical Officer assess the report against the standards. Where their assessments differ, the regional assessment applies. If more tests are needed, Transport Canada contacts you with the required next steps, and the results must go through a CAME. If you do not complete the tests, you will not get the certificate.
If you are assessed fit, the certificate is issued as a label and mailed to you. You place it in your aviation document booklet, and any restrictions, such as a requirement to wear glasses, are printed on it. Aviation students receive a standalone medical certificate instead, since they have no document booklet.
Sources: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V; content last revised 2008/06/30, page updated 2026-01-08; How to apply – Apply for or manage an aviation medical certificate (Transport Canada) — Initial certificates, renewals, telemedicine, extensions; page updated 2026-06-26
Validity periods and telemedicine renewals
Validity depends on your age and licence type, ranging from every 6 months to every 5 years; telemedicine renewal is only available if your previous exam was in person.
How often you need a medical exam depends on your age and the licence or permit you hold. Transport Canada summarizes the range as every 6 months at the most frequent, for professional pilots aged 40 and over, to every 5 years at the least frequent, for private or balloon pilots under 40. The complete validity table sits in Standard 424 Appendix II, so confirm your exact period there rather than assuming.
Renewal can happen by in-person exam or by telemedicine, meaning a remote assessment by telephone, audio or video conferencing. The eligibility rules matter: as of March 4, 2025, you qualify for a telemedicine exam only if your previous examination was in person. You must renew in person if you are a new applicant, your validity ended before March 17, 2020, your last exam was telemedicine, or a CAME or Transport Canada has asked you to attend in person.
Telemedicine renewals also carry shorter validity. A certificate renewed by telemedicine is valid for at most 12 months from the consultation, regardless of category. If you are 60 or older, or 40 or older and flying single-pilot operations with passengers on board, that drops to 6 months. As long as clinically appropriate, routine testing such as ECG, urine, audiogram and vision testing is not required for telemedicine, and a fit result is documented with a Fit Certification you keep with your certificate.
Practice case
You hold a Category 1 certificate. Your June 2025 renewal was done by telemedicine. Your next renewal falls due in 2026 and you would prefer telemedicine again. Are you eligible, and how long would the renewed certificate last if you were?
Show answer
No, you are not eligible for telemedicine this time and must renew in person. Had you been eligible, the renewed certificate would have been valid for at most 12 months, reduced to 6 months if you are 60 or older, or 40 or older flying single-pilot operations with passengers.
Transport Canada's rule effective March 4, 2025 limits telemedicine examinations to applicants whose previous examination was in person. Your last exam was telemedicine, which is one of the explicitly listed situations requiring an in-person renewal. The validity caps are separate rules: telemedicine renewals never exceed 12 months regardless of category, with the shorter 6-month period for older applicants or certain single-pilot passenger operations. The practical takeaway is to plan your renewal format one cycle ahead, because this cycle's choice constrains the next.
Extensions, temporary certificates and what happens if you are assessed unfit
You can extend validity up to 60 days under strict conditions; if you are assessed unfit, you can request the assessment description and pursue reconsideration and appeal routes.
If your expiry date is close, Transport Canada can extend your certificate's validity by up to 60 days past expiry, but only if you request the extension at least 10 days before expiry and show that completing a medical exam within the 90 days before expiry was not possible for you. You pay first, then email your closest Transport Canada Centre with the reason and payment reference; the extended temporary certificate arrives as a PDF you print, sign and carry with your document booklet.
A separate temporary medical certificate is available, for example when replacing a lost document, using Form 26-0738 and the same payment-first process. Neither the extension nor the temporary certificate produces a label for your booklet.
If Transport Canada cannot certify you as medically fit, you may request a description of the assessment along with your appeal options. An applicant assessed unfit at the regional level can submit additional reports from CAMEs, specialists and laboratories for reconsideration, and can ask that all reports go to the Chief, Clinical Assessment for presentation to the Aviation Medical Review Board.
Formal appeal to the Civil Aviation Tribunal is available where a certificate holder is assessed unfit to exercise licence privileges or where renewal of a medical certificate is refused. The timing rules above mean the practical mistake to avoid is waiting until near expiry to start any of this.
Sources: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V; content last revised 2008/06/30, page updated 2026-01-08; How to apply – Apply for or manage an aviation medical certificate (Transport Canada) — Initial certificates, renewals, telemedicine, extensions; page updated 2026-06-26
When a standard is not met: medical flexibility
Standard 424 permits certification despite a failed standard in special circumstances, through accredited medical conclusion, licence limitations and sometimes a practical flight test, but specific conditions apply to each case type.
Section 424.05 of the Standard allows flexibility in special circumstances. Certification can proceed where an accredited medical conclusion, meaning a conclusion by medical experts in aviation medicine acceptable to the licensing authority, indicates that failing the requirement is not likely to affect air safety, the licence is endorsed with any needed limitations, and the applicant complies with required conditions.
A practical flight test can be part of this evaluation. It is requested by the Regional Aviation Medical Officer or Aviation Medical Officer and approved by the Regional Director Aviation Licensing, and it is conducted only when needed to evaluate the applicant's capabilities accurately.
The examples in the Standard show that flexibility has limits that matter for Category 1 specifically. Monocular applicants can be certified for permits and licences requiring a Category 3 or lower medical, not Category 1. Paraplegic applicants can be certified for most licences but not a Commercial or Airline Transport Pilot Licence. Applicants with insulin-treated diabetes who already hold a professional pilot licence may be considered for a Category 1 certificate restricted to flying with an accompanying pilot; all other pilots with insulin-treated diabetes are considered only for Category 3 or 4.
The Handbook for Civil Aviation Medical Examiners collects guidance in the problem areas, including neurology, cardiology and diabetes, but note that it is written for examiners, not as a candidate study guide. If you have a condition that may not meet a standard, discuss it with your CAME before assuming an outcome either way.
Sources: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V; content last revised 2008/06/30, page updated 2026-01-08; Handbook for Civil Aviation Medical Examiners – TP 13312 — Foreword and condition guidelines (neurology, cardiovascular, diabetes, asthma); handbook addressed to CAMEs
Preparation priorities and a final checklist
The official requirements are procedural and regulatory, so prepare your documents, timing and disclosure; treat the site's physiology and human factors topics as background study rather than a tested syllabus.
Transport Canada does not publish a written exam syllabus or topic weights for this examination, and no official document retrieved lists tested subjects like hypoxia classification or illusion types. If you encounter such topics on study sites, treat them as aviation physiology background, not as certification requirements. The authoritative texts are Standard 424 and Transport Canada's application guidance.
What you can genuinely prepare is the process. Full and accurate disclosure works in your favour: the declaration and questioning at the exam are regulatory requirements, and an incomplete history leads to follow-up tests or an incomplete file, both of which delay certification. Where you have an uncertain condition or medication, raise it with the CAME rather than deciding yourself that it is minor.
Category 1 is the professional-pilot standard, so it is the certificate you need for licences involving flying for hire and reward. If your goal is a commercial or airline career, keeping the renewal cycle and reporting duties on track is part of keeping the career route open.
- Find a CAME and book well before your certificate expires
- Gather photo ID, medication list, lens prescription and medical history before the appointment
- Budget for the CAME's fee and watch for a separate Transport Canada invoice
- Confirm your exact validity period in Standard 424 Appendix II
- Check telemedicine eligibility one renewal cycle ahead, not at renewal time
- If a standard may not be met, discuss flexibility with your CAME early, since assessments, extensions and appeals each have their own deadlines
Sources: Standard 424 – Medical Requirements – Canadian Aviation Regulations (CARs) — Divisions I–V; content last revised 2008/06/30, page updated 2026-01-08; How to apply – Apply for or manage an aviation medical certificate (Transport Canada) — Initial certificates, renewals, telemedicine, extensions; page updated 2026-06-26; Handbook for Civil Aviation Medical Examiners – TP 13312 — Foreword and condition guidelines (neurology, cardiovascular, diabetes, asthma); handbook addressed to CAMEs
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