FAA Pilot Resource Center

Everything you need to prepare for your FAA medical exam — certificate classes, medication lookup, CACI worksheets, and pre-visit checklists.

Dr. Efraim Kessous is an FAA-authorized Senior Aviation Medical Examiner (AME) performing Class 1, 2, and 3 medical exams. Use the resources below to prepare for your visit and avoid unnecessary deferrals.

FAA Medical Certificate Classes

The FAA issues three classes of medical certificates. The class you need depends on how you fly. Montgomery Medical Clinic performs all three classes.

1st Class

Airline Transport Pilot (ATP)

Required for pilots exercising Airline Transport Pilot privileges — flying as pilot-in-command in scheduled air carrier operations. This is the highest medical standard.

  • Most comprehensive examination
  • EKG required at age 35, then annually after 40
  • Stricter vision and cardiovascular standards
2nd Class

Commercial Pilot

Required for commercial operations outside of airline flying — flight instructors, charter pilots, crop dusters, and other commercial certificate holders.

  • Moderate medical standards
  • No routine EKG requirement
  • Same validity period regardless of age
3rd Class

Private & Student Pilot

Required for private, recreational, and student pilots. This is the lowest medical standard and the most common starting point for new pilots.

  • Basic physical & mental health screening
  • Longest validity period
  • Great starting point for student pilots

Validity Periods & Renewal Schedule

Medical Class Privileges Under Age 40 Age 40 & Older
1st Class Airline Transport Pilot 12 months 6 months
2nd Class Commercial Pilot 12 months 12 months
3rd Class Private / Student Pilot 60 months (5 years) 24 months (2 years)

The validity "clock" starts on the last day of the month the exam was performed.

The "Step-Down" Rule — Don't Ground Yourself

Your FAA medical certificate doesn't just expire — it automatically drops down in privileges. When your Class 1 validity period ends, the same certificate becomes a Class 2. When the Class 2 period ends, it becomes a Class 3. You do not need a new piece of paper for this to happen.

Example: If you are a Class 1 pilot over age 40 and miss your 6-month renewal, you can still fly under Commercial (Class 2) privileges for another 6 months, or as a Private Pilot (Class 3) for up to another 18 months — all on the same certificate.

Guidance for New & Returning Pilots

Whether this is your first FAA medical or your twentieth renewal, the requirements are different. Select your situation below.

Getting Started

  1. 1. Choose your class wisely. If you plan to pursue an airline career, consider applying for a Class 1 from the start. This identifies any disqualifying conditions early, before you invest heavily in flight training.
  2. 2. Create a MedXPress account. Go to medxpress.faa.gov and complete Form 8500-8 online. This is mandatory before your exam. Your application is valid for 60 days.
  3. 3. Gather your records. You'll need your full medical history, a list of physician visits for the last 3 years, and a list of all current medications (including OTC and supplements).
  4. 4. Pre-check your color vision. First-time applicants will undergo a computerized color vision test. If you know you have color vision issues, discuss this with our office beforehand.

What to Expect at Your First Exam

  • Vision test — distance, near, and color vision
  • Hearing test — conversational voice or audiometric
  • Urine sample — screening for sugar and protein
  • Blood pressure & pulse
  • General physical exam — heart, lungs, abdomen, neuro
  • EKG — required for Class 1 at age 35 and annually after 40
  • Medical history review — the AME reviews your 8500-8 with you

Tip for parents: If you accompany your child for their first student pilot exam, you cannot complete the MedXPress application on their behalf. The FAA requires the applicant to complete their own application.

Certification Maintenance

  • Check your renewal date. Your certificate validity depends on your class and age (see the validity table above). The clock starts the last day of the month of your exam.
  • Update MedXPress. Report all physician visits since your last exam — this includes physicians, PAs, NPs, psychologists, and chiropractors. Include the date, name, address, and reason. Routine dental and standard eye exams (unless for a condition like glaucoma) can be omitted.
  • EKG reminder (Class 1). If you're age 40+, you need an EKG annually. This is the most common reason pilots accidentally "drop down" a class.
  • Aggregate repeat visits. If you see the same doctor multiple times for the same stable condition, you can list it as one entry using the most recent visit date.

Managing New Conditions

  • Check the CACI list. If you've been diagnosed with a new condition since your last exam, check our CACI worksheets section. Many stable conditions can now be certified in-office without deferral to Oklahoma City.
  • Bring a DCPN. For CACI conditions, bring a Current Detailed Clinical Progress Note from your treating physician dated within 90 days of your exam. A standard "After Visit Summary" is not sufficient — it must include history, exam findings, lab results, assessment, and a side effects statement.
  • Consider BasicMed. If you no longer need commercial privileges, BasicMed lets you fly with any state-licensed physician's exam plus an online course — no AME visit needed. You must have held a valid medical certificate after July 15, 2006.
  • Special Issuance support. If you don't meet CACI criteria, Dr. Kessous can help you through the Special Issuance (SI) process — gathering records and serving as your advocate with the FAA.

Flight Physical Pre-Visit Checklist

Complete these steps before your appointment to ensure a smooth exam and avoid unnecessary delays or deferrals.

  1. 1 Complete MedXPress online (mandatory). Fill out your FAA medical application (Form 8500-8) at medxpress.faa.gov before your visit. Bring your Confirmation Number and a printed copy of the 8500-8. The application is valid for 60 days.
  2. 2 Bring required identification. Government-issued photo ID, pilot’s license (if renewal), and your previous medical certificate. If you have a Special Issuance letter or waiver, bring it along with all documentation outlined in the letter.
  3. 3 Be at your best. Arrive well-rested and well-hydrated (you will need to provide a urine sample). Avoid alcohol, caffeine, excess sodium, sugar, and large portions of carbohydrates for at least 8 hours before the exam.
  4. 4 Know your medications. For every medication you take — prescription, over-the-counter, and supplements — know the brand or generic name, dosage, and reason. Check the AMAS Medication Database or the FAA Do Not Issue / Do Not Fly list in advance. Sedating antihistamines like Benadryl require a 60-hour wait time after the last dose.
  5. 5 Bring your vision correction. Bring all glasses and contact lenses you use for flying. Contacts may be kept in during the vision test. If you think you may need a new prescription, see your optometrist well in advance so your new lenses arrive before your exam.
  6. 6 Check your blood pressure. We recommend pre-testing your blood pressure. Readings above 155/95 may prevent certification; ideally it should be below 150/90. Most blood pressure medications are FAA-approved.
  7. 7 Prepare your medical history. Know the name, address, and date of all physician visits in the last 3 years. This includes physicians, PAs, NPs, psychologists, and chiropractors. A record of DUI or substance abuse may affect certification. You can pre-fill this on MedXPress.
  8. 8 CACI documentation (if applicable). If you have a CACI-qualified condition, bring a Current Detailed Clinical Progress Note (DCPN) from your treating physician dated within the last 90 days. The note must include: history summary, clinical exam findings, test results, assessment & plan (with ICD-10 codes), and a side effects statement. A standard "After Visit Summary" is not sufficient.

Good to know: Applicants must be at least 16 years old and able to read, speak, write, and understand English. You do not need to bring your pilot logbook. The airman medical exam is not a substitute for an annual preventive physical with your primary care physician. The exam typically takes 30–60 minutes.

FAA Medication Lookup — 1,000+ Medications

One of the most common reasons for FAA medical deferrals is medication use. Search our database of over 1,000 medications to quickly check if your prescription is FAA-approved, conditionally allowed, or prohibited. Always verify with the official sources linked below.

Quick Medication Search
Loading medications…

For informational purposes only. Based on publicly available FAA guidance. Always verify with official sources or call (301) 208-2273.

Common OTC Wait Times

Even common over-the-counter medications may require a "no-fly" waiting period:

Diphenhydramine (Benadryl)60-hour wait
Doxylamine (Unisom, NyQuil)60-hour wait
Melatonin24-hour wait
Pseudoephedrine (Sudafed)Ground trial
Ibuprofen, AcetaminophenGround trial
Loratadine, Cetirizine, FexofenadineNo wait

CACI Condition Worksheets

CACI stands for Conditions AMEs Can Issue. These are specific medical conditions that Dr. Kessous can certify at the time of your exam — without deferring the decision to the FAA in Oklahoma City — provided you meet the criteria on the corresponding worksheet.

To expedite your certification, download the appropriate worksheet and have your treating physician complete a Current Detailed Clinical Progress Note (DCPN) dated within 90 days of your exam. Bring both to your appointment.

What Must a DCPN Include?

Summary of condition history
Clinical exam findings
Lab / imaging results (per worksheet)
Assessment & plan with ICD-10 codes
Current medication & dosages
Side effects statement

Arthritis

Covers stable osteoarthritis and certain autoimmune arthritis conditions managed with approved medications.

PDF Worksheet

Asthma

For well-controlled symptoms with limited rescue inhaler use. Requires pulmonary function testing documentation.

PDF Worksheet

Bladder Cancer

For applicants at least 5 years post-treatment or on specific maintenance therapy with stable monitoring.

PDF Worksheet

Breast Cancer

For treated or stable breast cancer with documentation of treatment completion and current monitoring status.

PDF Worksheet

Carotid / Vertebral Artery Stenosis

Requires documented stability with imaging and neurological evaluation confirming no acute events.

PDF Worksheet

Chronic Immune Thrombocytopenia (C-ITP)

For stable platelet counts managed with approved therapy and documented hematology follow-up.

PDF Worksheet

Chronic Kidney Disease

Requires specific lab values (GFR, creatinine) demonstrating stability. Staging criteria must be met.

PDF Worksheet

CLL / Small Lymphocytic Lymphoma (SLL)

Chronic lymphocytic leukemia or SLL with documented stability and hematology/oncology follow-up.

PDF Worksheet

Colitis (UC, Crohn's, IBS)

Includes ulcerative colitis, Crohn's disease, and IBS. Covers approved medications including GC-C agonists and selective abdominal modulators.

PDF Worksheet

Colon / Colorectal Cancer

For localized, treated, or stable monitored colorectal cancer with documentation of treatment and surveillance.

PDF Worksheet

Essential Tremor

Neurological evaluation required. Must demonstrate tremor does not interfere with safe aircraft operation.

PDF Worksheet

Glaucoma

Requires specific visual field testing (Humphrey 24-2 or 30-2) and documentation of stable intraocular pressures.

PDF Worksheet

Hepatitis C — Chronic

For chronic hepatitis C with documented viral load, liver function testing, and treatment status.

PDF Worksheet

Hypertension (High Blood Pressure)

Allows combinations of up to three approved medications. Must demonstrate blood pressure control within FAA limits.

PDF Worksheet

Hypothyroidism

For stable conditions with a current TSH lab result within normal range. One of the most common CACI conditions.

PDF Worksheet

Low Testosterone / Hypogonadism

For testosterone replacement therapy with documented stable lab values and treatment plan.

PDF Worksheet

MASH / NASH (Liver)

Metabolic-associated or non-alcoholic steatohepatitis with documented liver function stability and monitoring.

PDF Worksheet

Migraine & Chronic Headache

Covers specific preventive and abortive treatments. Narcotics, Fiorinal, Fioricet, and Midrin are not acceptable. Required "no-fly" wait times apply.

PDF Worksheet

Mitral Valve Repair

Post-surgical cardiac evaluation required with echocardiogram and documentation of functional recovery.

PDF Worksheet

Polycystic Ovarian Syndrome (PCOS)

Requires documentation of condition stability, current treatment plan, and relevant lab values.

PDF Worksheet

Pre-Diabetes

For those managed by diet or Metformin with an A1C ≤ 6.5%. Requires current lab documentation of glycemic control.

PDF Worksheet

Primary Hemochromatosis

Iron overload condition requiring documented ferritin levels, treatment history, and organ function monitoring.

PDF Worksheet

Prostate Cancer

For localized, treated, or stable monitored prostate cancer. Requires PSA levels and treatment documentation.

PDF Worksheet

Psoriasis

Stable psoriasis managed with approved topical or systemic treatments. Dermatology documentation required.

PDF Worksheet

Renal Cancer

Treated or stable renal cancer with imaging surveillance and oncology documentation of remission status.

PDF Worksheet

Retained Kidney Stone(s)

Requires imaging documentation showing stone size and location, plus clinical assessment of symptom stability.

PDF Worksheet

Testicular Cancer

For treated testicular cancer with documentation of treatment completion and surveillance monitoring.

PDF Worksheet

Weight Loss Management (GLP-1)

Covers the use of approved GLP-1 medications such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) for weight management.

PDF Worksheet

Full list available at FAA CACI Conditions page. Worksheets are official FAA documents (PDF).

Frequently Asked Questions

Common questions about FAA medical certification, medications, and CACI.

What is a CACI condition?

CACI stands for Conditions AMEs Can Issue. These are specific medical conditions that your Aviation Medical Examiner can certify at the time of your exam without deferring the decision to the FAA in Oklahoma City.

You must meet the criteria on the corresponding worksheet and bring a Current Detailed Clinical Progress Note (DCPN) from your treating physician dated within 90 days. See the full CACI list above.

What happens if I don't renew my Class 1 medical on time?

Your certificate doesn't expire immediately — it "steps down" to the next lower class. A Class 1 becomes a Class 2, then eventually a Class 3. You can continue flying under the lower privileges until the Class 3 validity period expires completely.

You do not need a new certificate for this to happen. See the step-down rule for a full example.

Do I need to complete MedXPress before my exam?

Yes, this is mandatory. Complete your application (Form 8500-8) at medxpress.faa.gov before your appointment. Bring your Confirmation Number and a printed copy. The application is valid for 60 days.

How do I know if my medication is approved for flying?

Check these resources in order:

  1. The FAA Do Not Issue / Do Not Fly list — if your medication is on this list, you cannot be certified.
  2. The AMAS Medication Database — search by drug name, category, or purpose.
  3. The FAA Pharmaceuticals Guide — detailed drug-by-drug reference.

If you're unsure, call our office at (301) 208-2273 before your exam.

What is BasicMed?

BasicMed is an alternative to traditional FAA medical certification for non-commercial pilots. If you held a valid medical certificate after July 15, 2006, you can fly under BasicMed by:

  • Completing a physical exam with any state-licensed physician (not necessarily an AME)
  • Completing an online medical education course every 48 months

BasicMed has aircraft and operational limitations. Learn more at FAA BasicMed.

Does insurance cover FAA physicals?

FAA medical exams are generally not covered by insurance, as they are classified as regulatory/occupational screening exams rather than diagnostic medical visits. Payment is expected at the time of the exam.

Call (301) 208-2273 for current pricing.

What if I don't meet medical criteria at the time of exam?

If you don't meet the medical criteria, your application may be deferred to the FAA in Oklahoma City for further evaluation. Dr. Kessous will serve as your advocate in this process, helping gather the necessary records and documentation.

Important: The airman medical exam is an occupational screening exam, not a therapeutic physician visit. Tests required for your airman certificate are not covered under general medical services.

Ready to Schedule Your FAA Physical?

Book online or call us to set up your aviation medical examination with Dr. Kessous.