Introduction
To operate as a commercial pilot you must be 17 or over and will require a Class 1 medical certificate and have general medical fitness, good eyesight and hearing.
“There are a number of medical conditions that could prohibit you from making a career in flying, so obtain your Class 1 medical before you take any other step.”
This will ensure that either you are fit to complete the training and pursue the career, or identify that you have underlying medical issues that could prevent you from achieving your goals.
If you suffer from a problem which prevents you becoming a commercial pilot, it’s better to find out at the start rather than after you have spent thousands of pounds on flight training. There is no point in taking aptitude tests, visiting FTOs and signing up for courses if you cannot pass a Class 1 medical.
That said, if you do identify a medical issue that immediately prohibits you from getting a Class 1 medical – the most common reason for failure being eyesight – all is not lost with regard to becoming a commercial pilot.
Restrictions can occasionally be lifted if certain criteria have been met. This is obviously specific to the individual, and you should consult an aviation medical examiner (AME) for advice on specific medical conditions, if any are found.
Remember…
If you are embarking on the Integrated or MPL route you have to have the Class 1 medical in order to begin the course. With the Modular Route, as you start by completing a PPL, you do not require a Class 1 medical.
However, if you are starting your PPL with the intention of completing commercial training and becoming an airline pilot, we would recommend that you get a Class 1 medical before starting the PPL training. It would be heart breaking to be successful in your PPL and go through all the hours – only to find out you cannot be a commercial pilot for medical reasons.
Your first medical
The initial medical must be obtained from an Aeromedical Centre (AeMC), and once this has been done the yearly revalidations can be performed by a number of aviation medical examiners around the country. The initial medical is quite extensive and starts with your completion of their application form (available from the AeMC) and a medical consisting of an ophthalmology examination, ECG, audiogram, hemoglobin, lipid profile, lung function and cholesterol tests.
Medical Examination Class 1 (Professional pilot)
You should be fit, have good eyesight and hearing, and have no current or previous illness which might interfere with the safe exercise of a commercial or airline transport pilot’s licence.
The initial medical examination must be done at an Aeromedical Centre (AeMC) such as the CAA at Gatwick. Some of the tests have to be reported by external consultants and the results are then gathered together. The medical officer doing your physical examination should be able to tell you whether all seems normal. Once the results are collated, and are satisfactory, your medical certificate will be issued. Often this is possible on the same day as your initial examination. Medicals usually take around four hours.
Can I fly with diabetes?
Pilots with diabetes treated with insulin (and other medications that significantly lower blood glucose), may now be considered for medical certificates by the CAA.
Until now, only a limited number of medications for the treatment of diabetes have been allowed for pilots applying for Class 1, 2 and 3 medical certificates.
However, over recent years there have been advances in the treatment and monitoring of the disease, allowing the control of the condition and any complications to be managed more effectively. The decision should allow more licenced pilots who have diabetes, to continue to undertake operational duties safely.
Individual diabetic applicants who are granted medical certificates under the this protocol will, however, be subject to a rigorous monitoring regime, including demonstrated stability of their condition, and regular blood sample self-testing during flight/duty. This is to ensure that an individual does not begin a flight or shift with too high, or too low, a sugar level, and that a safe level is maintained.
The tests
Vision – Distance
This is the commonest cause of difficulty during the examination. The exact requirements are listed at JAR Class 1 Visual Standards/European Class 3 Visual standards. If you are in any doubt you should take a copy of the standards to an optician who will be able to interpret them. This will allow you to have an initial eye test before your examination. If there is any further doubt you should send the optician’s report to the AeMC for assessment.
“Your visual acuity (measured by your ability to see, in this case, lines of letters on a chart at six metres) must be at least 6/9 in each eye separately, and 6/6 using both eyes together, with or without glasses or contact lenses (correction).”
If you need correction, the refractive error (the amount of correction) must not exceed +5.00 dioptres of long sight or -6.00 dioptres of short sight. This is in the most ametropic meridian (taking into account any astigmatism). Astigmatism must not exceed 2.00 dioptres. The difference in correction between each eye (anisometropia) must not be more than 2.00 dioptres. Your optometrist will be able to explain these terms.
Vision – Near
On the standard near vision eye chart you must be able to read the N5 print between 30 and 50 cm and the N14 print at 100 cm, with or without correction.
Hearing
The basic hearing test used throughout JAR-FCL 3 is the ability to hear conversational speech when tested with each ear at a distance of two metres. An audiogram is required and measures the ability to hear sounds at different frequencies (pitch).
If you have doubts about your hearing, the required hearing levels are listed in JAR Class 1 Hearing Requirements/European Class 3 Hearing Requirements. It may be possible for you to have a preliminary test at a local hospital.
TIP: If you can hear a normal voice in each ear separately at two metres, you should not have a problem.
Medical Examination
Medical History
These are questions about any previous illness declared on your application form. You will be asked about them by the examining doctor, and if there is any major illness in your past, it is important to bring reports about it from your family doctor or specialist. Simple appendicitis or a broken arm are not regarded as major illnesses.
Physical Examination
A general check that all is functioning correctly. It will cover lungs, heart, blood pressure, stomach, limbs and nervous system.
Electrocardiogram (ECG)
This measures the electrical impulses passing through your heart. It can show disorders of the heart rhythm or of the conduction of the impulses, and sometimes it can show a lack of blood supplying the heart muscle.
In the unlikely event of these changes showing on your ECG, further tests with a report from a cardiologist will have to be sought (these can sometimes be carried out at the AeMC). Most changes turn out to be of no significance and if they appear again on your subsequent ECGs they can normally be discounted, as they have already been investigated.
Lung Function Test (spirometry)
This is a test to evaluate the efficiency of your airways. Having asthma does not disqualify you from holding a Class 1 medical, but it must be controlled by your medication and this is assessed by spirometry. If these results are outside the acceptable limits you will be required to undertake an exercise test.
Haemoglobin blood test
This is a finger prick blood test which measures the oxygen carrying capacity of the blood. A low haemoglobin is called anaemia and will need further investigation.
Cholesterol blood test
The same finger prick as above. There is no disqualifying level, but the possible health risks of a high cholesterol will be explained by the doctor at the time of your examination.
Urine test
Mainly looking for sugar (diabetes), protein or blood.
Estimated Medical Cost (2023):
£660
“If there is any major illness in your past, it is important to bring reports about it from your family doctor or specialist.”