FAA Medical Certificates in 2026: Classes, Duration and the AME Process
Match first-, second- and third-class FAA medical privileges to the operation, understand calendar-month duration and prepare for an AME examination.
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Updated July 16, 2026
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An FAA medical certificate should be matched to the pilot privilege being exercised, not only to the certificate printed at the top of the page. A first-class medical can continue to support lower-class privileges after the first-class period ends, but it does not remain valid for airline-transport-pilot privileges indefinitely.
The controlling duration table is in 14 CFR 61.23. Age on the examination date, the operation being conducted and any restriction or special-issuance authorization all matter.
This guide replaces a broad recommendation about which medical pilots should choose. It explains the current federal framework and examination sequence without deciding an individual's medical eligibility.
Which class matches which pilot privilege
The FAA's medical-standards synopsis uses this high-level alignment:
| Medical class | Privilege commonly requiring it | Important boundary |
|---|---|---|
| First class | Airline transport pilot serving as pilot in command where 61.23 requires it | The first-class privilege period depends on age at examination |
| Second class | Commercial pilot privileges where a medical is required | The commercial privilege period is shorter than the lower-class private privilege period |
| Third class | Private, recreational and student-pilot operations where a medical is required | Some pilots may instead qualify for another permitted pathway, including BasicMed or a driver's-licence operation |
This is not a complete operating-privilege table. Glider and balloon operations, sport-pilot privileges, BasicMed, military operations and certain instructor duties have their own treatment. The exact operation should be checked against 61.23 and the other rule governing that flight.
Medical duration is measured by privilege
For an unrestricted certificate under the standard duration rules, the practical calendar-month periods are:
| Certificate held | Privilege being exercised | Under 40 on exam date | 40 or older on exam date |
|---|---|---|---|
| First class | First-class/ATP operation | 12 calendar months | 6 calendar months |
| First or second class | Second-class/commercial operation | 12 calendar months | 12 calendar months |
| First, second or third class | Third-class/private operation | 60 calendar months | 24 calendar months |
The period runs to the end of the applicable calendar month. A medical issued on 8 July does not normally expire on the eighth day of the later month.
Pilots often call the progression a downgrade, but the certificate is not reissued as a lower class. The holder may continue to use it for a lower-class operation during the longer period if every other requirement is met.
The FAA's validity summary mirrors the rule and also warns that a special-issuance authorization can carry a shorter duration or additional conditions. The certificate and authorization should therefore be read together.
Start the AME process with the records, not the appointment
The FAA's current medical-certificate application guide sets out the sequence:
- complete the application in MedXPress;
- schedule an Aviation Medical Examiner, or AME;
- collect the records required for disclosed conditions, treatment and medication;
- attend the examination with the MedXPress confirmation number; and
- receive an issuance, deferral or the less common denial outcome based on the record and standards.
The submitted MedXPress application remains available for 60 days. The FAA recommends reviewing the AME Guide before the appointment if a past or current condition or medication may require documentation. Some condition pathways require a recent, detailed clinical progress note rather than a portal summary.
That preparation is administrative, not a way to self-certify. The AME or FAA decides whether the application can be issued under the applicable standard, needs further review or qualifies for a special-issuance path.
Issuance, deferral and special issuance are different outcomes
Issuance
The AME may issue when the application, examination and required documents meet the applicable standard and no FAA-only review is required.
Deferral
A deferral sends the application to the FAA for further review. It is not the same as a final denial. The FAA normally writes to the applicant identifying the information it needs, and delay can grow when records are incomplete or do not answer the requested question.
Denial and appeal
A denial means the unrestricted standard was not met on the available record. The FAA notice provides review or appeal instructions. Some applicants may still be eligible for an authorization under the special-issuance provisions in 14 CFR 67.401.
An article cannot predict which path applies to a diagnosis or medication. Pilots should use the current FAA condition guidance and an AME familiar with the relevant documentation.
Where BasicMed fits
BasicMed is not a fourth class of medical certificate. It is a separate operating pathway under Part 68 and 61.113(i) for pilots and operations that meet its eligibility, aircraft, passenger, speed and altitude limits.
The current BasicMed explainer covers the expanded operating limits and the required examination and course cycle. A pilot planning commercial operations, an operation outside BasicMed's limits or a career path with employer medical requirements still needs to identify the applicable certificate and policy.
Holding a valid medical also does not permit a pilot to operate while medically deficient. The separate self-grounding obligations remain relevant between examinations.
A planning checklist for students and career pilots
Before paying for an examination or committing to a training path:
- identify the exact pilot privilege and operation planned;
- confirm the medical class, BasicMed path or exception that applies;
- check age-dependent duration against the planned date of use;
- review disclosed conditions and medications in the current AME Guide;
- collect the requested clinical records before submitting MedXPress where possible;
- retain the submitted application and certificate records; and
- recheck employer, insurer and training-provider requirements separately from the FAA minimum.
An airline, flight school or insurer can impose a policy that is more restrictive than the federal minimum. That policy should not be presented as the FAA rule.
The 2026 bottom line
First-, second- and third-class medical certificates support different pilot privileges for different periods. The operative question is not simply which certificate a pilot holds, but which privilege is being exercised on the date of the flight.
Prepare the AME application around the current federal requirements and complete records. Use an AME and the FAA process for individual medical questions rather than relying on a generic checklist or a forum's outcome.
