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Medical Certification 10 min read October 28, 2025

EASA Class 1 Medical Certificate Guide: Requirements, Costs, and Examination Process

Complete guide to EASA Class 1 medical certificate for pilots. Requirements, examination process, costs (€300-€600), validity periods, and how to prepare for your aviation medical.

EASA Class 1 Medical Certificate Guide: Requirements, Costs, and Examination Process

Key Information

  • Cost: €300-€600 initial examination, €200-€400 renewals
  • Validity: 12 months (under 40), 6 months (over 40), varies by operation
  • Required For: Commercial pilot licenses, airline operations, flight instruction
  • Where: EASA-approved Aeromedical Centers (AeMC) or authorized AMEs
  • Processing: Results typically within 2-4 weeks after examination

What is an EASA Class 1 Medical Certificate?

The EASA Class 1 medical certificate is the highest level of aviation medical certification required for commercial pilot operations in Europe and EASA member states. This comprehensive medical assessment ensures pilots meet strict health standards necessary for safely operating aircraft carrying passengers or cargo for compensation.

Class 1 medicals are mandatory for holders of Airline Transport Pilot License (ATPL), Commercial Pilot License (CPL), and Multi-Crew Pilot License (MPL). The certificate must be obtained before beginning commercial flight training and maintained throughout a professional pilot's career through regular examinations.

The examination is conducted at EASA-approved Aeromedical Centers (AeMC) or by authorized Aeromedical Examiners (AME). The process includes comprehensive physical examination, vision and hearing tests, cardiovascular assessment, and psychological evaluation to ensure pilots can perform their duties safely under normal and emergency conditions.

EASA Class 1 Medical Requirements

Vision Requirements

Standards

Distance Vision
6/9 or better in each eye separately, correctable to 6/6 (20/20). Glasses or contact lenses permitted.
Near Vision
N5 at 30-50 cm, correctable if needed. Reading glasses acceptable for pilots over 40.
Color Vision
Must pass Ishihara test or alternative approved color vision testing. Color blindness is disqualifying.
Other Requirements
Normal fields of vision, no double vision, no significant eye disease or recent surgery.

Cardiovascular Requirements

Standards

Blood Pressure
Below 160/95 mmHg. Controlled hypertension acceptable with medication and monitoring.
EKG/ECG
Normal rhythm required. EKG mandatory at initial exam and age 30, then annually after 40.
Heart Disease
History of heart attack, bypass surgery, or significant disease requires special evaluation.
Cholesterol
Monitored but not automatically disqualifying. Treatment and control important for certification.

Hearing Requirements

Standards

Pure Tone Audiometry
Must hear conversational voice at 2 meters with back turned, or pass audiometry test.
Frequency Standards
Maximum hearing loss: 35 dB at 500-3000 Hz. More loss may require operational limitation.
Hearing Aids
Permitted if hearing corrects to acceptable standards and proper backup systems in place.
Assessment Frequency
Tested at initial exam, age 40, then every 4 years until 50, then every 2 years.

Neurological & Mental Health

Standards

Neurological Conditions
No epilepsy, unexplained loss of consciousness, or progressive nervous system disease.
Mental Health
No psychosis, severe depression, bipolar disorder, or conditions affecting judgment and reliability.
Medications
Antidepressants may be acceptable under careful monitoring. Reporting required for all medications.
Psychological Assessment
Required at initial examination. Evaluates personality, stress management, decision-making.

The Medical Examination Process

The Class 1 medical examination is comprehensive and typically takes 2-4 hours to complete. Appointments should be scheduled well in advance, particularly for initial examinations which require more extensive testing than renewals.

STEP 1

Schedule Appointment

Contact EASA-approved AeMC or AME. Book 4-6 weeks in advance. Bring identification, previous medical certificates, and medical history documentation.

STEP 2

Complete Medical History

Fill out detailed questionnaire about medical history, medications, surgeries, family history, and lifestyle factors. Be honest and complete.

STEP 3

Physical Examination

General health assessment including height, weight, blood pressure, heart and lung examination, abdominal exam, musculoskeletal check.

STEP 4

Vision and Hearing Tests

Comprehensive vision screening including distance, near, color vision, and visual fields. Audiometry testing for hearing assessment.

STEP 5

Laboratory Tests

Blood tests for glucose, cholesterol, and other markers. Urinalysis for kidney function and diabetes screening. EKG if required by age.

STEP 6

AME Review and Decision

Examiner reviews all results. Issue certificate immediately if fit, defer if additional information needed, or refer to licensing authority.

Important Notes

Results are typically available immediately for straightforward cases. If additional tests or specialist consultations are needed, processing can take 2-8 weeks. Certificate is issued by licensing authority, not the examiner. Always carry original certificate when flying commercially.

EASA Class 1 Medical Costs Breakdown

Service Initial Exam Renewal Exam Notes
Basic Examination €250-€400 €150-€250 Varies by country/center
EKG/ECG €50-€100 €50-€100 Required age 30+, annually 40+
Laboratory Tests €30-€80 €30-€80 Blood and urine analysis
Audiometry €40-€80 €40-€80 Age 40+, every 2-4 years
Psychological Test €100-€200 N/A Initial exam only
Typical Total €300-€600 €200-€400 Depends on age/tests

Additional Costs

  • Specialist consultations: €100-€300
  • Additional cardiac tests: €200-€500
  • Sleep apnea study: €300-€600
  • Neurological assessment: €200-€400
  • Licensing authority fees: €50-€100

Cost-Saving Tips

  • Compare prices between AeMCs
  • Schedule during off-peak periods
  • Maintain good health to avoid extra tests
  • Get blood work done beforehand if cheaper
  • Some flight schools offer group discounts

Medical Certificate Validity Periods

Validity by Age and Operation Type

Under 40 Years Old

12 months validity for all commercial operations including single-pilot and multi-crew.

Age 40-49 Years

12 months for multi-crew operations. 6 months for single-pilot commercial operations.

Age 50-59 Years

12 months for multi-crew operations. 6 months for single-pilot commercial operations.

Age 60+ Years

6 months validity for all commercial operations. More frequent monitoring required.

Important Validity Rules

Certificate must be valid when exercising privileges of commercial license. Grace period of 30 days after expiry allows examination but not flying. Certificates cannot be extended - new examination required. Age is determined at examination date, not issue date. Multi-crew operations require second pilot with valid medical, allowing longer validity for older pilots.

How to Prepare for Your Medical Examination

Before the Exam

  • Schedule early morning appointment
  • Get adequate sleep night before
  • Avoid alcohol 24 hours prior
  • Fast if blood tests required
  • Bring glasses/contacts
  • List all medications

Documents Needed

  • Valid government ID/passport
  • Previous medical certificates
  • Medical history summary
  • Current medication list
  • Specialist letters if applicable
  • Eyeglass prescription

Tips for Success

  • Be completely honest
  • Disclose all conditions
  • Stay calm and relaxed
  • Ask questions if unsure
  • Follow up on any issues
  • Maintain good health year-round

Long-Term Health Maintenance

  • Maintain healthy weight and exercise regularly to reduce cardiovascular risks
  • Schedule annual checkups with primary care physician between medical exams
  • Monitor blood pressure and cholesterol through regular testing
  • Avoid smoking and limit alcohol consumption
  • Manage stress through healthy coping mechanisms
  • Address any health concerns promptly rather than waiting for medical renewal
  • Keep detailed records of all medical consultations and treatments

Common Medical Certification Issues

Conditions Requiring Special Issuance

Many medical conditions don't automatically disqualify pilots but require additional documentation, monitoring, or operational limitations. Common conditions managed through Special Issuance or OML (Operational Multi-Pilot Limitation) include:

  • Controlled diabetes (non-insulin dependent)
  • Managed depression with stable medication
  • History of kidney stones
  • Controlled hypertension
  • Previous cancer with clear follow-up
  • Sleep apnea treated with CPAP
  • Corrected vision beyond standard limits

Vision Issues

Most common reason for medical concerns. Solutions include:

  • Corrective lenses acceptable if within limits
  • Laser eye surgery allowed after healing period
  • Progressive lenses permitted for near vision
  • Spare glasses required when flying

Mental Health

Increasingly managed with proper monitoring:

  • Antidepressants may be approved
  • Regular psychiatric monitoring required
  • Stable medication history important
  • Full disclosure critical for certification

Medical Certificate Renewal Process

Renewal examinations are typically faster and less expensive than initial examinations. However, the same medical standards apply and all testing must be repeated according to age-based requirements. Schedule renewal appointments 2-3 months before expiration to allow time for any unforeseen issues.

Renewal Requirements by Age

  • Under 30: Basic exam, vision, hearing (every 4 years), blood work
  • Age 30-39: Above plus EKG at age 30
  • Age 40-49: Annual EKG, hearing every 4 years, complete physical
  • Age 50+: Annual EKG, hearing every 2 years, expanded cardiovascular assessment
  • Age 60+: All above plus additional cardiac stress testing may be required

What If Your Medical Expires?

Flying with expired medical certificate is illegal and grounds for license suspension. If medical expires, you cannot exercise commercial pilot privileges until renewed. Schedule examination before expiry. If you develop a medical condition between exams, you must self-ground and consult AME before flying commercially. Always maintain awareness of expiration dates and plan accordingly.

Maintaining Your Medical Certificate

The EASA Class 1 medical certificate is essential for your commercial pilot career and must be maintained throughout your flying career. Focus on preventive health care, maintain detailed medical records, be completely honest with examiners, and address health concerns promptly. Most medical issues can be managed with proper documentation and monitoring. Schedule examinations well before expiration and budget for regular costs. Your medical certificate represents your commitment to safety and professionalism in aviation.

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