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Reference · Updated June 2026

Pilot medical certificate guide — EASA & FAA

A factual reference to pilot medical certification: EASA Class 1, Class 2, and LAPL requirements, validity periods, AeMC vs AME, revalidation vs renewal, mental health and peer support rules, and an FAA certificate comparison. Every figure on this page is sourced directly from the regulation cited beside it — see "Sources" at the end.

Certificate classes ↓ Examination process ↓ Revalidation vs renewal ↓ Mental health ↓ Limitation codes ↓ Vision & colour ↓ FAA comparison ↓ Obesity & BMI ↓ Tattoos ↓ FAQ ↓ Sources ↓
In short

Commercial and airline pilots need a Class 1 medical certificate, issued initially only by an AeMC (Class 1 revalidations and renewals can be done by an AME). Class 1 is valid 12 months. That drops to 6 months if either: you're flying single-pilot commercial air transport carrying passengers and have reached 40, or you've reached age 60 — the second trigger applies to every Class 1 holder, multi-crew airline pilots included. You can revalidate up to 45 days before expiry with no loss of validity; miss that window and you need a renewal instead, which can require extra assessment if your certificate lapsed more than 2 years. A comprehensive mental health assessment is mandatory at your initial Class 1 exam, and separately, your airline must give you access to a peer support programme. Wearing glasses, contact lenses, or having had LASIK/PRK does not disqualify you — neither EASA nor the FAA limits uncorrected vision, only whether it corrects to standard; around 55% of US civilian pilots use some form of vision correction. Colour deficiency isn't an automatic fail either — failing the initial Ishihara test leads to further testing, not instant unfitness. FAA-licensed pilots need a First-Class certificate for ATP pilot-in-command privileges.

A note on cost: Neither EASA nor individual states set a fixed examination fee — every AeMC and AME sets its own price, and prices genuinely vary a great deal between countries and centres. Rather than publish numbers we can't trace to an authoritative source, we point you to your national aviation authority's published list of approved AeMCs/AMEs, where current pricing should be confirmed directly with the centre.

Medical certificate classes

EASA Part-MED defines three certificate classes. A higher class always includes the privileges and validity structure of the classes below it — a Class 1 holder never needs a separate Class 2 or LAPL certificate.

Class 1 medical certificate

Required for

Required to exercise the privileges of a CPL, MPL, or ATPL — i.e. any commercial pilot or airline pilot role.

Issued by

Initial examination: AeMC (Aero-medical Centre) only. Revalidation or renewal: AeMC or an AME (Aviation Medical Examiner) holding Class 1 revalidation/renewal privileges.

Validity

Standard validity is 12 months. It drops to 6 months if either of two conditions applies: (a) the holder is flying single-pilot commercial air transport operations carrying passengers and has reached age 40, or (b) the holder has reached age 60 — this second trigger applies to every Class 1 holder regardless of single-pilot or multi-crew operations.

Class 2 medical certificate

Required for

Required to exercise the privileges of a PPL (Private Pilot Licence). A Class 1 certificate automatically includes Class 2 privileges.

Issued by

AeMC or AME.

Validity

60 months until age 40 (a certificate issued before age 40 ceases to be valid once the holder turns 42); 24 months between ages 40–50 (a certificate issued before age 50 ceases to be valid once the holder turns 51); 12 months above age 50.

LAPL medical certificate

Required for

Required to exercise the privileges of a Light Aircraft Pilot Licence (LAPL). A Class 1 or Class 2 certificate automatically includes LAPL privileges.

Issued by

AeMC or AME. In some EASA member states a GMP (General Medical Practitioner) may also issue an LAPL medical, subject to national rules.

Validity

60 months until age 40 (a certificate issued before age 40 ceases to be valid once the holder turns 42); 24 months for licence holders above age 40. Unlike Class 2, LAPL validity has only these two tiers — it does not step down again at age 50.

The examination process

The same general sequence applies whether you're booking an initial Class 1 or a routine renewal — only the depth of testing and who can perform it changes.

1
Choose the right examiner
An initial Class 1 examination can only be carried out at an AeMC. Class 2 and LAPL initial exams, and all Class 1 revalidations/renewals (if the AME holds that privilege), can be done by an AME. Your national aviation authority (NAA) publishes its list of approved AeMCs and AMEs — EASA itself does not maintain a central list.
2
Book the examination
Bring proof of identity, any previous medical certificates, your logbook, a list of current medication, and relevant specialist reports if you have a known condition. The AeMC/AME must review your most recent medical certificate before starting a revalidation or renewal examination.
3
Complete the assessment
Covers cardiovascular, respiratory, digestive, metabolic, haematological, urinary/genital, infectious disease, musculoskeletal, neurological, vision/colour vision, ear-nose-throat/hearing, and mental health systems, as set out in Part-MED Subparts B (Class 1), C (Class 2/LAPL).
4
Comprehensive mental health assessment (Class 1 initial only)
Since the 2019 amendment to Part-MED, a comprehensive mental health assessment is a mandatory part of every initial Class 1 examination, covering psychiatric history, substance use, and risk factors such as a documented history of self-harm.
5
Certificate issued, deferred, or referred
If fit, the certificate is normally issued the same day. If there is a clinical question the AeMC/AME cannot resolve, the case is referred to the medical assessor of the licensing authority (sometimes called the Authority Medical Section, or AMS) for a fitness decision, which can include additional tests, a time-limited certificate, or a formal limitation.

Revalidation vs. renewal

These two terms are not interchangeable under EASA rules, and the distinction has real consequences for your validity period.

Revalidation
Examination taken up to 45 days before your certificate's expiry date. Your new validity period is calculated from the original expiry date — you don't lose any time.
Renewal
Required if your certificate has already expired. Validity is calculated from the date of the renewal exam itself. If it lapsed more than 2 years, your records must be assessed first; if more than 5 years, the full initial-issue examination requirements apply.

Mental health, peer support & substance testing

Both rules below followed the Germanwings Flight 9525 accident, but they are two distinct regulatory layers, run by two different parties — a distinction that's frequently blurred online.

1. Comprehensive mental health assessment — part of the medical certificate

Since Commission Implementing Regulation (EU) 2019/27 amended Part-MED, a comprehensive mental health assessment is a mandatory part of every initial Class 1 aero-medical examination, conducted by the AeMC. It covers psychiatric history, substance use/misuse, and specific criteria such as a documented history of self-harm or suicide attempts, which require satisfactory psychiatric evaluation before a fit assessment can be given.

2. Operator-level psychological assessment & peer support — separate from the medical certificate

Commission Regulation (EU) 2018/1042 (consolidated into 2020/745) requires every commercial air transport operator — not the AeMC — to carry out its own pre-employment psychological assessment of flight crew before line flying begins, to give pilots access to a support programme (typically a peer-support programme, or PSP), and to maintain a policy on prevention and detection of psychoactive substance misuse, including systematic testing.

Limitation codes

Not meeting a standard outright doesn't always mean an unconditional "unfit." A certificate can instead carry an operational limitation. These are the general-purpose codes defined in AMC2 MED.B.001 of Part-MED (vision-specific codes are covered separately below):

TMLTime limitation — validity is limited to the specific duration shown on the certificate (shorter than the standard period), starting from the exam date. Used where a condition needs closer-than-normal monitoring.
OMLValid only as, or with, a qualified co-pilot — holder may act as PIC alongside a qualified co-pilot, or as the co-pilot themselves. Applies to Class 1 holders who don't fully meet single-pilot requirements but are fit for multi-pilot operations.
OCLValid only as a qualified co-pilot — a stricter version of OML: the holder may only act as co-pilot, not as PIC even alongside another qualified co-pilot.
OSLValid only with a safety pilot and in aircraft with dual controls — Class 2 and LAPL only. The safety pilot is briefed on the type of incapacity the holder might suffer and is ready to take over.
OPLValid only without passengers — for a Class 2 or LAPL condition where the increased risk is acceptable for the holder alone but not for carrying passengers.
ORLValid only with a safety pilot if passengers are carried, in an aircraft with dual controls — a narrower variant of OSL that only applies when passengers are on board.
OALRestricted to demonstrated aircraft type — used where a medical flight test or simulator test has shown the holder safe only on a specific class/type of aircraft, e.g. due to a limb deficiency.
HALValid only when hearing aids are worn — holder must use hearing aids that correct for defective hearing, and a spare set of batteries should be readily available.
APLValid only with approved prosthesis — for a musculoskeletal condition where a medical flight or simulator test showed a specific approved prosthesis is needed to safely exercise the licence.
AHLValid only with approved hand controls — for a limb deficiency or similar anatomical issue, shown by flight test to require the aircraft be fitted with suitable approved hand controls.
SICSpecific medical examination(s) — requires the AeMC or AME to contact the medical assessor of the licensing authority before starting a revalidation or renewal exam, usually due to a medical history the examiner needs to be aware of in advance.
SSLSpecial restriction(s) as specified — used for an individually tailored limitation not covered by one of the standard codes; the specific restriction is written out on the certificate or an accompanying document.

Glasses, contact lenses, corrective surgery & colour vision — the eyesight myths

One of the most persistent misconceptions about becoming a pilot is that you need naturally perfect eyesight. You don't. The FAA's own pilot safety brochure states plainly that about 55% of US civilian pilots use some form of refractive correction to meet medical certification standards. Neither EASA nor the FAA places any limit on uncorrected vision — an official EASA decision on the matter is explicit that "no limits apply to uncorrected visual acuity." What both regulators care about is whether your vision, corrected with glasses, contact lenses, or after surgery, meets the required standard.

Distant and near vision standards
Certificate Distant vision Near vision
EASA Class 16/9 or better in each eye separately, with or without correction; 6/6 or better with both eyes togetherN5 (30–50cm) and N14 (100cm), with correction if needed
EASA Class 26/12 or better in each eye separately, with or without correction; 6/9 or better with both eyes togetherN5 and N14, with correction if needed
FAA First/Second-Class20/20 or better in each eye separately, with or without correction20/40 at 16 inches; also tested at 32 inches if age 50+
FAA Third-Class20/40 or better in each eye separately, with or without correction20/40 at 16 inches

All figures with or without correction — meeting the standard with glasses, contact lenses, or post-surgery counts the same as meeting it naturally.

Refractive error — when contact lenses are recommended over glasses

EASA guidance recommends contact lenses (or high-index spectacle lenses) for applicants whose refractive error is large — specifically where hypermetropia (long-sightedness) exceeds +5.00 dioptres or anisometropia (the difference in prescription between the two eyes) exceeds 3.00 dioptres. This isn't a disqualifying threshold — it's a recommendation for which correction method works best at that level of prescription. Orthokeratological (OrthoK) lenses are not permitted for flying under EASA rules.

Refractive surgery — LASIK, PRK & similar procedures

EASA: immediately after refractive surgery you must not exercise your licence privileges, and you must inform your AME, who assesses you as unfit pending recovery. Once your surgeon confirms vision and refraction are stable with no significant complications, Class 1 and Class 3 applicants are reassessed at an AeMC; Class 2 applicants may be assessed by their AME. A degree of monovision (one eye corrected for distance, one for near) may be permitted after surgery, subject to no adverse effects and glasses being available that restore full correction in both eyes if needed.

FAA: the FAA accepts FDA-approved refractive procedures including PRK and LASIK. You must stop exercising airman privileges until your eye care specialist confirms your vision has stabilised with no significant adverse effects (glare, halos, impaired night vision), and the appropriate vision standard is met. This is reported to your AME or the FAA directly. Pilots who choose monovision LASIK must initially fly with near-vision correction, and after a 6-month adaptation period may apply for a Statement of Demonstrated Ability (SODA) with a medical flight test to have the correction requirement removed from their certificate.

Colour vision — what actually happens if you're colour deficient

Colour deficiency is another condition people assume is an automatic disqualifier. It isn't, and the actual process has several steps before any restriction is applied. Every applicant takes the Ishihara test at initial issue (the 24-plate version; passing means correctly reading the first 15 plates, shown in random order, without error).

Fail the Ishihara, and you don't go straight to "unfit" — you're offered further testing: an anomaloscope (passed if the colour match is trichromatic within a defined range), a colour lantern test (Spectrolux, Beynes, or Holmes-Wright — passed with no errors), or the modern CAD (Colour Assessment and Diagnosis) test, which sets numeric pass thresholds for deutan and protan colour deficiency.

Where it differs by class: Class 1 applicants must ultimately be a normal trichromat or otherwise "colour safe" (able to reliably identify aviation light colours) — there's no day-only fallback at Class 1. Class 2 and LAPL applicants who don't pass further testing aren't necessarily unfit either: they can be issued a VCL limitation — valid by day only — since colour cues from aviation lighting matter far less in daylight.

UK CAA vision limitation codes

If your certificate needs a vision-related condition recorded, it appears as one of these standard codes rather than a vague "fail." Sourced directly from EASA's AMC2 MED.B.001 and the UK CAA's own guidance on visual limitation codes:

VDLValid only with correction for defective distant vision — monofocal glasses or contact lenses required; a spare pair must be carried.
VNLValid only with correction for defective near vision — typically presbyopia; a second (reading) pair must also be carried.
VMLValid only with correction for defective distant, intermediate and near vision — multifocal correction; spare pair required.
CCLCorrection by means of contact lenses — used where spectacles alone cannot meet the standard (e.g. keratoconus); spare glasses must still be available.
VCLValid by day only — for Class 2 or LAPL holders with a colour vision deficiency who don't pass further colour testing; restricts flying to daytime, when colour cues (e.g. aviation lights) matter less.
RXOSpecialist ophthalmological examination required — used for complex eye conditions or where ocular pathology needs periodic specialist monitoring beyond the routine exam.

FAA certificate classes — comparison

For pilots targeting US-registered operators: the FAA uses a First/Second/Third-Class structure under 14 CFR Part 67, with validity governed by 14 CFR 61.23(d). The table below reproduces that table directly.

Certificate Age at exam Operation requiring it Expires
First-class medical certificateUnder 40 at examATP — pilot-in-command privileges, or second-in-command in a flag/supplemental Part 121 operation requiring 3+ pilots12th month after the month of examination
First-class medical certificate40 or older at examSame ATP privileges as above, or any Part 121 flightcrew duty once the pilot has reached age 606th month after the month of examination
First-class medical certificateAny ageCommercial pilot certificate, flight engineer certificate, or ATC tower operator certificate12th month after the month of examination
Second-class medical certificateAny ageCommercial pilot certificate, or ATP second-in-command (outside the operations above)12th month after the month of examination

Second- and Third-Class certificates also have separate, longer validity periods for private/recreational/student privileges — see the full table at the official source linked below.

Obesity, BMI and metabolic standards

Rising global obesity rates have pushed regulators to be more explicit about how body weight is assessed at the medical. ICAO's baseline framework doesn't set a number — Annex 1, Chapter 6 only notes that predisposing factors for disease, including obesity and smoking, may be relevant when deciding whether further evaluation is needed — but EASA, the UK CAA, and the FAA have each built their own specific approach on top of that, and they don't all work the same way.

EASA and UK CAA — the BMI 35 threshold

Both EASA (AMC1/AMC2 MED.B.025(b)) and the UK CAA apply the same acceptable means of compliance: applicants with a BMI of 35 or above may only be assessed as fit if the excess weight is unlikely to interfere with safe exercise of the licence, and the results of a risk assessment — including a cardiovascular evaluation and a check for the possibility of sleep apnoea — are satisfactory. This applies identically to Class 1 and Class 2. Crucially, it isn't an automatic fail: BMI 35 is the trigger for a closer look, not a disqualifying number on its own.

The UK CAA's full obesity protocol

The UK CAA has published a detailed operational protocol on top of the BMI 35 trigger. Initial applicants with a BMI of 35 or above undergo further assessment before a certificate is issued; existing certificate holders whose BMI crosses 35 must be investigated within 2 months, and a TML limitation is normally applied if a certificate is issued.

That assessment covers medical history and lifestyle, BMI, waist and neck circumference, lipid profile, blood glucose, urinalysis, blood pressure, and an Epworth sleepiness score, plus a cardiovascular QRISK score — an annual exercise ECG is required if 10-year cardiovascular risk exceeds 10%, with cardiologist review if abnormal. A Medical Flight Test (or ATCO Functional Test) is also required above BMI 35, specifically to confirm the applicant can fully and freely reach all controls and switches and can evacuate the aircraft quickly in an emergency.

Follow-up continues at every periodic medical until BMI drops back under 35, and the flight/functional test must be repeated if BMI increases by 2.5 points or more since the last one.

The FAA's different approach: no BMI cutoff

The FAA actually proposed a hard BMI ≥ 40 grounding rule in 2013 and walked it back after significant pushback. The current protocol is explicit that airmen are not deferred from certification on the basis of BMI alone — a sleep apnea risk assessment is built into the standard exam using American Academy of Sleep Medicine risk criteria, with the examiner applying clinical judgement rather than a fixed number.

That's because BMI alone is a poor predictor either way: over 90% of people with a BMI of 40 or higher have clinically significant obstructive sleep apnea, but up to 30% of people with sleep apnea have a BMI under 30. The FAA instead triages every applicant into one of six risk groups based on BMI alongside neck circumference, treatment-resistant hypertension, diabetes, and atrial fibrillation. Most applicants are still issued a certificate the same day even when flagged, with further information requested within 90 days; only overtly safety-relevant symptoms trigger an immediate deferral.

Weight-loss medications: GLP-1 drugs (semaglutide, tirzepatide)

This is the fastest-moving part of the picture, given how widely GLP-1 medications are now prescribed. One naming point worth knowing first: Mounjaro and Zepbound are the same drug, tirzepatide — Mounjaro is the brand name used for the type 2 diabetes indication, Zepbound for the weight-loss indication. Ozempic and Wegovy are likewise both semaglutide, branded by indication. Aviation authorities generally regulate by the active substance, not the brand name.

EASA / UK CAA: subcutaneous (injectable) GLP-1 and combined GIP/GLP-1 agonists used for obesity — covering semaglutide and tirzepatide — are compatible with all certificate classes (Class 1, 2, 3, and LAPL). Oral formulations are not currently compatible, due to variable absorption. On starting treatment, Class 1/2/LAPL holders must be unfit for at least 2 weeks before an AME confirms there are no impairing side effects (nausea, GI upset, and similar, which could theoretically worsen with cabin pressure changes); a dose increase requires a shorter 72-hour stand-down with no AME visit needed to resume flying.

FAA: metformin, liraglutide, semaglutide (Wegovy), and tirzepatide (Zepbound) are each acceptable as a single agent for weight loss under the FAA's CACI (Conditions an AME Can Issue) pathway, provided HbA1c is 6.4% or below with no diagnosis of diabetes and no history of hypoglycaemia requiring intervention — the AME can issue a certificate on the day of the exam without deferring to the FAA. The timing matches the UK closely: 2 weeks off flying after starting for weight loss, 72 hours after any dosage change. Combining two diabetic-medication components requires a Special Issuance instead, and older weight-loss drugs — phentermine and similar sympathomimetics, plus serotonin agonists like fenfluramine — remain unacceptable outright, with no Special Issuance route available.

A note on currency: pharmaceutical certification policy is one of the fastest-changing areas of aeromedical regulation — the FAA's own weight-loss medication guidance has been revised multiple times since 2023. Always confirm the current position with your AME or AeMC before starting, stopping, or changing the dose of any medication, and never conceal medication use — concealment, not the underlying treatment, is what typically ends a career.

Tattoos and visible body modifications

A question that comes up often enough to warrant its own section, precisely because it is not a medical certification matter. Tattoos don't appear anywhere in EASA Part-MED or the FAA's 14 CFR Part 67 — your Class 1, Class 2, or LAPL medical assesses physical and mental fitness to fly, and a tattoo has no bearing on any of that. No aviation authority regulates it, positively or negatively.

Whether a tattoo affects your career instead comes down entirely to individual airline grooming policy — the same category as uniform fit or facial hair rules. Policies vary enormously: some airlines have none at all, others require tattoos to stay covered while in uniform, and a smaller number still prohibit them for flight crew outright. Visibility while in uniform is the single biggest factor where a policy does exist — tattoos on the torso, upper arms, back or legs are far less likely to be restricted than ones on the face, neck, or hands, which are the locations most commonly singled out. Offensive, extremist, or discriminatory imagery is essentially universally prohibited regardless of placement.

Two things worth knowing if you're researching this: pilots and cabin crew at the same airline aren't necessarily covered by the same policy — most public reporting on airlines "relaxing" tattoo rules is actually about cabin crew, since they're more customer-facing. And we'd caution against relying on the "airline tattoo policy" comparison lists that circulate online — these routinely contradict each other on the same airline and are usually describing cabin crew standards rather than flight deck. The only reliable answer comes directly from that airline's recruitment team — ask before booking the appointment if you're weighing a new tattoo, not after.

FAQ

What is the difference between an AeMC and an AME?
An AeMC (Aero-medical Centre) is a certified medical facility with multiple specialists and full diagnostic equipment on site. An AME (Aviation Medical Examiner) is an individual doctor authorised by a national aviation authority. Per EASA, an initial Class 1 examination can only be performed at an AeMC; revalidation or renewal of a Class 1 certificate can be performed by either an AeMC or an AME holding the relevant privilege. Class 2 and LAPL medicals can be issued by either an AeMC or an AME from the start.
How long is an EASA Class 1 medical certificate valid for?
Standard validity is 12 months. It drops to 6 months if either of two conditions applies: you are flying single-pilot commercial air transport carrying passengers and have reached age 40, or you have reached age 60. The second condition applies to every Class 1 holder, including multi-crew airline Captains and First Officers — once you turn 60, your Class 1 moves to a 6-month cycle regardless of operation type. Class 2 and LAPL certificates follow a different, longer validity schedule that also shortens with age.
What is the difference between revalidation and renewal?
Revalidation happens before your certificate expires — you can be examined up to 45 days before the expiry date, and the new validity period is calculated from the original expiry date, so you lose no time. Renewal happens after the certificate has already expired — the new validity period starts from the date of the renewal examination instead, and if the certificate lapsed more than 2 years (and especially more than 5 years), additional assessment or a full initial-style examination may be required.
Does EASA require a psychological assessment for pilots?
There are two separate requirements that are often confused. First, since 2019, a comprehensive mental health assessment is mandatory as part of every initial Class 1 aero-medical examination, carried out by the AeMC. Second, since 2018/1042 (now consolidated as 2020/745), commercial air transport operators — not the AeMC — must carry out their own pre-employment psychological assessment of flight crew before line flying begins, separate from the medical certificate process.
Do airlines have to offer pilot peer support programmes?
Yes. Following the Germanwings Flight 9525 accident, EASA introduced a requirement (Commission Regulation (EU) 2018/1042, amended by 2020/745) for all commercial air transport operators to give pilots access to a support programme — typically a peer-support programme (PSP) where trained pilot volunteers support colleagues under professional supervision — alongside a policy on prevention and detection of psychoactive substance misuse.
What happens if I do not meet the medical standard?
You are not automatically and permanently grounded. Many conditions can be certified with limitations (such as an OML, OSL, or OPL code) or after a satisfactory specialist evaluation. Cases the AeMC or AME cannot resolve directly are referred to the medical assessor of the licensing authority (the Authority Medical Section) of the state that holds your licence, who can request further tests or grant a certificate with conditions.
What medical certificate do FAA-licensed pilots need?
A First-Class medical certificate is required to exercise pilot-in-command privileges of an Airline Transport Pilot (ATP) certificate. A Second-Class certificate covers Commercial Pilot privileges. A Third-Class certificate covers Private Pilot, Recreational Pilot, and Student Pilot privileges. Validity periods differ by class and age — see the comparison table above, sourced directly from 14 CFR 61.23(d).
Is a UAE (GCAA) medical certificate the same as my EASA medical?
No. The GCAA requires its own Class 1 medical certificate under CAR-MED, issued separately from your EASA Class 1, even if your EASA medical is currently valid. This is covered in detail, alongside the rest of the EASA-to-GCAA licence conversion process, on our licence conversion guide.
Can I become a pilot if I wear glasses?
Yes. Wearing glasses, contact lenses, or having had corrective surgery does not disqualify you. Neither EASA nor the FAA places any limit on your uncorrected (natural) vision — what matters is whether your vision corrects to the required standard. The FAA states that around 55% of US civilian pilots use some form of vision correction to meet medical certification standards. This is one of the most persistent myths about pilot eligibility, and it is simply not true.
Can pilots wear contact lenses while flying?
Yes. EASA requires contact lenses worn for flying to be monofocal, non-tinted, and not orthokeratological (OrthoK); monovision contact lens correction (a different prescription in each eye) is not permitted. A back-up pair of glasses must be available. Pilots who routinely wear contacts for distance vision and would also meet the standard with glasses do not need a contact lens limitation on their certificate.
Can pilots have LASIK, PRK, or other laser eye surgery?
Yes, both EASA and the FAA accept laser refractive surgery. Under EASA rules, the pilot is assessed as unfit immediately after surgery and must be reassessed once vision and refraction have stabilised — typically at minimum several weeks post-operatively, with Class 1 and Class 3 applicants assessed at an AeMC. Under FAA rules, pilots must stop flying until an eye care specialist confirms vision is stable with no significant complications (such as glare, halos, or impaired night vision), then submit a report to their AME or the FAA.
What is the RXO limitation, and does it mean something is wrong with my eyes?
No — RXO simply means a specialist ophthalmological examination is required at defined intervals, typically because of a high refractive error or a condition that needs periodic monitoring rather than a one-off check. It is a routine monitoring requirement, not a sign of disqualifying pathology, and many pilots fly for years with an RXO limitation on their certificate.
Does colour blindness disqualify you from being a pilot?
Not automatically, and the rules differ by certificate class. Everyone takes the Ishihara test first; if you fail it, you get further testing (anomaloscope, colour lantern, or the CAD test) rather than an immediate fail. Class 1 applicants ultimately need to be colour safe or a normal trichromat, with no fallback option. Class 2 and LAPL applicants who still don't pass can instead be issued a VCL limitation — valid by day only — since colour cues matter far less in daylight, rather than being assessed unfit outright.
Is there a BMI limit to become or remain a pilot?
Not a single global one. EASA and the UK CAA treat a BMI of 35 or above as a trigger for closer assessment (cardiovascular risk review and a check for sleep apnoea), not an automatic fail — the certificate can still be issued if that assessment is satisfactory. The FAA goes further in the other direction: its current policy explicitly states airmen are not deferred from certification on the basis of BMI alone, since BMI alone is a poor predictor of sleep apnea risk either way.
What happens if my BMI is above 35?
Under EASA and UK CAA rules, you'll need a satisfactory cardiovascular and sleep apnoea risk assessment before being assessed fit, and a TML limitation is normally applied. The UK CAA additionally requires a Medical Flight Test above BMI 35 (confirming you can reach all controls and evacuate the aircraft quickly), with follow-up at every periodic medical until your BMI drops back under 35.
Can I fly while taking Ozempic, Wegovy, Mounjaro, or Zepbound for weight loss?
Generally yes, under current EASA, UK CAA, and FAA guidance, provided you go through the required process. All three authorities treat the injectable GLP-1 medications (semaglutide, tirzepatide) as compatible with medical certification when used for weight loss, but require a stand-down period after starting (2 weeks under EASA/UK CAA/FAA) and after any dose change (72 hours), plus confirmation from your AME/AeMC that there are no impairing side effects. You must disclose use to your AME — concealment, not the medication itself, is what risks your certificate.
Are Mounjaro and Zepbound the same medication?
Yes. Both are tirzepatide — Mounjaro is the brand name used for the type 2 diabetes indication, Zepbound is the same drug branded for the weight-loss indication. Ozempic and Wegovy are similarly both semaglutide, branded by indication. Aviation authorities regulate by the active substance rather than the brand name, so the same certification rules apply regardless of which brand name appears on the prescription.
Does my medical certificate cover whether I can have tattoos?
No. Tattoos are not a medical certification matter at all — they don't appear anywhere in EASA Part-MED or the FAA's 14 CFR Part 67, because they have no bearing on fitness to fly. Whether a tattoo affects your career depends entirely on individual airline appearance policy, not your medical certificate. See the "Tattoos and visible body modifications" section above for the full picture.
Do EASA or the FAA have any rule about pilot tattoos?
No. Neither EASA Part-MED nor the FAA's 14 CFR Part 67 medical standards mention tattoos at all. Medical certification is about physical and mental fitness to fly — cardiovascular health, vision, hearing, mental health, and so on. A tattoo has no bearing on any of that, and it is not a topic either regulator addresses, positively or negatively.
So why do some airlines restrict tattoos if it isn't a safety issue?
Because it isn't treated as a safety issue — it's treated as an appearance and grooming standard, the same category as uniform fit, hair length, or facial hair policy. Airlines set these independently as part of their corporate image, and policies vary enormously: from no restriction at all, to "must be covered while in uniform," to a small number of airlines that still prohibit tattoos for flight crew outright.
Where can I find an airline's actual tattoo policy?
Directly from the airline — ideally its careers or recruitment team — rather than from forums or aggregator blog posts. Lists of "airline tattoo policies" circulating online are frequently outdated, contradict each other on the same airline, and are usually written about cabin crew appearance standards rather than flight deck crew specifically, which is a separate question even within the same airline. If you already have an offer or are deep into an application, ask your recruiter directly; if you're considering a new tattoo, ask before booking the appointment, not after.
Does it matter if the tattoo is visible or covered by the uniform?
Generally, yes, and this is the one pattern that holds fairly consistently across airlines that do have restrictions: tattoos that stay fully covered by the standard uniform (torso, upper arms, back, legs) are far less likely to be an issue than tattoos on the face, neck, or hands, which are the locations most commonly restricted when an airline does have a policy. Offensive, extremist, or discriminatory imagery is essentially universally prohibited, regardless of placement.
Are the rules the same for pilots and cabin crew at the same airline?
Not necessarily. Most public reporting on airline tattoo policy changes in recent years has actually been about cabin crew appearance standards, since cabin crew are more customer-facing and policy changes there get more press coverage. That doesn't mean the same policy automatically applies to flight deck crew at the same airline — it's a separate question worth asking about specifically if you're a pilot or pilot applicant.
Do I need to stand down after getting vaccinated?
If you experience side effects, yes — under the same general self-certification rule (EASA MED.A.020, FAA 14 CFR 61.53(a)) that applies to any medication side effect, not a vaccine-specific rule. During COVID-19, both EASA and the FAA issued specific guidance recommending or requiring a standdown period after each vaccine dose; the FAA's version is now officially archived as historical. See our dedicated pilot vaccination guide for the full picture across ICAO, EASA, FAA, and UK CAA.

Sources

For UAE (GCAA) medical requirements, see the EASA→GCAA section of our licence conversion guide.

Methodology & disclaimer: Every regulatory fact on this page is sourced directly from the official EASA Easy Access Rules / EU regulation text, EUR-Lex, the UK CAA, or the official eCFR, each linked above. No examination costs are quoted, since EASA and the FAA do not set or publish examination fees — these are set independently by each AeMC/AME and vary by country. This page covers EASA and FAA requirements; national variations and case-specific outcomes are decided by your national aviation authority's medical assessor. Note that medical certification does not cover appearance standards such as tattoos — that's an airline-specific employment policy, not a medical matter; see the tattoos section above for that separate question. For the related question of vaccinations and post-vaccine fitness to fly, see our pilot vaccination guide, covering ICAO, EASA, FAA, and UK CAA rules. This is general information, not medical or legal advice — always confirm your individual situation with an AeMC, AME, or your licensing authority. Last verified against primary sources June 2026.