A medical examination is a fundamental step for anyone wishing to pursue a career as a pilot, as it ensures that one’s physical and mental health is compatible with the operational and safety requirements of flight.
In Italy, there are several types of aeronautical medical certification, depending on the license held and the type of flight activity: the LAPL medical certificate, the Class 1 medical examination, and the Class 2 medical examination.
All of these are governed by EASA regulations and implemented in Italy by ENAC, which defines the requirements, validity, and procedures for issuance and renewal, as well as the authorized medical examiners and aeromedical centers.
For those aspiring to become professional pilots, the Class 1 medical examination is the starting point.
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Find out how to become an airline pilot
Why a medical examination is essential for pilots
Medical examinations for pilots are not merely a bureaucratic requirement; they are a safety tool designed to ensure that those operating an aircraft are capable of reacting appropriately in critical situations—even when experiencing fatigue, stress, or an emergency.
ENAC constantly monitors the health status of flight crew through a medical certification system that includes various levels of oversight—ranging from an initial level for trainees to periodic examinations for active airline pilots.
Medical examination for pilots: LAPL, Class 1 and Class 2
LAPL medical certificates, as well as Class 1 and Class 2 medical examinations, all assess an individual’s psychophysical fitness for flight; however, they differ in terms of their purpose, requirements, and the level of detail involved in the assessments.
The Class 1 medical examination follows very strict criteria, as it is designed for those who work on commercial flights carrying passengers (such as airline pilots and commercial pilots). It entails more in-depth checks, more extensive diagnostic testing, a shorter validity period, and a lower threshold for clinical tolerance.
A Class 2 medical examination, on the other hand, is primarily intended for private pilots and those who fly for non-commercial purposes. It is less rigorous in terms of the diagnostic tests required, has a longer validity period, and allows for slightly broader margins of tolerance regarding certain medical conditions—provided, of course, that safety is always maintained.
The LAPL medical examination is required for those intending to obtain or maintain a LAPL license. The requirements are proportionate to non-professional flight activities and are generally less stringent than those for Class 1 and Class 2 medical certificates.
Characteristics of Level 1 medical examinations for pilots
Level 1 medical examinations for pilots consist of psychophysical assessments conducted when a candidate begins a flight training course or applies for an ATPL or CPL license.
In Italy, the initial issuance of a Class 1 medical certificate can only be carried out at an authorized Aeromedical Centre (AeMC). Subsequent renewal and revalidation examinations may be conducted either at an AeMC or by an Aeromedical Examiner (AME) authorized for Class 1.
During this visit, it is verified that:
- there are no chronic or acute medical conditions that are incompatible with flying
- the cognitive and mental faculties are adequate
- medical history and laboratory data should be collected for future renewal visits.
A Class 1 medical examination is also required for those training to become airline pilots; it is necessary to certify from the very beginning that one possesses the required psychophysical fitness.
At Asteraviation, in compliance with European regulations, we require every student to hold a valid Class 1 medical certificate as a prerequisite for enrollment in the course.
Asteraviation assists the student throughout the process, handling the arrangements for the medical examination and the formalities required to obtain a Class 1 medical certificate.
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Class 1 medical examination for pilots: what are the requirements?
To pass the Class 1 medical examination, one must meet a set of very rigorous physical, visual, auditory, and psychological requirements. Authorized physicians conduct a series of clinical and instrumental tests—such as an ECG, an audiometric examination, and blood and urine analyses—as well as more specific assessments should any risk factors arise.
Let’s look in more detail at the requirements that must be met for a Class 1 medical certificate.
What are the physical requirements for becoming an airplane pilot?
An assessment is made of general health status, the cardiovascular and respiratory systems, blood pressure, weight and height, mental health, and the possible presence of any medical conditions that could compromise flight safety.
The initial visit also includes screening for alcohol and drug use.
What are the vision requirements for becoming an airline pilot?
Often, those who are not well-versed in the regulations governing the medical certification of pilots wonder whether someone who wears glasses can become a pilot.
In fact, it is possible to use glasses or contact lenses, provided that the correction remains within the limits set by the regulations and that there are no serious eye conditions, such as glaucoma or retinal diseases.
The visual standards for a Class 1 medical certificate include:
- distance visual acuity of at least 7/10 in each eye and 10/10 with both eyes, with or without correction (as mentioned);
- adequate near and intermediate vision;
- normal color perception;
- normal binocular function;
- visual field within normal limits.
Auditory and neurological requirements
Hearing must be adequate for flight operations to allow for radio communication and effective hearing in noisy environments.
During the initial visit, a comprehensive otolaryngological examination is also performed, which includes an assessment of the ear and vestibular function.
Neurological conditions—such as epilepsy or degenerative diseases—that carry a risk of loss of consciousness or impaired reaction time must be absent. During the neurological examination, the individual’s level of coordination and balance is also assessed.
Psychological and behavioral requirements
Naturally, to pursue a career as a pilot, one must possess psychological stability—that is, the absence of serious psychiatric disorders and a good ability to manage stress and workload.
You must not suffer from substance dependencies, and you are required to declare whether you are undergoing any pharmacological treatments, so that it can be determined whether these are compatible with the regulations.
Furthermore, the physician also assesses psychological aptitude by examining personality traits, awareness of one’s own limitations, and the ability to work in a team—a skill that is essential for the profession and for airline recruitment processes, and which Asteraviation incorporates into its training program.
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Results of the Class 1 medical examination for pilots
At the end of the Class 1 medical examination, the physician may certify various outcomes:
- full eligibility: the candidate may continue the course or activity without limitations
- eligibility with limitations: for example, daytime flight only, or only under specific conditions
- temporary eligibility: entails a requirement for further examinations
- unfitness, which may be temporary or permanent, depending on the medical condition.
In this latter case, it is possible to request a re-evaluation from the AMS ENAC.
Expiration and renewal of the medical examination for aircraft pilots
To avoid interruptions in the exercise of one’s qualifications, it is essential to keep track of the expiration dates of medical certifications.
The validity of the two certifications (1st and 2nd class) differs significantly: the 1st class has a short duration and requires frequent renewal, whereas the 2nd class lasts longer.
Validity of the Class 1 certificate
A Class 1 medical examination must be repeated annually to maintain eligibility for commercial or airline flight operations, and it is strictly dependent on age and the type of operation being performed:
- under 60 years of age: the Class 1 medical certificate is valid for 12 months
- For those over 60, or for those flying single-pilot aircraft with passengers from the age of 40 onwards, the validity period is reduced to 6 months.
Validity of the Class 2 certificate
As previously mentioned, the Class 2 medical examination is primarily for those who fly as private pilots or in non-commercial contexts; consequently, check-ups are less frequent:
- under 40 years of age: the Class 2 certificate is valid for 5 years
- between 40 and 49 years of age: valid for 2 years
- From age 50 onwards: valid for 1 year.
A certificate issued before the age of 40 ceases to be valid upon reaching the age of 42; if issued before the age of 50, it ceases to be valid upon reaching the age of 51.
We suggest scheduling renewals at least 2–3 months before the expiration date and ensuring that you have up-to-date medical records.
How much does a first-class or second-class medical examination cost?
ENAC does not have an “official” fee schedule for Class 1 and Class 2 medical examinations; prices are determined by the facilities conducting the examinations, although all rates must still comply with the general regulatory framework.
The cost of a Class 1 medical examination generally falls within these price ranges:
- For the initial issuance, the cost is approximately 250–600 euros, depending on the facility and the required checks.
- The renewal of a Class 1 medical certificate costs approximately 170–180 euros.
For a Class 2 medical examination—whether for initial issuance or renewal—several aeromedical centers quote a price of approximately 180 euros.
The cost may increase if additional tests not included in the basic package are required (for example, further blood tests or specialist consultations).
The importance of health during a flight
To pursue a career as a pilot, one must be aware of the significant role one has chosen to take on, the importance of safety, and the extent to which this impacts the lives of the people who choose to fly every day.
For this reason, maintaining excellent health and staying consistently aware of one’s own physical and mental well-being is essential to ensuring the highest level of professionalism at all times.
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