Pilotium Editorial Team
May 9, 2026
The EASA Class 1 Medical certificate is the single most important document in a commercial pilot's career. Without it, no licence, no type rating, and no job. Yet many aspiring pilots approach the medical examination underprepared — surprised by the scope of the assessment, the waiting times, and what happens if something doesn't pass first time.
This guide covers everything you need to know: what's tested, where to go, how to prepare, and what to do if you receive a fit with limitation or an unfit decision.
What Is the EASA Class 1 Medical?
The EASA Class 1 Medical is the highest category of aviation medical certificate issued under EASA regulations. It is required for:
Commercial Pilot Licence (CPL)
Airline Transport Pilot Licence (ATPL)
Multi-Crew Pilot Licence (MPL)
It must be renewed every 12 months for pilots under 40, and every 6 months for pilots aged 40 and over. First-time applicants must attend an Aeromedical Centre (AeMC) — renewal examinations can be conducted by an Aeromedical Examiner (AME) after the initial issue.
What Does the Class 1 Medical Examine?
The initial Class 1 medical is comprehensive. Expect the examination to cover:
Cardiovascular system — ECG (resting and sometimes exercise), blood pressure, full cardiac assessment. This is the area most likely to produce unexpected findings in otherwise healthy applicants.
Vision — visual acuity, colour vision, depth perception, visual fields. Corrected vision is accepted within defined limits. Colour vision deficiency is assessed using Ishihara plates and, if failed, the Farnsworth D-15 test. A colour vision deficiency does not automatically disqualify you — operational colour vision (OCV) testing may allow certification with limitations.
Hearing — pure tone audiometry. Mild hearing loss is generally acceptable within EASA limits.
Neurological assessment — history review, reflex testing, and for first-time applicants, an EEG is required. A history of seizures, blackouts, or significant head injury will be scrutinised carefully.
Psychiatric and psychological evaluation — EASA introduced mandatory psychological assessment protocols following the 2015 Germanwings accident. First-time applicants complete a structured psychological questionnaire reviewed by the AeMC.
Respiratory — lung function tests (spirometry). Asthma that is well-controlled and does not require significant medication is generally certifiable.
ENT — ear, nose, and throat examination including tympanometry.
Haematology and biochemistry — full blood count, lipid profile, liver function, kidney function, glucose, HbA1c. Borderline findings such as elevated cholesterol or glucose will be reviewed in context.
Urinalysis — routine screening for glucose and protein.
BMI — there is no strict BMI cutoff, but significant obesity may trigger additional cardiovascular assessment.
Where to Get Your Class 1 Medical
Initial Class 1 medicals must be conducted at an EASA-approved Aeromedical Centre (AeMC). Each EU member state designates its own AeMCs. Common options for EASA applicants include:
CAA AeMC, London — one of the busiest in Europe, significant waiting times
DLR Institute of Aerospace Medicine, Hamburg
CEMPAP, Madrid
Turkish Directorate General of Civil Aviation (SHGM) AeMCs — for Turkish applicants
Irish Aviation Authority (IAA), Dublin — popular for international applicants due to short waiting times
Waiting times vary significantly. For the IAA in Dublin, appointments are often available within 2–4 weeks. For the UK CAA, waiting times can stretch to several months. Plan accordingly — do not book a type rating course without a valid Class 1 in hand.
How to Prepare
Get a full GP check-up first. Before attending the AeMC, have your GP run a basic blood panel. Knowing your cholesterol, glucose, and blood pressure in advance removes surprises on the day.
Know your eye prescription. If you wear glasses or contact lenses, bring your current prescription. Contact lenses must meet specific requirements — daily disposables are generally the safest choice for aviation.
Colour vision. If you have any doubt about your colour vision, test yourself using an online Ishihara plate test before your appointment. A colour vision deficiency is not disqualifying, but it's better to know in advance.
Be honest about your medical history. Concealing a medical condition is grounds for permanent licence revocation if discovered later. The AeMC assessment is confidential — disclose everything and let the aeromedical examiner make the determination.
Sleep well the night before. Blood pressure readings are sensitive to fatigue and anxiety. A poor night's sleep before the examination can push a borderline reading into an unfavourable range.
If You Receive an Unfit Decision
A first-time unfit decision is not the end of the road. Many conditions that initially appear disqualifying can be certified with a fit with limitation (FWL) or operational multi-crew limitation (OML).
Common pathways after an initial unfit:
Cardiovascular findings — further cardiology assessment, stress ECG, Holter monitoring. Many borderline findings are certifiable after specialist review.
Colour vision — OCV testing at an approved centre can result in certification with a limitation restricting flight to multi-crew operations.
Mental health history — EASA has a defined protocol for certifying pilots with a history of depression or anxiety. Treatment type, duration, and current status are all considered.
If you receive an unfit decision, do not accept it without seeking a second opinion. EASA regulations allow applicants to appeal decisions and to seek review by the competent authority of another member state.
Maintaining Your Medical
Once certified, maintaining your Class 1 medical is an ongoing responsibility. Key points:
Any new medical condition, prescription medication, surgical procedure, or hospital admission must be reported to your AME
Flying while unfit is a serious regulatory offence
Many airlines require pilots to self-ground and notify their chief pilot if they take any new medication — check your airline's Operations Manual
The most common reasons for mid-career medical issues are cardiovascular (hypertension, cholesterol), mental health (depression, anxiety, burnout), and musculoskeletal (back problems from long-haul operations). All three are increasingly manageable within the EASA certification framework — the key is early disclosure and proactive management.
Start Your Aviation Career with the Right Foundation
The Class 1 medical is the starting point of every commercial aviation career. If you are preparing for your first examination, or navigating a medical finding, Pilotium's AI Coach can help you understand the pathway forward — from initial certification to revalidation at every stage of your career.
This article is for informational purposes only and does not constitute aeromedical advice. For decisions relating to your specific medical situation, consult a qualified Aeromedical Examiner (AME).
