A CAA medical is a fitness certificate issued by the Civil Aviation Authority confirming that a pilot (or air traffic controller) meets the health standards required to fly. In the UK, you cannot hold a pilot licence without a valid medical certificate, and the class of certificate you need depends on the type of flying you do. The process involves a physical examination by an approved Aeromedical Examiner (AME) who checks your vision, hearing, heart, lungs, and general health.
Classes of CAA Medical Certificate
The CAA issues several classes of medical, each tied to a specific licence type:
- Class 1: Required for commercial and airline transport pilots. This is the most thorough examination and the strictest standard.
- Class 2: Required for private pilots flying under a Private Pilot Licence (PPL).
- Class 3: Required for air traffic controllers.
- LAPL: A lighter medical for holders of a Light Aircraft Pilot Licence, with less demanding requirements than Class 2.
If you’re learning to fly recreationally, a Class 2 or LAPL medical is typically what you need. If you plan to fly commercially or work for an airline, you’ll need a Class 1 from the outset.
What the Examination Covers
The exact tests vary by class, but a Class 1 initial examination (the most comprehensive) gives a good picture of what to expect. The exam covers your lungs, heart, blood pressure, abdomen, limbs, and nervous system in a general physical check. On top of that, you’ll go through several specific assessments.
For eyesight, you need to achieve visual acuity of 6/6 (equivalent to 20/20) or better in each eye. The CAA allows corrective lenses, but there are limits on how strong your prescription can be: long-sightedness up to +5.0 dioptres, short-sightedness up to -6.0 dioptres, and astigmatism up to 2.0 dioptres. You’ll also take an Ishihara colour vision test at your initial examination.
Hearing is tested with pure tone audiometry. You cannot have hearing loss greater than 35 decibels at the lower frequencies (500, 1000, and 2000 Hz) or more than 50 decibels at 3000 Hz in either ear. A lung function test measures how quickly you can expel air. You’ll also provide a urine sample, which is screened for signs of diabetes, kidney problems, or blood in the urine. Arrive with a full bladder.
An electrocardiogram (ECG) is required at the initial application for Class 1, 2, and 3 certificates, and periodically after that. From age 45 onward, a stress ECG may be required depending on the findings.
Mental Health Assessment
Mental health is assessed as part of the medical, particularly for Class 1 applicants. The examiner will ask about your psychological history, how you’ve coped under stress, any childhood behavioural issues, and your interpersonal relationships. The goal is to identify anything that could affect flight safety.
A history of a mood disorder, anxiety disorder, personality disorder, or substance misuse doesn’t automatically disqualify you, but it does require a full psychiatric evaluation before you can be assessed as fit. Active substance abuse or dependence results in an unfit assessment until recovery is confirmed and treatment is complete. If the examiner spots any signs of concern during the appointment, they’ll refer you for a specialist opinion.
Conditions That May Affect Your Certificate
Several medical conditions can complicate or prevent certification. These include coronary heart disease that has been treated or caused symptoms, epilepsy, diabetes requiring medication, bipolar disorder, psychosis, a history of heart attack, and any unexplained loss of consciousness. A permanent pacemaker or heart valve replacement are also flagged.
That said, many of these conditions don’t permanently bar you from flying. When a condition is well controlled and documented, the CAA can issue a certificate with restrictions or require periodic medical reports. The key is disclosure. Failing to declare a known condition is a serious matter, so it’s always better to be upfront and let the process work.
How Long a CAA Medical Lasts
Validity depends on your certificate class and your age. For Class 1 medicals used for airline transport privileges, the certificate lasts 12 months if you’re under 40, dropping to 6 months once you turn 40. Class 2 and LAPL certificates last longer, generally up to 5 years for pilots under 40, reducing to 2 years at age 40 and over. Class 2 validity shortens further as you get older, with annual renewals typically required from age 60.
Renewal examinations are less intensive than the initial one. You won’t repeat every test each time, though the core checks on vision, hearing, blood pressure, and urine remain standard.
How to Apply
The UK CAA uses an online system called Cellma, accessed through the CAA Customer Portal. This replaced the old paper forms and lets you submit applications for any class of medical, view your medical record, and track referrals. You’ll need to register on the portal and complete an identity verification, which can be done face to face with an AME or at the CAA Medical Department.
Once registered, you book an appointment with an approved Aeromedical Examiner. The CAA maintains a list of AMEs across the UK. For a Class 1 initial examination, the appointment must be at the CAA’s Aeromedical Centre at Gatwick or with a specially authorised AME. Class 2, LAPL, and renewal examinations can be carried out by any approved AME, and most have clinics you can visit locally. Costs vary, but expect to pay several hundred pounds for an initial Class 1, and somewhat less for Class 2 or LAPL assessments.
If you’re starting flight training, it’s worth getting your medical done early. There’s no point investing time and money in lessons only to discover a medical issue that needs resolving. Most AMEs are happy to discuss your health history informally before you commit to the full examination.