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I have an FAA 3rd class and EASA 2nd class medical. On my EASA 2nd class medical it says "This medical certificate complies with ICAO standards".

To obtain an FAA commercial pilot license, will I need to re-take the 2nd class medical by FAA standards with a different AME or does the FAA accept an "ICAO compliant" medical?

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FAA medical certificate requirements are:

Medical certificates are designated as first-class, second-class, or third-class.

  • First-class is designed for the airline transport pilot
  • Second-class for the commercial pilot
  • Third-class for the student, recreational and private pilot

Coming to your question, this site states (my highlighting):

... the ICAO naming structure for the various classes of medicals does not fit with that of the U.S. Under the ICAO definition, a second class medical applies only to holders of private pilot licenses.

In most States, outside of the U.S. and Canada, it is easier to simply carry a valid first class medical rather than trying to explain to a foreign inspector that a FAA second class medical equals an ICAO class 1 medical.


For more information, please read this PDF.

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    $\begingroup$ This is good information, but it seems to be about using an FAA medical for international flying, not using an ICAO medical to get an FAA license. $\endgroup$ – Pondlife Dec 9 '14 at 17:19
  • $\begingroup$ Yeah, I forgot about the EASA only having one medical for both commercial and ATP. So the EASA 2nd class is worth nothing, unfortunately. Which i stupid because it was a much more thorough examination. Got my EKG taken which was not needed for the FAA medical at all. $\endgroup$ – Philipp Dec 10 '14 at 15:05
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You can "obtain" an FAA Commercial Pilot Certificate with a Third Class Medical Certificate; the Second Class Medical Certificate is only required to be able to "exercise the privileges" of a Commercial Pilot.

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There's no provision in the FARs for using a foreign medical in place of an FAA one. The only place it's mentioned is under 14 CFR 61.75, where you can apply for an FAA foreign-based private license using a foreign license and medical.

But you don't need a second-class medical to get a commercial license, you only need it to exercise commercial privileges (see 14 CFR 61.23(2)(ii)). If you just want to get the commercial license as a personal training/development achievement then you can use your existing third-class medical, but if you plan to use your new privileges then you do need a second-class one.

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