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About 57 months ago I got my first FAA medical, a second class certificate. I am currently a sophomore in college. I'm in AFROTC trying to become an Air Force pilot so I wanted to get a first class medical just to make sure that I can (I realize military aviation medicals are even more intense though).

What types of things do they do during an exam for a first class medical that aren't included in the exam for a second class? Also, if I "fail" one of the tests while being examined for a first class - can I still get a second or third class medical to keep my private pilot privileges?

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You can see the requirements for all FAA medicals in 14 CFR 67.

Specifically, Subpart C (67.2xx) deals with second class medicals and Subpart B (67.1xx) deals with first class medicals.

The only difference my cursory read of these regulations revealed is:

  • x.111 - Cardiovascular. A first class medical requires EKG after your 35th birthday and every year after age 40.

This leads me to believe any real differences are likely in the ME's guidelines for issuing the medical, and I am not familiar with those.

The only other differences relate to duration and requirement for the exercise of privileges.

On your second question, if you apply for a first class medical and for some reason could not qualify for one, you will be denied or deferred even if you could hold a lower class medical (this is also true of a second class application). The only possibilities at the end of a medical exam are walking out with a medical of the class you applied for or walking out without a medical. There is no fallthrough to a lower class.

If you have an issue that you believe would inhibit your ability to get a first class medical, an avenue to explore this is through AOPA where you can talk with a doctor and get advice on your ability to pass a medical and support in handling a deferred medical application.

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  • $\begingroup$ Thanks! I was worried about the different frequencies I am supposed to be able to hear just cause my hearing's not great. But since the hearing requirements are identical for first and second class I'm not at all worried. $\endgroup$
    – Keegan
    Sep 8, 2014 at 22:48
  • $\begingroup$ @KeeganMcCarthy The only hearing test I've ever experienced at an AME office is being able to hear the doc in normal conversation. $\endgroup$
    – casey
    Sep 9, 2014 at 1:55
  • $\begingroup$ That's how my second class was, too. But when I took my DODMERB (military medical), I had to wear special headphones and tell them when I could hear certain frequencies. Even though I passed, it was really hard for me - I was hoping the class 1 FAA medical wouldn't be like that. $\endgroup$
    – Keegan
    Sep 9, 2014 at 5:58
  • $\begingroup$ I wouldn't worry about getting your first class unless you have a real need for it. The AF won't look at it and will conduct their own medical assessment of your suitability. $\endgroup$
    – tmptplayer
    Sep 10, 2014 at 23:21
  • $\begingroup$ Seconded. I can easily pass an FAA first class but the AF wouldn't even let me be on an aircrew, let alone fly the thing. $\endgroup$
    – casey
    Sep 10, 2014 at 23:23

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