FAA Part 121 Senior Pilot Physical: Requirements and Process

A senior pilot operating under FAA Part 121 (U.S. airline regulations) is required to hold a first-class medical certificate. This exam is performed by an Aviation Medical Examiner (AME) and is designed to ensure that pilots are healthy enough to operate large, scheduled airline flights safely.

Tests and Procedures PerformedDuring a Part 121 first-class medical exam, the following assessments are typically accomplished:

• Vitals: Height, weight, pulse (for cardiac assessment), and blood pressure (guideline maximum is 155/95).
• Vision:
  • Distant vision of 20/20 or better in each eye (with or without correction).
  • Near vision of 20/40 or better at 16 inches; for age 50 or older, near and intermediate vision are checked at additional distances.
  • Color vision, field of vision, and absence of significant eye disease.
• Hearing: Must be able to understand a normal conversation at 6 feet or pass an audiometry test.
• Electrocardiogram (ECG): Required at age 35 and annually after age 40 for first-class certificates.
• Urine Test: Usually to check for sugar (diabetes indication), protein, and for evidence of drug abuse.
• Physical Examination:
  • General inspection of skin, eyes, ears, nose, throat, mouth, chest, lungs, heart, abdomen, vascular and genitourinary systems.
  • Musculoskeletal assessment (reflexes, strength, coordination).

Additional assessments may be made based on individual medical history.Medical StandardsCertain conditions are disqualifying unless cleared by the FAA, such as:

• Diabetes requiring medication
• Angina or significant heart disease
• Uncontrolled hypertension
• Mental health issues (such as psychosis, bipolar disorder)
• Substance dependence or abuse
• Epilepsy or unexplained disturbances of consciousness

"Riggers" or Rigors of the Exam

• Exhaustion Level: The physical itself is not usually exhausting in a physical sense; it’s a standard medical checkup rather than a physical fitness or endurance test. The process is not strenuous—typically under an hour unless a specific concern is identified.
• Mental or Emotional Stress: Some pilots find these exams stressful due to the high stakes of keeping their medical certificate (and their career) if a potentially disqualifying issue is found.
• Preparation: Bringing recent medical documentation (if you've seen a specialist or received treatment) is strongly encouraged to avoid delays if the AME needs clarification.

Frequency and Age Considerations

• Pilots under 40: Certificate valid for 12 months from the exam date.
• Pilots 40 and older: Certificate valid for 6 months from the exam date.

Additional Notes

• Substance Testing: Strict standards regarding drug and alcohol use. A diagnosis of substance addiction or abuse within the past two years is disqualifying.
• Disqualifying and Deferral: If a disqualifying condition is identified, the AME may deny or defer the case to the FAA for further review.
• Fatigue Risk: While not directly addressed in the physical exam, pilot fatigue is a major safety and regulatory consideration in Part 121 airlines. Regulations mandate rest periods and limit duty hours in addition to medical checks.

Summary Table: Key Parts of the FAA Part 121 Senior Pilot Physical Exam

The physical itself is not physically demanding, but it is stringent with high standards due to the immense responsibility of airline pilots. In summary, while the FAA Part 121 senior pilot physical is thorough and has serious implications, it is not an exhausting physical ordeal—the rigor is in the breadth and seriousness of what is evaluated, not in the physical effort required during the exam.