Medical Certification Considerations in International Operation

Many nations’ airman medical certification standards and requirements differ from those of the United States. Like the FAA, ICAO standards (published as ICAO Annex 1—Personnel Licensing, available online at the ICAO website) recognize three categories of airman medical certificate. But the U.S. and ICAO differ on what medical certificate must accompany what pilot certificate. ICAO requires a Class 1 medical (“medical assessment” in ICAO terminology) for holders of commercial and air transport pilot certificates; Class 2 for private pilots; and Class 3 only for air traffic controllers.

Under U.S. standards in 14 CFR §61.23, the category of current airman medical certificate a pilot must hold depends on the nature of the particular operation. For example, an ATP making a non-commercial flight, such as for personal transportation or recreation, would require only a Class 3 airman medical certificate for that flight. In contrast, under ICAO standards the category of current airman medical standards a pilot requires depends on the category of pilot certificate the individual holds, regardless of the nature of the particular flight operation. 

The National Business Aviation Association (NBAA) reports that while U.S. standards for FAA first and second class airman medical certificates are similar to ICAO’s Class 1, the differing classification structure and standards have historically caused confusion in international flying. As a practical matter, NBAA recommends that pilots (including those serving as second-in-command) operating outside the U.S. and Canada (whose standards are similar) carry a current FAA first class medical certificate. Otherwise, a foreign inspector may require the crew to bring in a replacement or replacements holding current FAA first class medicals to operate the aircraft.