Part 67 Series — How FAA Medical Certification Really Works (For Private Pilots)

For most private pilots, the FAA medical exam feels like a formality.

You fill out MedXPress.
You visit an Aviation Medical Examiner (AME).
You read a line on the eye chart.
You answer a few health questions.
You walk out with a certificate.

Simple… right?

Not exactly.

Behind that short office visit is 14 CFR Part 67 — the section of the Federal Aviation Regulations that defines the medical standards for airmen. For small-aircraft pilots flying under a Private Pilot Certificate, Part 67 determines:

• Whether you qualify for a Third-Class medical

• How long it remains valid

• What conditions may disqualify you

• When the FAA must review your case

• How special issuance works

Understanding Part 67 isn’t about memorizing medical jargon. It’s about knowing how the certification system works — and how to protect your flying privileges.

In this five-part series, we’ll break down Part 67 into clear, practical explanations tailored specifically to private pilots flying small aircraft.

Let’s start with the structure of the system.

The Structure of Part 67 & Medical Certification

In this article, we’re covering:

• §67.1 — Applicability and definitions

• §67.3 — Issue of medical certificates

• §67.5 — Duration of medical certificates

• §67.401 — Special issuance of medical certificates

These sections define how the FAA medical system functions.

§67.1 — Applicability and Definitions

Part 67 establishes the medical standards for airman certification. It applies to:

• First-Class medical certificates

• Second-Class medical certificates

• Third-Class medical certificates

For private pilots flying small aircraft, the relevant standard is generally the Third-Class medical certificate.

Part 67 outlines medical standards by body system and certification level. While First- and Second-Class standards are more stringent, the Third-Class standards are designed to ensure private pilots can safely exercise private pilot privileges.

The regulation provides structured medical criteria rather than leaving determinations purely to examiner discretion.

§67.3 — Issue of Medical Certificates

This section explains that an applicant who meets the medical standards for the applicable class will be issued a medical certificate.

The Aviation Medical Examiner (AME):

• Reviews your MedXPress application

• Conducts the physical examination

• Applies the Part 67 standards

If you clearly meet the standards, the AME may issue the certificate on the spot.

If a condition falls outside the standards, the AME may defer the application to the FAA for further review.

This is where many pilots become anxious — but deferral is a process, not a denial.

§67.5 — Duration of Medical Certificates

While Part 61 governs when you must hold a medical to act as PIC, Part 67 establishes the classes of medical certificates.

For private pilots:

• A Third-Class medical is typically required.

• The duration depends on age (under 40 vs. 40 and over) under Part 61 rules.

Part 67 defines the certification class; Part 61 determines how long you may exercise privileges with that certificate.

Understanding that distinction prevents confusion.

§67.401 — Special Issuance Authorization

This is one of the most important sections in Part 67.

If an applicant does not meet the standard medical requirements due to a disqualifying condition, the FAA may grant a special issuance authorization if the condition:

• Is stable,

• Is adequately treated or controlled, and

• Does not pose a significant risk to aviation safety.

Special issuance allows many pilots with certain medical histories to continue flying — under defined monitoring conditions.

It is not automatic, but it is common.

At this level, you now understand how the structure of Part 67 works:

• It defines medical standards.

• It establishes classes of certification.

• It allows for deferral and review.

• It provides a pathway through special issuance when needed.

But there’s more happening behind the scenes.

How the FAA Medical Decision Process Actually Works

Let’s go deeper into how Part 67 operates in real-world general aviation.

The AME’s Role vs. The FAA’s Role

An Aviation Medical Examiner does not “override” Part 67.

The AME:

• Applies the published standards.

• Issues certificates when clearly qualified.

• Defers cases that require FAA review.

If your condition is listed as specifically disqualifying under Part 67 (for example, certain cardiac, neurological, or psychiatric conditions), the AME must defer.

The FAA’s Aerospace Medical Certification Division then reviews the case.

“Does Not Meet the Standard” Is Not Always the End

Many pilots assume that failing to meet a listed medical standard automatically ends their flying career.

In reality:

• Part 67 defines disqualifying conditions.

• §67.401 provides a mechanism for review.

• The FAA evaluates risk, stability, and treatment compliance.

Special issuance often includes:

• Periodic medical reporting,

• Specialist evaluations,

• Follow-up documentation.

It is structured oversight — not permanent grounding.

Medical Certification vs. Self-Grounding

Even if you hold a valid Third-Class medical certificate, Part 61 (§61.53) requires you to self-ground if you develop a condition that makes you unable to meet medical standards.

Part 67 governs certification.
Part 61 governs operational responsibility.

Understanding both protects your certificate.

Why Part 67 Is Structured This Way

The FAA medical system balances:

• Individual pilot opportunity,

• Public safety,

• Predictability in decision-making.

Instead of relying solely on examiner judgment, Part 67 provides standardized medical criteria. At the same time, special issuance provides flexibility.

This structure allows many private pilots with manageable conditions to continue flying safely in small aircraft.

Coming Up Next

In Article 2 of this series, we’ll break down:

• Vision standards

• Visual acuity requirements

• Color vision testing

• Hearing standards

These are some of the most objective and clearly defined medical standards in Part 67 — and some of the most commonly misunderstood.

Because before the FAA evaluates your heart…
They check your eyes.

Until then:

Know the structure.
Understand the process.
And remember — the medical exam is governed by regulation, not mystery. 🛩️