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    Important: Whilst we endeavour to keep this information up to date, the only definitive and current source for UK aeromedical examination requirements is the UK Civil Aviation Authority. Always check the CAA website before booking any medical examination.

    In the UK, Aeromedical Examiners (AMEs) are doctors authorized by the Civil Aviation Authority (CAA) to perform medical examinations for pilots and air traffic controllers. Their authority is tiered: while almost all AMEs can perform Class 2 or LAPL medicals, only certain AMEs are authorized for Class 1 (Commercial) or Class 3 (Air Traffic Control) renewals.

    Types of Medical Certifications

    The CAA categorizes AMEs based on the level of medical they are permitted to issue:

    Certification TypeDescriptionWho can issue it?
    Class 1 Medical (Initial)
    		For commercial pilots (CPL/ATPL)Aeromedical Centres (AeMCs) only. Individual AMEs cannot perform initial Class 1s.
    Class 1 Renewal
    		Revalidation of commercial medicalsSenior AMEs with "Class 1" privileges (and AeMCs).
    Class 2 Medical
    		Private Pilot Licences (PPL)Any UK CAA-certified AME.
    Class 2 Renewal
    		Revalidation of PPL medicalsAny UK CAA-certified AME.
    Class 3 Medical (ATCO Initial)
    		For Air Traffic Controllers (ATCOs)AeMCs only.
    Class 3 Renewal
    		Revalidation of ATCO medicalsAMEs with specific "Class 3" extension privileges.
    LAPL Medical
    		Light Aircraft Pilot LicencesAny UK CAA-certified AME (and some GPs).
    LAPL Renewal
    		Revalidation of LAPL medicalsAny UK CAA-certified AME (and some GPs).
    Flight Crew Medical
    		Cabin crew and other operational flight crew medicalsAuthorised AMEs offering occupational/flight crew medicals.
    Full AeMC Services
    		Complete aeromedical centre services including initial certificationsAeromedical Centres (AeMCs) only.
    Pilot Medical Declaration (PMD)
    		NPPL, UK PPL, and UK CPL (Balloons) holders meeting DVLA Group 1 driving standards and not subject to a disqualifying conditionSelf-declared via the CAA Cellma medical records system — no AME visit needed.

    In aviation medicine, what you might call "EMAs" are officially known as AMEs (Aeromedical Examiners). There is a specific hierarchy of doctors and centres, as not every doctor can issue every type of licence.

    Here are the four different "types" of aeromedical entities you will encounter:

    1.Aeromedical Centres (AeMCs)

    AeMCs are the highest-tier facilities (located at Gatwick, Heathrow, Birmingham, etc.). They are the only entities authorized to perform:

    Role
    Initial Class 1 (Commercial) for any student starting a career as an airline or commercial pilot (CPL/ATPL). Initial Class 3 (ATCO) for student Air Traffic Controllers. Complex Cases: referrals for pilots with significant medical issues (e.g., post-heart surgery or complex neurology) that a standard AME cannot clear. All Renewals: they can also perform any renewal or lower-class medical.

    Why?
    As the highest-tier facility, AeMCs are staffed by a team of specialists including cardiologists, optometrists, and psychiatrists, ensuring the most thorough assessments.

    2.Class 1 AME

    A Class 1 AME is a senior Aeromedical Examiner authorized by the CAA to oversee the medical fitness of Commercial Pilots (CPL, ATPL, and MPL). Their role is more advanced than a standard AME because they manage the high-stakes medical requirements for the airline industry.

    Role
    Commercial Pilot Revalidations & Renewals — their primary function. Once you have your Initial certificate, a Class 1 AME can: Revalidate (extend your medical before it expires, up to 45 days early), Renew (issue a new certificate if your Class 1 has lapsed for less than 5 years), and perform routine ECGs, audiograms, and lung function tests as mandated by age or medical history.

    Casework & Fitness-to-Fly
    If a commercial pilot has an injury, surgery, or new diagnosis, a Class 1 AME can assess recovery by reviewing hospital reports, and liaise with the CAA as the "middle-man" submitting detailed medical dossiers to lift a "Temporary Unfit" status.

    Full Tier 3 Privileges
    A Class 1 AME can do everything a Tier 3 (Class 2) AME can do, including Initial Class 2 & LAPL medicals for private pilots and Cabin Crew Assessments.

    Cannot Do
    They cannot perform the very first Class 1 medical (must be done at an AeMC), cannot do Initial Class 3 (ATCO) exams, and cannot renew a Class 1 that has been lapsed for 5+ years — you must return to an AeMC for a "re-initial" exam.

    3.Class 2 AME

    A Class 2 AME is a doctor certified by the CAA to manage medical fitness for the General Aviation (GA) sector. Their authority is specifically focused on private, recreational, and student pilots.

    Role
    Initial Class 2 Medicals (PPL, BPL, SPL), Class 2 Renewals/Revalidations, LAPL Medicals (initial and renewal), Cabin Crew Assessments, basic cardiovascular screening (resting ECGs mandatory at age 40+), and determining fitness after minor illnesses or injuries without referring to the CAA.

    Authorized
    Initial & renewal Class 2 medicals for private pilots. LAPL medicals. Cabin Crew attestations. Standard resting ECGs. Fitness-to-fly clearance after minor issues.

    Cannot Do
    NO Commercial Initial Exams (Class 1) — exclusive to AeMCs. NO Commercial Renewals (Class 1) — unless they hold a specific extension. NO Air Traffic Control (Class 3) exams. NO complex cardiology/neurology sign-offs — must refer to CAA Medical Department. NO high-level "booth" audiograms required for commercial instrument ratings.

    4.Class 3 AME

    Class 3 Aeromedical Examiners (AMEs) are specialists authorized by the CAA to manage the medical certification of Air Traffic Control Officers (ATCOs) and student air traffic controllers. While their work is similar to Class 1 (Commercial Pilot) examiners, their focus is specifically on the unique physiological and psychological demands of the air traffic control environment.

    Role
    Class 3 Renewals & Revalidations for active ATCOs, managing fitness-to-work assessments after illness/injury/surgery, specialist vision & hearing checks (including tonometry for those over 40), all Class 2 & LAPL medicals (PPL and Light Aircraft), and Cabin Crew medical reports.

    Specialist Checks
    They perform high-standard audiograms (hearing) and vision tests including tonometry for those over 40, as required for the Class 3 standard.

    Lower Tier Privileges
    Because a Class 3 authorization is a "higher" tier, these doctors are fully authorized to perform all private pilot (PPL) and Light Aircraft (LAPL) medicals, as well as Cabin Crew medicals.

    Cannot Do
    NO Initial Class 3 Exams — must be conducted at an AeMC or the NATS Aeromedical Centre. NO Initial Class 1 Exams. NO Class 1 Renewals (unless dual-certified as both Class 3 and Class 1). Complex case final sign-off must be referred to the CAA Medical Department via Cellma.

    Summary Comparison

    Medical TypeGPTier 3 AMETier 2 AMETier 1 (AeMC)
    Initial Class 1 (Comm)❌❌❌YES
    Initial Class 3 (ATCO)❌❌❌YES
    Class 1 Renewal❌❌YESYES
    Class 3 Renewal❌❌YESYES
    Class 2 (PPL)❌YESYESYES
    LAPL (Light)YES*YESYESYES

    *GPs can only issue LAPL medicals for "clean" medical histories.

    AME Privileges

    PrivilegeClass 2 AMEClass 1 AME / AeMC
    Initial PPL (Class 2)✅✅
    Initial LAPL✅✅
    Cabin Crew Medical✅✅
    Class 1 Renewal❌✅
    Initial Class 1❌AeMC Only
    Initial Class 3 (ATCO)❌AeMC Only

    Important Notices for 2026

    The CAA requires all Class 3 applicants to bring a specific "Standard Eye Examination Form" completed by an optician to their AME appointment if they are over 40 or have a significant vision prescription. Your AME cannot complete the medical without this supporting documentation.

    The "Instructor" Rule for 2026

    As of early 2026, the CAA has reinforced that Flight Instructors (FIs) providing instruction for a PPL must hold at least a Class 2 Medical issued by an AME. A Class 2 AME is the primary authority for ensuring these instructors meet the higher safety standard compared to a simple self-declaration (PMD).

    What is a "Medical Assessor"?

    Occasionally, you will hear about Medical Assessors. These are senior doctors who work directly for the CAA at their Gatwick headquarters. They don't usually see pilots for routine exams; instead, they review "complex cases" where an AME is unsure if a pilot is fit to fly (e.g., after a heart attack or a major surgery).

    Upcoming 2026 Changes

    The CAA has announced or is consulting on the following changes that may affect UK aeromedical certification during 2026.

    Pilot Medical Declaration (PMD) — instructor privileges

    The CAA has opened a public consultation (CAP3218, 5 February – 9 March 2026) proposing to remove the right of flight and class-rating instructors on SEP/TMG aircraft to operate on a PMD. Affected instructors would instead need to hold at least a Class 2 Medical. Microlight, balloon and sailplane instructors are not affected by the proposed change.

    Insulin-treated diabetes — assessment protocol

    The CAA is taking part in a Horizon Europe research project trialling insulin pumps and continuous glucose monitors in flight conditions. The findings, due in early 2026, are expected to update the medical requirements so that Class 1 applicants with controlled diabetes remain eligible, with work underway to extend a similar pathway to Class 3 (ATCO) applicants.

    Electronic medical certificates and licences

    The CAA and the Department for Transport are amending legislation to allow medical certificates and pilot licences to be issued in either electronic or physical form, on an individual basis. The changes are expected to be in place by mid-2026. Under the ICAO Convention, holders may not carry both an electronic and a hard copy of the same document.

    For further information, contact the CAA.

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