Medical Requirements for pilots – What gives?

Ever agonized over the medical requirements for pilots? Would you like to know more about the medical examination required for a pilot applicant? And maybe you have to use glasses and wonder if this will stop you from a career as an airline pilot? Fret not, I’ll run you through the basics. The rules are easier, and a lot more forgiving than you might think.

My name is Martin Trankell. Today I am a First Officer on the ATR-72. It is a twin-engine turboprop airplane used to carry up to 70 passengers on short-haul flights. I and my happy colleagues do this most days in Scandinavian Airlines colors. If you happen to take a flight between Arlanda and Visby, or Arlanda and Kalmar, then you may find yourself flown by me.

Tell the flight attendant to say hi!

View from the ATR 72-600

This is my view on a normal evening shift. It is a view possible thanks to my good pair of contact lenses.

But not too many years ago, I questioned if I ever could become a pilot.

Sometime in high school, I started to squint whenever I was seated in the back of the classroom. I struggled to read road signs, find keys I had misplaced and I had difficulty making out who was waving at me from across the street.

The evidence was right there. I needed glasses.

It wasn’t fun admitting it. I dreamt of a career as a pilot and I had heard that with vision problems it could be a tough dream to pursuit. But I still decided I was going to apply and give it a shot, hoping that my vision was good enough.

Once the time had come for me to apply I choose OSMAA and then completed my admission test. The next step was the medical evaluation, performed in Stockholm. To my great relief, I passed all tests, including my vision test, but I was ordered to get glasses and use them while flying. Next step: Flight training!

The Medical Exam

The initial medical examination carried out for a commercial pilot applicant is quite extensive. The tests take one full day during which you are shuttled between different specialists, each assessing your health and ailments and their potential effects in the cockpit. My day looked somewhat like this:

    • At arrival: Completion of a general health declaration. I was asked to answer a series of questions about my own, as well as, my relative’s health status. This included relatively simple questions such as if I was taking any medicines, if there was a history of high blood pressure in the family or if I suffered from any allergies.
    • General health exam: The general declaration was followed by a general health examination. A doctor looked through my answers, asked follow-up questions, and completed a simple exam. This included testing my reflexes, listening to my lungs and heart, and a general examination.
    • ECG: My heart was checked with an ECG/EKG. This means that electrodes are fitted to your upper body and the doctor then measures the electrical activity of the heart. My blood pressure was also measured.
    • Lung function test: My lung capacity and functionality were tested by letting me exhale forcefully through a narrow pipe. This measured the total volume of the lungs, as well as the functionality of the respiration system.
    • Blood/urine samples: A normal blood and urine sample was taken to conduct a general health exam.
    • Vision test: You are seated in front of an ordinary board with letters and made to read (or guess!) as many as you can. If so required the optician will thereafter let you look through a machine that has the ability to correct defective vision. Through these means, it is determined if your vision is “good enough” for a pilot. More on this below.
    • Color blindness test: The applicant must complete an Ishiria-test, which is the famous test with colored circles. See below. 
  • Hearing test: You are seated inside a sound-proofed chamber with a pair of headphones. Each time you hear a tone in the headphones you are to push a button. A very common type of hearing test.
  • In conclusion, there are further tests as deemed necessary by the doctor. This could be more extensive heart condition checks or follow-up blood tests at a later date.

It is a few years since I did my tests now, and the rules and requirements are in constant motion. Because of this, your test may look different. During my test, I also completed an epilepsy test and an eye-pressure test, tests which during the years have come and gone.

What is NOT allowed?

So, what would actually generate a “NO” or a “MAYBE” on your medical exam? Generally, the doctors have leeway to make their own decision in their area of expertise. This means that it is impossible to make a general list of all the conditions barring you from a career as a pilot.

However, there are some common conditions that often are perceived as being disqualifying. These conditions are found in the official rules and it is, therefore, possible to give some more information:

  • Allergies and Asthma: Common allergy is not disqualifying. If you are often taking medication this may have to be changed or discontinued when you commence flying duties (e.g. many allergy medicines cause drowsiness). Asthma may be disqualifying and it is evaluated on an individual basis.
  • Hearing impairment: Your hearing should be “normal”. There are no requirements to have perfect hearing (scoring a top score on the hearing test). However, there are some pretty extensive rules regarding this which you can read about yourself. There is a link at the end of this blog post to the official rule book.
  • Vision: There is no requirement to have good vision without correction. The vision acuity requirements are all given for CORRECTED vision. The actual requirement is that you are required to be able to read 1.0 with both eyes and at least 0.7 in each individual eye. Being able to read about 2/3 of the way down a letterboard approximately constitutes 1.0 vision (being able to read only the first line = 0.1 vision). There are further requirements for the vision that can be barring but acuity itself is rarely a problem if you are able to correct it with glasses or contacts.
  • Astigmatism: Suffering from astigmatism can be disqualifying. It depends on the severity of the condition. I suffer from astigmatism which is corrected through the use of contact lenses.
  • Psychological ailments: The rules stipulate: “Applicants  shall  have  no  established  medical  history  or  clinical  diagnosis  of  any  psychiatric  disease  or  disability,  condition  or  disorder,  acute  or  chronic,  congenital  or  acquired,  which  is  likely  to  interfere  with  the  safe  exercise  of  the  privileges  of  the  applicable  licence(s).”


  • Epilepsy/Sense organs: Epilepsy is normally disqualifying. There is a loophole that allows it to be “evaluated” if there have been no symptoms and no medication for at least ten years, but it is unknown to me if it is exercised that way in reality. Problems with the sense organs/the vestibular system may be disqualifying and are dealt with on an individual basis.
  • Body shape/length: Your general health condition is taken into account when determining if you are fit to fly. There are no max/min lengths in aviation anymore (at least not practiced as such here in Sweden) but there are ergonomic considerations to take into a personal account. Airplanes are made for an average population. OSMAA recommends that you visit the school and get into an airplane yourself (you’re welcome to contact us, any time. That said, I have colleagues of all lengths and it is usually OK. Obesity, however, can be a problem.

“I need my glasses to fly”

SAS turbo prop aircraft ATR 72-600

I wouldn’t step onto an airplane without my contacts. Chances are I would have trouble getting up the stairs without them. I’m also rather allergic, especially in the summers.

Since I’ve started flying I’ve had to switch to approved allergy medicine, and I now always carry a spare set of glasses in my bag at all times. This is a legal requirement from the aviation authority in case my primary pair (contacts or glasses) break.

Every year I have to visit an aviation doctor for an annual assessment. This includes a check-up and update of my general health status, a new vision test, blood test, and a urine sample. I also have to go visit an optician every other year, to evaluate my astigmatism. Apart from this, I work and fly without any changes to my life.