The Complete Guide to UK Pilot Medicals (2026): Class 1 vs Class 2 Requirements, Costs, and Common Myths
- PPL Club
- Jan 12
- 7 min read
Updated: Jan 16
The "Bogeyman" of Flight Training
For many aspiring pilots, the first hurdle isn't the Air Law exam or the first solo landing—it is the medical. There is a persistent myth in the UK aviation community that you need to be an Olympic athlete with 20/20 vision to fly a Cessna 152.
Let’s put those fears to rest immediately: You do not need to be Superman.
Whether you are pursuing your Private Pilot Licence (PPL) for weekend adventures or aiming for the airline cockpit with a Commercial Pilot Licence (CPL), the UK Civil Aviation Authority (CAA) medical standards are designed to ensure safety, not perfection.
In this guide, we will break down exactly what happens during a Class 1 and Class 2 medical, how to navigate the notorious Cellma portal, and answer the most Googled health questions UK student pilots ask in 2026.
Which Medical Do I Need? Class 1 vs. Class 2
Before you book an appointment, you must identify which medical certificate matches your aviation goals.
The Class 2 Medical (The PPL Standard)
If your goal is to fly privately (PPL) or fly on a Light Aircraft Pilot Licence (LAPL) with slightly fewer restrictions, the Class 2 Medical is your target.
Who is it for? Private pilots flying for fun or personal transport.
What does it cover? Standard health checks to ensure you aren't at risk of sudden incapacitation.
Where to get it: Any UK-certified Aeromedical Examiner (AME). These are essentially GPs with specialist aviation training.
The Class 1 Medical (The Professional Standard)
If you dream of turning left into the cockpit of a Boeing or Airbus, or even becoming a flight instructor one day, you eventually need a Class 1 Medical.
Who is it for? Commercial pilots (CPL, ATPL) and those flying for remuneration.
What does it cover? A far more comprehensive assessment of your cardiovascular, visual, and neurological health.
Where to get it: Crucially, your Initial Class 1 cannot be done by a local doctor. It must be performed at a certified Aeromedical Centre (AeMC).
The Digital Hurdle (Navigating Cellma)
Before you even step foot in a doctor's surgery, you have to survive the paperwork. In the past, you filled out a paper form in the waiting room. Today, everything is digital.
You must register for the CAA Customer Portal and access the Cellma medical system.
Verify Identity: You may need to upload a passport or driving licence.
Apply for a Medical Certificate: Inside Cellma, you will complete the application form and pay a small fee to the CAA (separate from your doctor's fee).
The "Reference Number": You will generate a CAA reference number. Do not lose this. Your AME cannot start your physical exam without it.
💡 Pro Tip:
Do this at least a week before your appointment. The system can take time to process your details.
The Class 2 Medical: What Actually Happens?
For most PPL Club members, the Class 2 is the main event. It typically takes 30 to 60 minutes. Here is the step-by-step breakdown of what your AME will look for.
1. The Lifestyle Chat
The AME will review your medical history (which you declared on Cellma). Be honest. If you have had surgery, kidney stones, or mental health history, bring reports from your GP. Hiding things is the quickest way to lose your licence permanently.
2. Eyesight & Colour Vision
You will read letters from a chart (near and distant). You can wear glasses or contact lenses (more on that later), but you must bring your prescription with you.
Colour Vision: You will likely look at "Ishihara Plates" (circles of coloured dots with hidden numbers). If you struggle with these, you aren't automatically grounded—you may be sent for a more advanced "Lantern Test."
3. The Physical Check
Expect a standard physical:
Listening to your heart and lungs.
Checking reflexes.
Palpating your abdomen.
Height and weight check (BMI is a factor, but usually only extreme cases cause issues).
4. The Fluids (Urine Test)
You will provide a urine sample to check for diabetes (sugar), kidney issues (protein), or blood.
Advice: Drink water before you go, but maybe lay off the sugary energy drinks on the morning of the exam!
5. The ECG (Electrocardiogram)
For a Class 2, you don’t always need an ECG. It depends on your age and history.
Under 40: Usually only if clinically indicated.
Over 40: Required at the first exam after turning 40, then every two years after age 50.
The AME will attach sticky sensors to your chest to check your heart's electrical rhythm. It is painless and takes minutes.
The Class 1 Medical: The "Initial" Difference
If you are going for the Class 1, expect a much longer day (up to 4 hours).
You will undertake almost all the tests you did for your Class 2 Medical but will also include:
Past Medical History (PMH) Screening: A detailed look at your PMH to include any significant hospital admissions; tests or procedures.
Comprehensive Eye Exam: Drops will be put in your eyes to widen the pupils for a thorough retina check. You won't be able to drive home immediately after this. You should take your most up-to-date eye test report, from your optician, as well as your glasses and contact lenses.
Audiometry: You will sit in a soundproof booth to test your hearing across specific frequencies.
Lung Function Test: Spirometry testing to determine your overall lung function.
Blood Tests: Often a finger prick for haemoglobin and cholesterol.
Alcohol Test: A breath test to check for alcohol levels.
ECG: A heart trace.
Initial then:
<30 years: 60 Months
30 - 39 years: 24 Months
40 - 49 years: 12 Months
>50 years: At every medical or when clinically indicated.
Psychological Assessment (depending on medical) A discussion about your mental health and coping mechanisms.
💡 Pro Tip:
If you plan to fly commercially, we highly recommend getting an Initial Class 1 done before you spend £15,000 on PPL training. It is better to know now if there is a medical reason you can't be an airline pilot, rather than finding out after you've spent the money.
Validity: Depending on the reasons for obtaining your Class 1 (Single Pilot/Other Commercial reasons), the validity is slightly different. The below graphic demonstrates the validity for non-single pilot operations.
Costs and How to Book (2026 Prices)
Medical fees are not set by the CAA; they are set by the individual doctors (AMEs), so it pays to shop around.
Estimated Costs for 2026:
Class 2 Initial/Renewal: £180 - £250
LAPL Medical: £140 - £180
Class 1 Initial (at an AeMC): £600 - £800
Class 1 Renewal: £200 - £300
How to find a doctor: Use the CAA "Find an AME" search tool. We recommend finding one who is an active pilot themselves—they tend to be more sympathetic to the anxiety of the exam!
Summary: Don't Let "White Coat Syndrome" Ground You
It is normal to be nervous. Your heart rate might be slightly higher than normal when the cuff goes on—AMEs call this "White Coat Hypertension" and they account for it.
The UK medical system is designed to keep you safe, not to stop you from flying. The vast majority of applicants pass their Class 1 and 2 medicals without issue.
Ready to start your journey? Once you have that piece of paper in your hand, the real work begins. Head over to our Air Law Mock Exams to start studying for the first exam you’ll need to pass alongside your medical.
Disclaimer: PPL Club provides guidance for student pilots. We are not medical professionals. Always consult an official UK AME for specific medical advice regarding your fitness to fly.
Frequently Asked Questions
Do I need a Class 1 Medical for a Private Pilot Licence (PPL)?
No. For a standard UK PPL(A), you only need a Class 2 Medical. A Class 1 Medical is strictly for pilots who intend to fly commercially (CPL/ATPL). However, if you plan to upgrade to a commercial licence later, we recommend getting an Initial Class 1 now to ensure you are medically fit before investing in training.
Can I pass a Class 1 Medical with glasses?
Yes, but the standards are stricter than Class 2. You must have normal fields of vision and your prescription must not exceed certain dioptre limits (typically regarding astigmatism and refractive error). If you have a high prescription, we strongly advise consulting an AME before booking your initial exam. You must always carry a spare pair of glasses when flying.
How much does a UK Pilot Medical cost in 2026?
Prices are set by the clinics, not the CAA, so they vary significantly:
Class 2: Expect to pay between £180 and £250.
Class 1 (Initial): This is a comprehensive 4-hour exam and typically costs between £600 and £800.
Class 1 (Renewal): Usually costs between £200 and £300.
How long are the medicals valid for?
Class 1: Valid for 12 months (if you are under 60) or 6 months (if you are over 60 or flying single-pilot commercial passengers over 40).
Class 2: Valid for 60 months (under 40), 24 months (40–49), or 12 months (50+).
Where can I get my medical examination?
This depends on the class.
Class 2: Can be done by any UK-certified Aeromedical Examiner (AME). These are usually local GPs with specialist aviation training.
Class 1 (Initial): MUST be done at a certified Aeromedical Centre (AeMC). You cannot go to a local AME for your very first Class 1.
Class 1 (Renewal): Once you have the initial certificate, renewals can usually be done by a standard AME.
What happens if I fail my Class 1 Initial?
If you fail the Class 1 standards, you may still meet the standards for a Class 2. This means you could still fly privately (PPL) but would not be able to fly commercially.
I have asthma. Can I still get a Class 1?
Usually, yes, provided your asthma is well-controlled with medication and you have not had a recent severe attack or hospitalisation. You will likely be required to perform a spirometry (lung function) test and potentially an exercise test to prove your fitness is compatible with commercial flying duties.
How do I book a medical?
First, you must register on the CAA Customer Portal and pay the application fee via the "Cellma" system. Once you have your reference number, use the CAA website to find an AME (for Class 2) or an AeMC (for Class 1 Initial) and book your appointment directly with them.
