How to Pass the Air Traffic Controller Medical: Requirements, Disqualifications & Prep Tips

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Meeting the medical requirements for an air traffic controller is a critical step to ensure you are ready for the demands of this high-responsibility role. 

These standards are set to confirm that controllers have the physical and mental fitness needed to make split-second decisions and maintain safety in the skies.

This guide provides a clear and detailed overview of air traffic controller medical requirements. 

You will learn about the specific health standards you need to meet, the certification process, and what to expect during exams. 

It also includes practical tips for maintaining your fitness over time and advice on handling common challenges or disqualifications.

Let’s dive into everything you need to know to succesfully pass this step.

What’s on This Page

Understanding the Air Traffic Controller Medical Requirements

Safety Implications of Medical Fitness

Controllers must stay physically and mentally fit to ensure safe air traffic operations. Their job requires focus, quick thinking, and clear communication at all times.

A sudden health issue, like vision problems or a heart condition, could cause delays or put lives at risk. Regular medical evaluations help catch potential problems early and ensure controllers remain fit to perform their duties.

Regulatory Bodies Setting Medical Standards

Two major organizations set medical standards for air traffic controllers. These guidelines ensure controllers worldwide meet the same safety and health requirements.

  • Federal Aviation Administration (FAA) – The FAA enforces medical regulations for controllers in the U.S. These cover vision, hearing, heart health, neurological function, and psychological well-being.
  • International Civil Aviation Organization (ICAO) – ICAO provides global medical guidelines that align with aviation safety rules. These ensure consistency in air traffic control medical standards across different countries.

The Role of the Flight Surgeon

A Flight Surgeon is a medical doctor responsible for determining whether air traffic controllers meet medical clearance requirements. They review medical exams, assess special cases, and oversee appeals.

Each region has an assigned Flight Surgeon who makes final decisions on medical clearances. A separate Flight Surgeon on the Virtual Hiring Team (VHT) handles medical reviews for new hires and works with medical teams to process clearances.

General Overview of Medical Standards

Key Areas of Evaluation

Air traffic controllers undergo thorough health assessments. These evaluations focus on critical areas to ensure they can perform their duties safely.

  • Vision – Controllers must have 20/20 vision in each eye, with or without corrective lenses. Near and intermediate vision must also be sharp enough for reading monitors.
  • Hearing – Strong hearing is necessary for clear communication in noisy environments. Audiometric tests confirm controllers can detect speech and essential frequencies.
  • Cardiovascular Health – Examinations check for heart disease, high blood pressure, and other conditions that could impact performance.
  • Neurological and Psychological Fitness – Evaluations screen for epilepsy, anxiety, and other disorders that could affect cognitive function.

Scheduling Your Aviation Medical Examiner (AME) Appointment

After receiving your CIL email, you will receive a list of FAA-approved Aviation Medical Examiners (AMEs). You must choose an examiner from the list and contact their office to schedule your medical exam.

How to Schedule Your Appointment:

  1. Find an FAA-Authorized AME
    • Use the FAA AME locator tool to find an examiner near you: FAA AME Locator.
  2. Call the AME’s Office
    • Inform them the exam is for ATC New Hire Medical, not a pilot’s Class 1, 2, or 3 medical.
    • Confirm the appointment date, time, and location to avoid scheduling issues.
  3. Ask About MedXPress
    • Some offices may ask if you have a MedXPress account.
    • You won’t have one yet—the FAA will assign you an Applicant ID and provide MedXPress instructions after you schedule your exam.
  4. Need Assistance?
    • If you experience scheduling issues, contact your medical point of contact provided in your FAA correspondence.
    • For general inquiries, contact the FAA Aerospace Medical Certification Division at (405) 954-4821.

Want to know what to expect on the other ATC hiring steps? Check our in-depth 2025 guide for the Air Traffic Controller hiring process.

Understanding MedXPress and Its Role in Medical Certification

MedXPress is the FAA’s online medical application system, where controllers submit their medical history before their AME exam. This allows AMEs to review records in advance, making the process more efficient.

What You Need to Do:

  1. Wait for FAA Instructions
    • The FAA will assign you an Applicant ID and provide MedXPress login details after you schedule your AME appointment.
  2. Complete the MedXPress Application
    • Fill out the required medical history forms as instructed.
    • Double-check all information to avoid errors or missing details.
  3. Bring Your MedXPress Confirmation Number to Your Exam
    • After submission, you will receive a MedXPress confirmation number.
    • You must bring this to your AME appointment, as the examiner will need it to access your records.
  4. Need Help?
    • For technical issues, contact the FAA MyIT Service Center at helpdesk@faa.gov or call 1-844-FAA-MyIT (1-844-322-6948).
    • If you need to update information, reach out to your medical point of contact before your exam.

A complete and error-free MedXPress submission ensures your medical clearance is processed smoothly, reducing the chances of delays.

Pre-Employment Interview Worksheet (PEIW)

The Pre-Employment Interview Worksheet (PEIW) is a required document for all air traffic control (ATC) candidates. It helps determine if you need further medical evaluation before receiving clearance.

What You Need to Include:

  • Medical History: List all diagnosed conditions, past surgeries, and treatments.
  • Medications: Include prescription drugs, over-the-counter medications, and supplements.
  • Legal History: Disclose any substance-related incidents, felonies, or misdemeanors that could affect your eligibility.

If additional tests or specialist evaluations are required, you will be notified before moving forward. Submitting an accurate and complete PEIW can help prevent unnecessary delays.

Certification Process and Frequency

Controllers must pass an annual medical exam to stay certified. These exams ensure they meet all physical and mental fitness requirements.

Aviation Medical Examiners (AMEs) conduct these exams. They evaluate vision, hearing, heart health, neurological function, and psychological stability. If a controller has a medical condition, they may need additional tests or waivers to continue working.

Some conditions qualify for waivers if they are well-managed and do not pose safety risks. Controllers who do not meet medical standards may need treatment before returning to work. Failing to meet the requirements could result in suspension or loss of certification.

What Kind of Medical Clearance Do Air Traffic Controllers Receive?

Controllers must hold a Special Class II Medical Certificate to ensure they meet FAA health and safety requirements. This certification confirms that they are physically and mentally fit for the job.

The medical clearance includes vision, hearing, cardiovascular, and neurological assessments. Controllers must renew their certification annually to maintain their eligibility for duty.

Detailed Medical Standards for Air Traffic Controllers

Vision Standards

Controllers must have 20/20 vision in each eye, either naturally or with corrective lenses. Bifocal contact lenses are not permitted for near vision correction.

They must also have normal color vision to distinguish between crucial signals, such as aircraft lights and radar displays. Any history of glaucoma, cataracts, chronic eye disease, or past eye surgeries may require additional evaluation.

Hearing and Speech Requirements

Clear hearing is essential for effective communication in busy air traffic environments. Controllers must meet these standards:

  • No disease or damage in the outer, middle, or inner ear that could affect function.
  • No perforated eardrums or chronic conditions of the ear canal or sinuses.
  • No hearing loss greater than 25 decibels in critical frequency ranges (500, 1000, or 2000 Hz).
  • No deformities of the outer ear that could interfere with standard aviation headsets.
  • Controllers must have clear, understandable speech, free from stuttering or other speech impairments.

Cardiovascular Health

Controllers must have a healthy heart and normal blood pressure to handle the demands of the job. Requirements include:

  • No history of heart disease or ongoing cardiovascular conditions.
  • A normal electrocardiogram (EKG) and clinical exam confirming heart health.
  • No evidence of enlarged heart size on an X-ray.
  • Any form of treatment for a cardiovascular condition may result in disqualification.

Neurological Health

Controllers must not have any condition that could affect brain function, coordination, or decision-making. They must meet the following criteria:

  • No history of seizures or convulsive disorders such as epilepsy.
  • No other neurological diseases that could interfere with performance.
  • No ongoing treatment for any nervous system disorder (including preventive treatment).

Musculoskeletal Fitness

Controllers need a strong musculoskeletal system to handle long hours at a workstation. Requirements include:

  • No spinal or limb deformities that would interfere with job duties.
  • No missing extremities or digits that could impact control operations.
  • No conditions that could cause fatigue or discomfort during extended periods of sitting or standing.

General Health Standards

Controllers must be free from any serious medical conditions that could affect safety. This includes:

  • No history of diabetes mellitus requiring insulin.
  • No chronic diseases or conditions that could interfere with safe job performance.
  • Controllers must undergo clinical evaluations and lab tests as needed to confirm overall health.

Psychiatric and Psychological Health

Mental fitness is just as important as physical health. Controllers must have no history of psychiatric conditions that could impact their ability to perform under pressure.

Disqualifying conditions include:

  • Psychotic disorders, such as schizophrenia.
  • Severe neuroses, including disabling anxiety disorders.
  • Personality or mental disorders that pose a safety risk in the air traffic environment.

Determinations are based on a combination of medical history, psychological evaluations, and clinical assessments by board-certified specialists.

Substance Use and Dependency

Controllers must remain free from alcohol or drug dependency to maintain medical certification.

  • A full history review and lab testing are used to detect any past or current substance use issues.
  • Controllers may be subject to random drug screenings to confirm ongoing compliance.

Common Disqualifying Conditions

Certain health conditions can disqualify candidates if they pose a safety risk. These include:

  • Uncorrectable vision impairments or issues with color vision.
  • Severe hearing loss that affects clear communication.
  • Heart conditions such as uncontrolled high blood pressure or arrhythmias.
  • Neurological disorders like epilepsy or other conditions causing sudden incapacitation.
  • Mental health disorders that interfere with focus, judgment, or decision-making.
  • Substance dependency, including past or current drug or alcohol abuse.

Some temporary conditions may not lead to permanent disqualification if treated successfully.

Appeals and Medical Waivers

If a controller is denied medical clearance, they can appeal the decision. The appeal must be submitted within 15 days of receiving the denial notice.

To support the appeal, they have 60 days to provide additional medical records or test results. Further evaluations may be required, but the applicant is responsible for any medical costs.

Some conditions qualify for medical waivers if they are well-managed and do not pose a safety risk. A Flight Surgeon reviews all appeals before making a final decision.

Preparation Tips for the Medical Exam

  • Schedule Wisely: Choose a time when you’re feeling your best to undergo the medical examination.
  • Gather Medical Records: Bring all relevant documents, including prescriptions and recent test results, to provide a comprehensive health overview.
  • Address Minor Health Concerns: Attend to issues like vision correction or weight management before the exam to meet the necessary health standards.
  • Adopt Healthy Habits: Engage in regular exercise, maintain a balanced diet, and ensure adequate sleep to promote overall well-being.

Career Implications of Medical Requirements

Maintaining Medical Fitness During Your Career

Consistent health maintenance is vital. Attend all required medical examinations and promptly address any health concerns. 

Inform your employer about any changes in your health that could impact your certification. Implementing stress management techniques is also essential for long-term success.

Losing Medical Certification

Loss of certification can significantly affect your career. Conditions like untreated hypertension or mental health challenges may necessitate a temporary leave until resolved.

Steps to Regain Certification

  • Seek Treatment: Address the disqualifying condition with appropriate medical care.
  • Provide Documentation: Submit updated medical records to the examiner for review.
  • Undergo Re-evaluation: Demonstrate your fitness to return to duty through a follow-up assessment.

Regaining certification allows you to continue your career while upholding safety standards.

FAQs

Can I become an air traffic controller if I have had a past surgery?

Yes, past surgeries do not automatically disqualify you, but you may need to provide medical records and a Current Status Report from your doctor. The FAA will determine if your condition is stable and does not interfere with ATC duties.

What happens if I develop a medical condition after I’m hired?

You must report any new medical condition that could affect your ability to perform your job safely. Depending on the condition, you may need additional testing, temporary medical leave, or a waiver before returning to duty.

Can I take prescription medication while working as an air traffic controller?

Certain prescription medications that affect cognitive function, alertness, or decision-making may disqualify you from performing ATC duties. Always consult with your Flight Surgeon or medical point of contact before starting any new medication.

How long does it take to get medical clearance after my exam?

The process can take a few weeks to several months, especially if additional medical evaluations are needed. If you have a complex medical history, expect potential delays as the FAA thoroughly reviews your case.

If I fail my medical exam, can I reapply in the future?

It depends on the reason for the failure. If your condition improves or is successfully treated, you may undergo a new medical evaluation and reapply once you meet the required medical standards.