General medical condition

This regulation sets the general medical standards for a first-class medical certificate (required for airline transport pilots).

You cannot hold a first-class medical if you have diabetes controlled by insulin or other blood-sugar-lowering medications. Beyond that specific condition, the Federal Air Surgeon evaluates whether any medical condition, medication, or treatment makes you unable to safely perform pilot duties—either now or during the certificate's validity period.

This is a catch-all provision. Even if your condition isn't specifically listed elsewhere in Part 67, the FAA can deny or revoke your medical certificate if they determine it affects flight safety. The Federal Air Surgeon makes these determinations based on your medical history and expert medical judgment about your specific situation.

In practice, this means Aviation Medical Examiners report conditions that might affect safety, and the FAA reviews borderline cases individually. Many conditions can be approved through the special issuance process if you can demonstrate you can fly safely.

*This is a plain-English summary for study only. The official 14 CFR text on this page is controlling — always read the current regulation and consult a CFI.*