FAA medical review timelines range from same-day AME issuance to about 30 working days after all required documents reach the FAA.
If you’re staring at MedXPress and wondering when you’ll hold a fresh medical in hand, the answer depends on who can make the call and whether your file is complete. Many pilots walk out of the exam with a certificate the same day. Others enter a review queue in Oklahoma City and wait until every required page lands on the examiner’s desk. The sections below lay out the usual paths, realistic ranges, and smart steps that shave days off the process.
FAA Medical Review Timeframes: What To Expect
There are three broad paths. First, an Aviation Medical Examiner (AME) can issue at the visit when standards are met. Second, the AME can defer the case to the FAA for review. Third, you may need a special issuance for conditions that call for periodic follow-up. The FAA states that, once it has everything it needs for non-special-issuance cases, processing runs within about 30 working days. Most pilots never hit that queue because their AME issues on the spot.
| Situation | Who Decides | Typical Timeline |
|---|---|---|
| Clean exam, meets standards | AME issues at visit | Same day (walk out with certificate) |
| Minor issue with documentation ready (e.g., stable hypertension with records) | AME issues using published pathways | Same day to a few days (office paperwork) |
| Deferral for FAA review (all requested docs already gathered) | FAA Aerospace Medical Certification Division (AMCD) | About 30 working days after FAA receives all info (FAA brochure) |
| Deferral with missing items (FAA will ask for more) | AMCD | Varies; add mailing/upload time and back-and-forth cycles |
| Special issuance needed (e.g., cardiac, diabetes protocols) | FAA with required tests and follow-ups | Several weeks to months, depending on test dates and queue |
| HIMS pathway (substance/alcohol or select mental health cases) | HIMS AME + FAA | Longer; driven by monitoring periods and reports |
Two facts shape everything: AMEs can issue on the spot when standards are met, and the FAA quotes a 30 working day window once it has a complete, non-special-issuance file. See the AME authority page for who can issue, defer, or deny, and the medical page for the process overview through MedXPress.
What Drives The Wait
Issuance At The Exam
Most applicants pass and receive the certificate at the visit. That’s straight from FAA safety brochures, which note that the large majority are cleared by the AME at the time of exam. If your history is straightforward and your exam lines up with Part 67 standards, you leave with the slip in your wallet.
Deferral To The FAA
When the AME can’t issue, the file goes to the Aerospace Medical Certification Division. The FAA’s own brochure states it will process non-special-issuance cases within 30 working days after all needed medical information arrives. That clock doesn’t start until the last lab, letter, or test report hits the system. Any missing item pauses the march.
Special Issuance Cases
Some conditions trigger special issuance protocols. Expect more steps: specific tests, clear time windows for those tests, and follow-up notes from treating clinicians. The timing depends on how fast you can complete the tasks and how quickly the documents reach the reviewers. The FAA’s AME Guide is updated monthly, so your AME checks current criteria before submitting a recommendation.
File Completeness And Quality
Thin or mismatched documentation drives repeat letters and extra weeks. Tight packets move faster. Think legible scans, dated test results, and doctor narratives that answer the FAA’s exact questions. Upload or mail through the channels your AME prefers so the documents tie cleanly to your case.
MedXPress And Status Tracking
Use MedXPress for the application, and watch status updates during review. The FAA added a tracking feature so applicants can follow progress online. That feed won’t jump every day, but it confirms when the office logs new material. If files sit with no change past the normal window, it’s time to call or coordinate with your AME.
Practical Ranges By Scenario
Below are realistic windows pilots often see. These aren’t promises; they roll up the FAA’s stated standard plus everyday experience from AMEs and airmen.
Same-Day Outcomes
- Healthy history, clean exam, no disqualifying meds.
- Common, well-controlled conditions that fit an AME worksheet pathway where you brought records to the visit.
About A Month After A Complete Submission
- Deferral sent with a full packet already assembled.
- Non-special-issuance review where every requested item is present.
Several Weeks To A Few Months
- Special issuance that requires scheduled tests, waiting for results, and a physician’s narrative.
- Cases that ping-pong because the FAA asks for clarifications or newer labs.
Actions That Speed Things Up
The fastest path is walking in ready for the AME to issue. When that isn’t possible, stack the deck with a complete, orderly file so the FAA can close your case in a single pass.
Prep Before The Exam
- Pre-brief with your AME. Ask what the current guide requires for your condition and gather exactly that. The guide posts updates monthly, so criteria can shift.
- Bring primary records. Office notes, test results, medication lists with doses, and clear dates. Keep them in one PDF or neat packet.
- Use MedXPress early. Fill the application, double-check answers, and print the confirmation for the visit. MedXPress reduces office time and speeds transmission.
If You’re Deferred
- Read the letter line by line. It spells out exactly what’s missing. Answer every bullet in one response rather than mailing piecemeal.
- Submit clean, legible scans. Blurry labs lead to extra requests. Label files with your name, date of birth, and content.
- Track the case. Watch MedXPress status updates. If nothing changes after a reasonable window, your AME can nudge the office.
When Special Issuance Applies
Map the testing calendar the day you leave the AME. Book labs and imaging right away, and queue follow-up visits so your physician can write a single, comprehensive letter. Many weeks slip away when results trickle in.
Where To Check Official Details
Two FAA links are worth saving to your bookmarks. The Medical Certification page explains MedXPress and the overall process, and the Medical Certification Q&A brochure explains common outcomes, including same-day issuance and when a case goes to review. For timing language on non-special-issuance cases, see the FAA’s medical brochure that cites “30 working days” after a complete file is received.
When To Call Or Escalate
If your case sits past the normal window and MedXPress shows no movement, call the Aerospace Medical Certification Division. Keep your reference number ready, and note the date and name of the person you speak with. Contact details are posted on the FAA’s site.
Second Table: Speed-Up Checklist And Why It Works
Use this compact checklist once you leave the exam. It’s designed to keep you out of the “send one more thing” loop.
| Action | Why It Helps | Where To Do It |
|---|---|---|
| Ask your AME for a document list tailored to your case | Prevents gaps that trigger extra letters | At the visit; based on the AME Guide |
| Bundle all requested items in one submission | Starts the “complete file” clock | AME office upload or mail to AMCD |
| Book tests immediately with earliest dates | Cuts idle time between deferral and review | Your clinic or imaging center |
| Give treating doctors a sample FAA letter format | Ensures the narrative answers the FAA’s questions | From your AME or advocacy groups |
| Watch MedXPress status weekly | Confirms receipt and flags stalls | MedXPress portal |
| Call if no change beyond the usual window | Prompts a status check in the office | AMCD contact line |
Key Points About Timelines
Most Cases Are Issued At The Exam
The majority of applicants leave with a certificate. That single fact is the best “timeline” there is: same day, no waiting line.
For FAA Review, The Clock Starts With A Complete File
Non-special-issuance reviews move in roughly 30 working days after the office has every page it asked for. If you send pieces over several weeks, expect the window to reset as each item arrives.
Special Issuance Takes Longer
Extra testing and follow-up letters add calendar time. Your pace in scheduling tests and collecting notes drives most of it.
Common Questions Pilots Ask The AME (Answered Briefly)
“Can I Fly While I Wait?”
If your previous medical has expired or your application is still pending without an unrestricted certificate issued, you can’t act as PIC under that class. Certain paths like BasicMed have separate rules; talk to your AME about eligibility before you plan a flight.
“What If I Spot An Error In My Application?”
Tell your AME right away. Corrections are easier while the case is still local to the AME and before it moves to review.
“Who Do I Call For Status?”
Start with your AME, then call the Aerospace Medical Certification Division using the contact info on the FAA website. Have your reference number and dates ready.
How To Build A Clean Packet
Make Documents Easy To Read
- Combine multi-page reports into one PDF per topic (e.g., “Cardiology-Visit-2025-06-12.pdf”).
- Keep scan resolution sharp and pages in order.
- Include chart notes, test results, and medication lists with current doses.
Answer The FAA’s Prompts Directly
- If the letter asks for “fasting labs within 90 days,” don’t send last year’s panel.
- If it asks for “physician narrative addressing diagnosis, stability, prognosis,” make sure your doctor covers each word.
Mind The Dates
Time windows matter. Many protocols require testing within a set period before the FAA reads your file. Book early so you aren’t waiting on a lab slot while your case sits idle.
Putting It All Together
Here’s a simple way to think about timing. If your AME can issue, you’re done that day. If your case goes to the FAA and isn’t a special issuance, plan on roughly a month after the office receives a complete set of documents. If you need a special issuance, the calendar stretches based on testing schedules and reporting. Your best lever is completeness: one clean packet, fast.
Useful references: the FAA’s Medical Certification page covers MedXPress and the exam flow, and the FAA’s status tracking announcement shows where to follow your case online.
Need to reach the office? The FAA lists phone and mail details for the Aerospace Medical Certification Division on its contact page.