Cadet Medical Standards: Prepare for Your Aviation Medical in Hong Kong

A detailed guide to the Class 1 and Class 2 medical certificate requirements for aspiring pilots in Hong Kong, including preparation tips, common disqualifiers, and what to expect during the examination.

For anyone serious about becoming a pilot in Hong Kong, passing the aviation medical examination is a non-negotiable step. Whether you are applying to a cadet programme, starting a Private Pilot Licence (PPL), or aiming for a Commercial Pilot Licence (CPL), you must hold a valid medical certificate issued by the Civil Aviation Department (CAD) or an approved medical examiner. The standards are set by the International Civil Aviation Organization (ICAO) and are implemented locally by the CAD under the Air Navigation (Hong Kong) Order 1995.

This article explains the differences between Class 1 and Class 2 medical certificates, outlines the specific tests and thresholds, and offers practical advice on how to prepare, physically, mentally, and administratively, so that you can approach your medical with confidence. The information is based on publicly available CAD guidance, ICAO Annex 1, and common practices among Hong Kong aviation medical examiners.

Understanding the Two Classes of Medical Certificate

The ICAO framework defines two main classes of medical certificate relevant to aspiring pilots in Hong Kong. Your choice depends on the type of licence you intend to hold.

Class 2 Medical Certificate

A Class 2 medical certificate is required for a Private Pilot Licence (PPL), a Glider Pilot Licence, or a Balloon Pilot Licence. It is also the minimum standard for student pilots flying solo. The examination is less stringent than Class 1, but still covers vision, hearing, cardiovascular health, and general fitness. In Hong Kong, Class 2 medicals are conducted by CAD-authorised medical examiners, who are usually general practitioners or specialists with aviation medicine training.

The validity period for a Class 2 certificate depends on your age at the time of examination:

Under 40 years old: valid for 60 months (5 years).
40 to 49 years old: valid for 24 months (2 years).
50 years and older: valid for 12 months (1 year).

For more context on how the medical fits into the broader licensing process, see our article on Eligibility Requirements in Hong Kong.

Class 1 Medical Certificate

A Class 1 medical certificate is required for a Commercial Pilot Licence (CPL), an Airline Transport Pilot Licence (ATPL), and for most cadet programmes. The standards are stricter, particularly for vision, blood pressure, and electrocardiogram (ECG) findings. Class 1 medicals must be conducted by a CAD-appointed Aeronautical Medical Examiner (AME) who is specifically trained to assess pilots for commercial operations.

Validity periods for Class 1 certificates are shorter:

Under 40 years old: valid for 12 months (1 year).
40 to 59 years old: valid for 6 months.
60 years and older: valid for 6 months (with additional tests).

If you are aiming for a career in the cockpit, you should start with a Class 1 medical to avoid surprises later. Many Hong Kong cadet programmes, such as those offered by Cathay Pacific and Hong Kong Airlines, require a valid Class 1 certificate at the time of application. Read more in our guide to Cadet Programmes in Asia.

What the Examination Covers

The aviation medical examination is comprehensive. The CAD follows ICAO Annex 1, Part 4, which specifies detailed requirements for each body system. Below is a summary of the key areas assessed.

Vision and Colour Perception

Visual standards are among the most common reasons for medical disqualification. For Class 1, the minimum distant visual acuity is 6/9 in each eye separately, with or without correction. For Class 2, the standard is 6/12 in each eye. Near vision must be at least N5 (Class 1) or N8 (Class 2) at 30-50 cm. Intermediate vision (100 cm) is also tested for Class 1.

Colour vision is assessed using the Ishihara plates (24-plate edition) or the Farnsworth D-15 test. For Class 1, normal colour vision is required. For Class 2, a colour deficiency may be accepted if the applicant can safely perform airwork, but this is decided on a case-by-case basis by the CAD.

If you wear glasses or contact lenses, bring your current prescription. The examiner will check that your correction does not exceed +5.0 or -5.0 dioptres for Class 1 (or +5.0 to -6.0 for Class 2). Laser refractive surgery (LASIK/PRK) is generally acceptable, but you must wait at least three months post-surgery and provide a stable refraction report.

Hearing and Ear, Nose, and Throat (ENT)

Hearing is tested using pure-tone audiometry. For Class 1, the hearing threshold must not exceed 35 dB at any of the frequencies 500, 1000, 2000, and 3000 Hz in each ear separately. For Class 2, the limit is 40 dB. If you fail the pure-tone test, a speech discrimination test may be used as an alternative.

The examiner will also check for chronic conditions such as otitis media, perforated eardrum, or Meniere’s disease, which can affect balance. Sinusitis and severe allergies may require treatment or a specialist report before certification.

Cardiovascular System

The heart and blood vessels are scrutinised because sudden incapacitation in flight is catastrophic. For Class 1, a resting 12-lead ECG is mandatory for all applicants. For Class 2, an ECG is required only for those aged 40 or older, or if there is a history of heart disease.

Blood pressure must be below 155/95 mmHg on the day of examination for Class 1, and below 160/100 for Class 2. If your reading is higher, the examiner may allow a repeat test later the same day or request a 24-hour ambulatory blood pressure monitor report. Hypertension controlled by medication (e.g., ACE inhibitors, beta-blockers) is acceptable, but some medications (e.g., diuretics) may be restricted.

Other cardiovascular tests may include an exercise stress test or echocardiogram if there are risk factors such as family history of sudden cardiac death, elevated cholesterol, or diabetes.

Respiratory System

Asthma is a common condition that can be certified if well controlled. You will need to provide a lung function test (spirometry) and a report from your specialist. For Class 1, any asthma requiring regular medication must be assessed by the CAD Aeromedical Section. Inhaled corticosteroids and short-acting beta-agonists are generally acceptable; oral steroids are not.

Pneumothorax, tuberculosis, or sleep apnoea may require additional evaluation. If you use a CPAP machine for sleep apnoea, bring a compliance report showing usage of at least 6 hours per night on 70% of nights.

Neurological and Psychiatric Conditions

Any history of epilepsy, seizures, or unexplained loss of consciousness will likely result in a denial or deferral. The CAD requires a minimum of 10 years seizure-free without medication for Class 1. For Class 2, the period is 5 years. Migraines with aura may be acceptable if they are infrequent and not incapacitating.

Psychiatric conditions such as depression, anxiety, or bipolar disorder are assessed on a case-by-case basis. Mild, well-controlled depression with a single antidepressant (e.g., SSRIs like sertraline) may be certified after a specialist report. However, any history of psychosis, suicidal attempt, or substance dependence is disqualifying.

Other Systems

The examination also covers:

Urinalysis: to check for glucose, protein, and blood, indicators of diabetes or kidney disease.
Blood tests: haemoglobin, fasting blood glucose, and cholesterol (for Class 1 applicants over 40).
Body mass index (BMI): there is no hard limit, but a BMI over 35 may require additional tests for sleep apnoea and cardiovascular risk.
Musculoskeletal: any condition that limits full range of motion or strength may be disqualifying. Previous fractures or joint replacements require a functional assessment.

How to Prepare for Your Aviation Medical

Preparation should begin weeks, not days, before your appointment. Here are concrete steps you can take.

Gather Your Medical Records

Collect all relevant documents: your vaccination record, a list of current medications (including dosages), any hospital discharge summaries, specialist reports, and previous surgical notes. If you have a chronic condition, bring a letter from your treating doctor stating the diagnosis, treatment, and stability. The examiner will need to see a complete picture.

For a Class 1 medical, you will also need to complete the CAD Form 202 (Application for Medical Assessment), which is available on the CAD website. The form asks for detailed personal and family medical history. Fill it out honestly, any omission can lead to suspension or revocation of your licence later.

Optimise Your Vision and Hearing

If you wear glasses or contact lenses, have your prescription checked by an optometrist at least a month before the medical. For contact lens users, consider switching to glasses for the examination day to avoid any issues with dry eyes or lens fit. If you have had laser eye surgery, obtain a post-operative stability report from your surgeon.

For hearing, avoid loud noises (concerts, power tools, shooting ranges) for 48 hours before the test. If you have a history of ear infections, ask your ENT specialist to confirm that your eardrums are intact and your middle ear pressure is normal.

To understand how these standards relate to your overall training plan, read our Complete Guide to Learning to Fly in Hong Kong and the Region.

Manage Your Blood Pressure and Heart Health

High blood pressure is the most common reason for a deferred medical. Start monitoring your blood pressure at home using an approved upper-arm monitor. If your reading is consistently above 140/90, consult your GP. Lifestyle changes such as reducing salt intake, exercising 30 minutes daily, and limiting alcohol can help. If medication is needed, ensure it is on the CAD’s acceptable list (ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers are generally allowed).

For cholesterol, aim for a total cholesterol below 5.2 mmol/L and LDL below 3.0 mmol/L. If you are on statins, bring a recent lipid profile.

Watch Your Diet and Hydration

In the 24 hours before the examination, avoid caffeine, alcohol, and heavy meals. Caffeine can elevate blood pressure and heart rate. Alcohol can affect your ECG and liver function tests. Drink plenty of water to stay hydrated for the urine test. Avoid salty foods, which can raise blood pressure.

If you are diabetic or pre-diabetic, fast for at least 8 hours before the blood test. Bring a snack to eat immediately after the blood draw to prevent hypoglycaemia.

Get a Good Night’s Sleep

Sleep deprivation can raise blood pressure, impair cognitive function, and cause abnormal ECG findings. Aim for 7-8 hours of quality sleep the night before. If you have sleep apnoea, use your CPAP machine and bring the compliance data.

Common Disqualifiers and How to Avoid Them

Some conditions are almost always disqualifying for Class 1, but many can be managed or appealed with proper documentation.

Epilepsy: a single seizure after age 5 is disqualifying unless you can prove a benign cause (e.g., febrile seizure).
Diabetes requiring insulin: generally not acceptable for Class 1, though some states allow it with strict monitoring. Hong Kong CAD currently does not issue Class 1 to insulin-dependent diabetics.
Coronary artery disease: any history of heart attack, stent, or bypass surgery disqualifies you for Class 1, though a waiver may be possible after 6-12 months with excellent recovery and stress test results.
Psychiatric admissions: any hospitalisation for mental illness within the last 2 years is disqualifying. Longer periods may be accepted with a favourable psychiatrist report.
Substance dependence: alcohol or drug dependence is permanently disqualifying. A history of abuse may be considered after 2-5 years of abstinence with random testing.

If you have a known issue, consult an AME before applying. They can advise whether a waiver is possible and what tests you need. Delaying the medical until you are fully prepared can save you time and money.

Where to Get Your Medical in Hong Kong

The CAD maintains a list of approved AMEs for Class 1 and Class 2 examinations. As of 2025, there are approximately 12 AMEs in Hong Kong, most of whom are based at private hospitals or clinics. The Hong Kong Aviation Club also hosts periodic medical sessions for club members.

Typical costs:

Class 2 medical: HK$1,500, HK$2,500 depending on the clinic.
Class 1 medical: HK$3,000, HK$5,000, including ECG and basic blood tests.
Additional tests (e.g., audiometry, stress ECG, lung function) are charged separately, usually HK$500, HK$1,500 each.

Appointments can be booked directly with the AME. Wait times vary from 1-4 weeks. For cadet programme applicants, it is wise to book your medical early, as some programmes require the certificate to be submitted with the application. Check with your chosen flight school in Hong Kong for their specific requirements.

What to Do If You Are Denied or Deferred

A denial does not always mean the end of your flying dreams. You have the right to appeal to the CAD Aeromedical Section. The appeal process typically involves submitting additional medical reports, specialist opinions, and sometimes a re-examination. The CAD may grant a conditional certificate with operational limitations (e.g., with a safety pilot, or only during daytime).

If your condition is permanent, consider a Class 2 medical for a PPL instead of a Class 1. Many recreational pilots fly safely with conditions that would disqualify them from commercial operations. For a detailed comparison of the two classes, see our article on Medical Certificate Class 1 vs Class 2.

Also, keep in mind that the medical standards for cadet programmes can be more stringent than the CAD minimum. For example, Cathay Pacific’s Cadet Pilot Programme requires a Class 1 medical with no colour vision deficiency and no history of asthma after age 12. Always check the specific programme requirements before applying. Read about the Commercial Pilot Licence Path to understand how the medical fits into your career progression.

Conclusion

Passing your aviation medical is a milestone that requires preparation, honesty, and proactive health management. Start by understanding which class you need, gather your records, and address any health issues well in advance. The examination itself is thorough but not something to fear, most healthy individuals pass without difficulty. By following the steps outlined above, you can walk into the AME’s office with confidence and take one more step toward the cockpit.

The Complete Guide to Learning to Fly and General Aviation in Hong Kong and the Region
Eligibility Requirements for Pilots in Hong Kong
Medical Certificate Class 1 vs Class 2: What’s the Difference?
Cadet Programmes in Asia: A Comprehensive Guide
The Commercial Pilot Licence Path
Flight Schools in Hong Kong

Cadet Medical Standards: How to Prepare for Your Aviation Medical