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Pilot Health: How Pilots Are Checked, Body and Mind

3 min read

The short answer

Airline pilots have regular medical checks — every 6 or 12 months — covering both body and mind. In Europe, they also pass a psychological assessment before joining an airline. Every airliner has at least two fully trained pilots, each able to fly it alone. A pilot becoming unwell in flight is rare, and a pilot deliberately causing harm is extremely rare.

Two Pilots, Every Flight

Every airliner flies with at least two fully qualified pilots. Either one can fly and land the plane alone. They practise in the simulator for the moment one becomes unwell, so the other can take over smoothly.

Regular Medicals: Body and Mind

To fly an airliner, a pilot needs the highest class of medical certificate. It's renewed every 12 months, and in many cases every 6 months as pilots get older. The check covers the heart, eyesight, hearing, blood pressure and more — including mental health.

In Europe and the UK, a pilot's very first medical includes a full mental health assessment. Later checks also look at stress and wellbeing. In the US, the regulator updated its guidance in 2024. It now encourages pilots to seek help early for common issues like anxiety or low mood.

Checked Before Joining an Airline

Since 2021, European airlines must give every new pilot a psychological assessment before they start flying. Pilots and cabin crew in Europe also face random alcohol tests, and new crew are tested for drugs. US airline pilots face random drug and alcohol tests too.

Support When Life Gets Hard

Pilots are human, and like anyone they can go through difficult times. Since 2021, every European airline must give its pilots access to a confidential peer support programme. Trained fellow pilots, backed by mental health professionals, help colleagues early — without punishment.

This makes flying safer. When pilots can ask for help without fear, problems are spotted and treated early.

Fit to Fly, Every Day

Before every flight, pilots must be sure they're fit to fly. If they feel unwell, too tired or under strain, they're expected to step off duty — and the rules back them up. Read about pilot rest rules.

The two pilots also look out for each other. They're trained to notice when a colleague isn't themselves, and to speak up.

How Rare Problems Are

  • A pilot becoming unwell during a flight is rare. A US study found it happened about once every 1.7 million flying hours. Even then, the second pilot is trained to take over.
  • A pilot deliberately causing harm is extremely, extremely rare. Researchers who reviewed every known case found only a handful on passenger airlines, over several decades. Meanwhile, around 38 million flights take off every year.

If You've Seen the Recent News

Cases like the one in the news in autumn 2026 are reported around the world because they're so unusual. Read why headlines make rare events feel common.

In that case, people on board acted fast. The plane landed safely, and the airline confirmed that all passengers were safe. Investigators are now studying what happened. As always in aviation, the lessons will be used to make the checks even stronger.

The Bottom Line

Airline pilots are among the most closely checked professionals in the world. Regular medicals, mental health checks, peer support, random testing and a second trained pilot on every flight all work together. You can sit back and let them do their job.

Sources

Keep reading

How Pilots Are Trained

The years of training and regular testing that make airline pilots some of the most qualified professionals anywhere.

Pilot Rest: How Tiredness Is Prevented

The strict rules on how long pilots can fly and how much rest they must have.

Cockpit Security: Why Hijackings Are So Rare

The locked, reinforced cockpit door, the screening of every passenger and bag, and the other layers of security that make hijackings extremely rare today.

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