Do I actually need a fit to fly letter or is it overkill?

Flying five weeks after keyhole surgery on my knee. Someone at my physio mentioned a "fit to fly letter" and now I am second guessing whether I need one, or whether that is one of those things people do to feel organised.

Is this an actual airline requirement or a nice-to-have? And is it the same as the medical clearance form thing I have also seen mentioned, or two different things? Genuinely confused about which bit is which.

They are two different things and it took me a while to get this straight too, so you are not being slow.

The airline's medical clearance form, often called a MEDIF, is the airline deciding whether it will carry you given a recent operation or condition. That is their process, it goes to their medical desk, and you usually want to allow around 48 hours for it. The fit-to-fly letter is separate: it is your surgeon confirming that you personally are fit to travel, usually dated within about 10 days of the flight so it is current.

Whether you specifically need either one at five weeks after keyhole knee surgery depends on the airline and on your surgeon, so ring the airline and ask if they want a MEDIF for your situation. I got the letter for my knee even when I was not certain the airline required it, simply because it cost me nothing and it meant that if anyone at the gate asked a question, I had the answer in my bag instead of a shrug. The whole clearance process is written up in medical clearance to fly after surgery.

Get the letter. I did not for one trip, got asked at check-in whether I had recently had surgery because I was moving stiffly, and had a stressful ten minutes I could have skipped for the sake of one sheet of paper. It is the cheapest insurance there is.

That makes sense, thank you both. Ringing the airline today to ask about the MEDIF and I will get the surgeon to do a letter regardless. Better to carry it and not need it.

While you are getting organised, make sure you have told your travel insurer about the operation too. Different piece of paper, same principle, and the one that actually bites people if they skip it.