There are really two seperate issues here: 1) getting a first-class medical and 2) getting a job.

If you can get a first class medical, you can probably get a job at a regional, charter, or corporate operation. Some don't ask any medical questions, they just want to see your certificate.

However if your medical is a "Special Issuance" (it will say that on the medical), the rumor is that that could be a problem with some airlines, especially majors. I think some even say that on their web sites...do a little research there.

Check out these guys...they have a lot of experience with these kinds of problems and provide some free info.
http://www.aviationmedicine.com/inde...useaction=home

Your local AME could sort out the medical itself, but he may not know much about airline hiring limitations.

Good Luck