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What is a Civil Surgeon?

Medically Reviewed by Sarah Goodell on November 09, 2022

Civil surgeons are doctors who perform medical exams on immigrants to the United States — in particular, those seeking permanent residency or certain types of visas. They are licensed doctors who have at least four years of experience working in their chosen specialty. To become a civil surgeon, doctors must be certified by the United States Citizen and Immigration Services (USCIS).

A civil surgeon may or may not specialize in performing surgery outside of immigration exams. Surgery is not part of these exams. They include testing for infectious diseases, vaccinations, and a mental and physical examination. The doctor performing the exam is responsible for ensuring it follows all of the guidelines outlined by the U.S. Centers for Disease Control and Prevention (CDC).

If candidates receive an immigration medical exam from someone who is not a civil surgeon, the exam won’t qualify, and they will have to seek another exam from a certified civil surgeon. 

What Does a Civil Surgeon Do?

Civil surgeons perform immigration medical exams using steps outlined in the CDC’s Technical Instructions for Medical Examinations of Aliens in the United States

First, civil surgeons verify that the person attending the appointment is the person applying for immigration status. Then, they perform a thorough examination, including:

  • A detailed history check that looks into hospitalizations, illnesses, drug use, psychiatric conditions, and harmful behavior
  • A review of other records, like police reports or school records that may have other information about health history
  • A physical and mental examination intended to discover certain severe conditions
  • Administration of vaccinations

Civil surgeons do not treat any conditions diagnosed in the examination. Immigration candidates should seek out their own medical care after the exam if needed.

The U.S. government asks civil surgeons to search for Class A and Class B conditions. Class A conditions render a person ineligible for admission to the United States. They include:

Class B conditions do not necessarily exclude someone from admission to the United States but do present a significant challenge for the person with the condition. A class B condition may affect someone's ability to work or attend school, or it may require a lot of medical treatment in the future. 

After the medical exam, the civil surgeon completes and signs form I-693, which the immigration candidate then submits to the Immigration and Nationalization Service (INS). Civil surgeons do not determine your eligibility for a Green Card or visa — they only perform the medical exam.

Education and Training

Civil surgeons have completed medical school and are licensed doctors. They are either MDs or DOs. Once they have been working and out of medical school for four years, they can apply to become designated by the U.S. government as a civil surgeon.

The certification process includes a filing fee and verification of the doctor's:

  • Immigration status
  • Current medical license
  • Medical degree
  • Employment

All military doctors are civil surgeons by default and do not need to seek additional certification to perform immigration medical exams.

Reasons to See a Civil Surgeon

If you need an immigration medical examination, you need to see a civil surgeon. An exam with a certified civil surgeon is only required for those who are already in the United States seeking an adjustment to their immigration status.

Outside of the U.S., Department of State panel doctors perform these exams.

What to Expect at the Civil Surgeon

The first step to getting an immigration medical exam is to use USCIS's "find a doctor tool" to find a civil surgeon near you. 

Before you go to the civil surgeon, decide how you will file your exam with your application. You can get the exam before you send in your application. You’ll then send in the results on Form I-693 when you begin the application process.

You can also get the exam after submitting your application. In this case, you’ll either file your results after you've already sent your application, or bring them with you to your immigration interview.

Make sure to bring the following to the exam:

  • Government ID (usually a driver's license or passport)
  • Medical records including vaccination records
  • A blank copy of Form I-693

If you have ever had tuberculosis, syphilis, significant mental illness, or substance abuse in your past, you will need a letter from your doctor detailing the treatment and prognosis. You should also bring payment to the exam. The cost varies by provider.

The civil surgeon will start by asking you a number of questions about your mental and physical health. Many of the questions will be concerned with either Class A or Class B conditions.

The exam includes a tuberculosis test for anyone over the age of two. If your test comes back with any signs of the disease, you will need to return to the civil surgeon for chest x-rays. For anyone over the age of 15, the exam also includes a blood and urine test for syphilis and gonorrhea. 

Finally, the civil surgeon will review your vaccination records and administer any vaccinations you may be missing. The vaccines required for adjustment to immigration status are:

COVID-19

However, civil surgeons must follow age-appropriate guidelines for vaccine administration. So, your child will only receive the vaccinations that are safe for their age group.

Once the exam is complete, the civil surgeon will fill out and sign Form I-693. It’s up to you to submit it in a sealed envelope and complete the rest of your application.

Show Sources

SOURCES:

Centers for Disease Control and Prevention: "CDC Immigration Requirements: Introduction and Background to the Technical Instructions."

Centers for Disease Control and Prevention: "Vaccination Technical Instructions for Civil Surgeons."

Centers for Disease Control and Prevention: "Medical History and Physical Examination."

Centers for Disease Control and Prevention: "Tuberculosis Technical Instructions for Civil Surgeons."

Centers for Disease Control and Prevention: "Technical Instructions for Civil Surgeons."

Centers for Disease Control and Prevention: "CDC Immigration Requirements: Technical Instructions for Syphilis for Civil Surgeons."

Centers for Disease Control and Prevention: "CDC Immigration Requirements: Technical Instructions for Gonorrhea for Civil Surgeons."

American Academy of Pediatrics: "How to Apply to Be a Civil Surgeon."

United States Citizenship and Immigration Services: "Finding a Medical Doctor."

United States Citizenship and Immigration Services: "Chapter 2 - Application for Civil Surgeon Designation."

United States Citizenship and Immigration Services: "Designated Civil Surgeons."

United States Citizenship and Immigration Services: "Blanket Civil Surgeon Designation."

United States Citizenship and Immigration Services: "Chapter 2 - Medical Examination and Vaccination Record."

United States Citizenship and Immigration Services: "Chapter 6 - Communicable Diseases of Public Health Significance."

United States Citizenship and Immigration Services: "Find a Doctor."

Centers for Disease Control and Prevention: "Haemophilious Influenza Disease (Including Hib)."

United States Citizenship and Immigration Services: "Chapter 4 - Review of Medical Examination Documentation."

United States Department of State - Bureau of Consular Affairs: "Medical Examination FAQs."

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