A civil surgeon is a doctor specifically designated by U.S. Citizenship and Immigration Services (USCIS) to perform medical examinations for people applying for a green card (permanent residence) inside the United States. The term has nothing to do with surgery. It refers to a licensed physician authorized to evaluate whether an immigration applicant meets the health-related requirements of U.S. immigration law.
What a Civil Surgeon Actually Does
When you apply to adjust your status to permanent resident while living in the U.S., you need a medical examination. A civil surgeon conducts that exam and records the results on Form I-693, the Report of Immigration Medical Examination and Vaccination Record. This form gets submitted to USCIS along with your green card application.
During the appointment, the civil surgeon checks for specific health conditions that could affect your admissibility. They also review your vaccination history and administer any required vaccines you’re missing. The exam typically includes a physical examination, a review of your medical history, and sometimes blood tests or other screenings depending on your age and risk factors.
Who Qualifies as a Civil Surgeon
Not just any doctor can perform an immigration medical exam. USCIS has strict requirements for designation:
- Medical degree: The physician must hold either an M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) degree.
- Unrestricted state license: They must be licensed to practice medicine without restrictions in the state where they perform the exams.
- Four years of post-training experience: The doctor needs at least four years of professional practice after completing all training, including residency. Internships and residencies do not count toward this requirement.
Nurse practitioners, physician assistants, chiropractors, podiatrists, and other healthcare professionals who are not licensed M.D. or D.O. physicians cannot serve as civil surgeons. Military physicians can be designated as “military blanket designated civil surgeons” to perform immigration exams at military treatment facilities for veterans, service members, and their dependents.
Civil Surgeons vs. Panel Physicians
If you’re applying for a green card from inside the U.S. (adjustment of status), you see a civil surgeon. If you’re applying from outside the U.S. through a consulate or embassy, you see a panel physician instead. Panel physicians are appointed by the Department of State, not USCIS, and they operate in foreign countries. A panel physician cannot perform the exam for someone adjusting status within the U.S., and a civil surgeon cannot substitute for a panel physician abroad. The two roles serve the same basic function, screening applicants for health-related inadmissibility, but they operate under different authorities and in different jurisdictions.
Health Conditions That Affect Admissibility
The civil surgeon evaluates you for two categories of medical findings. Class A conditions can make you inadmissible, meaning they could block your green card. There are four types:
- Communicable diseases of public health significance
- Missing required vaccinations
- A physical or mental disorder with associated harmful behavior (past or present, if the behavior is likely to recur)
- Drug abuse or addiction
Class B conditions are serious or permanent health issues that don’t make you inadmissible on their own but are still noted on the form. These are conditions that could interfere with your ability to care for yourself, attend school, or work, or that may require significant medical treatment in the future. A Class B finding doesn’t block your application, but USCIS is made aware of it.
Required Vaccinations
One of the civil surgeon’s main responsibilities is confirming you’re up to date on vaccines recommended by the CDC’s Advisory Committee on Immunization Practices. The current list of required vaccinations covers 15 diseases: diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, rotavirus, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, meningococcal disease, varicella (chickenpox), pneumococcal disease, and influenza. Which specific vaccines you need depends on your age. If you can show proof of prior vaccination or blood test evidence of immunity, you won’t need every shot on the list.
Bring any vaccination records you have to your appointment. Records from other countries are accepted as long as they’re legible and contain enough detail for the civil surgeon to verify what was given. Missing records typically mean you’ll need to get vaccinated again or have blood drawn to check for immunity.
How Long the Exam Results Stay Valid
This is an area where the rules have recently shifted. In April 2024, USCIS announced that a Form I-693 signed on or after November 1, 2023, would be valid indefinitely. That policy was reversed. As of June 2025, a Form I-693 signed on or after November 1, 2023, is only valid while the specific application it was submitted with is still pending. If that application is withdrawn or denied, the form is no longer valid, and you would need a new exam for any future application. USCIS said the indefinite validity policy was “overly broad and could potentially threaten public health.”
How to Find a Designated Civil Surgeon
USCIS maintains an online search tool at uscis.gov where you can enter your address, city, state, or ZIP code to find designated civil surgeons near you. This is the only reliable way to confirm a doctor currently holds the designation. Costs for the exam vary by provider and location, typically ranging from a few hundred dollars to over $500 depending on which vaccinations you need. The exam is not covered by most insurance plans since it’s considered an immigration requirement rather than a standard medical visit.
When scheduling, ask what the appointment includes and whether vaccines are administered on-site or if you’ll need to get them elsewhere first. Some civil surgeons handle everything in one visit, while others require you to return after completing vaccinations at a pharmacy or health department. The process from first appointment to receiving your completed Form I-693 can take anywhere from a single day to a few weeks, depending on whether lab results or additional vaccines are needed.