Two Separate Immigration Medical Exam Systems

The U.S. immigration system has two separate medical examination systems, each governed by a different federal agency. The panel physician exam is overseen by the U.S. Department of State and applies to applicants going through consular processing outside the United States. The civil surgeon exam is overseen by U.S. Citizenship and Immigration Services (USCIS) and applies to applicants adjusting status inside the United States.

These two systems have different requirements, different forms, different physicians, and different legal purposes. Understanding which system applies to you is essential for completing the correct exam.

Panel Physician Exam (Consular Processing)

The panel physician exam is conducted by a physician designated by the U.S. Department of State at a U.S. embassy or consulate abroad. Panel physicians are typically located in the applicant's home country or the country where the consular processing is taking place.

The panel physician completes Form DS-2053 (Medical Examination for Immigrant or Refugee Applicant) and submits the results directly to the U.S. embassy or consulate. The applicant does not receive a copy of DS-2053 to submit to USCIS — the form goes directly to the embassy.

• Performed by a U.S. Department of State-designated panel physician
• Conducted overseas at or near a U.S. embassy or consulate
• Results documented on Form DS-2053
• Form submitted directly to the embassy or consulate
• Required for immigrant visa applicants going through consular processing

Civil Surgeon Exam (Adjustment of Status)

The civil surgeon exam is conducted by a physician designated by USCIS inside the United States. Civil surgeons are located throughout the country and can be found using the USCIS Civil Surgeon Locator tool.

The civil surgeon completes Form I-693 (Report of Medical Examination and Vaccination Record) and seals it in an envelope. The applicant receives the sealed envelope and submits it to USCIS with their I-485 application. USCIS opens the sealed envelope when adjudicating the I-485.

• Performed by a USCIS-designated civil surgeon
• Conducted inside the United States
• Results documented on Form I-693
• Sealed envelope provided to applicant for submission to USCIS
• Required for adjustment of status applicants filing Form I-485

Key Differences at a Glance

The two exams are similar in content — both include a physical examination, TB testing, laboratory tests, and a vaccination review — but they differ in jurisdiction, form, physician designation, and submission process. The DS-2053 and I-693 are not interchangeable. If you complete a panel physician exam overseas and then need to adjust status inside the United States, you will need a new civil surgeon examination.