F-1 to Green Card Pathways

F-1 international students can pursue a green card through several pathways: marriage to a U.S. citizen or permanent resident, employer sponsorship (typically after completing OPT or STEM OPT), self-petition for extraordinary ability (EB-1A), or national interest waiver (EB-2 NIW). Each pathway requires filing Form I-485 to adjust status.

Regardless of which pathway you use, if you are adjusting status in the United States, you must complete an immigration medical exam with a USCIS-designated civil surgeon.

Medical Exam Requirement for I-485

All I-485 applicants must complete an immigration medical examination with a USCIS-designated civil surgeon and submit Form I-693. F-1 students are not exempt from this requirement. The university health center or student health services cannot complete the I-693 unless they are a USCIS-designated civil surgeon.

The exam must be completed by a civil surgeon — a physician specifically designated by USCIS. You can find a civil surgeon near you using the USCIS civil surgeon locator at uscis.gov.

What the Exam Covers

The immigration medical exam covers a complete physical examination, tuberculosis testing, required laboratory tests, and a vaccination review. The civil surgeon will administer any missing required vaccines.

International students often have gaps in their vaccination records, particularly for vaccines that are not routinely administered in their home countries. Common gaps include MMR, varicella, hepatitis A, and meningococcal vaccines. The civil surgeon will review your records and administer any missing vaccines.

Timing With OPT Expiration and I-485 Processing

If you are on OPT or STEM OPT, your authorized stay is tied to your OPT authorization. Once you file Form I-485, you are generally protected from removal by the pending application. However, you should consult your immigration attorney about maintaining status during the transition.

Schedule your medical exam 2 to 4 weeks after your I-485 receipt notice. Do not wait until your OPT expires to schedule the exam.

Common Vaccine Gaps for International Students

International students from many countries may not have received all vaccines required for U.S. immigration. Common gaps include hepatitis A (not routinely given in many countries), meningococcal vaccine, HPV vaccine (if under 26), and varicella vaccine (if no history of chickenpox).

Bring all your vaccination records to the exam appointment, including records from your home country. If your records are in a foreign language, the civil surgeon can review them with translation assistance. Having records can reduce the number of vaccines you need at the appointment.

Practical Tips for F-1 Students

F-1 students should gather their vaccination records from their home country and from the university health center before the exam. If you received vaccines at your university, ask for an official vaccination record. Schedule your exam promptly after filing your I-485 to ensure the I-693 is ready before your USCIS interview.