Two Different Exams for Two Different Purposes

The overseas panel physician exam and the domestic civil surgeon exam serve different legal purposes and are governed by different federal agencies. The panel physician exam is conducted by a physician designated by the U.S. Department of State and satisfies the medical requirements for visa issuance. The civil surgeon exam is conducted by a physician designated by USCIS and satisfies the medical requirements for adjustment of status.

These are separate designations with separate protocols, separate forms (DS-2053 vs. I-693), and separate legal authorities. In most cases, completing one does not satisfy the requirement for the other.

When the Overseas Exam Is NOT Sufficient

For the vast majority of adjustment of status applicants, the overseas panel physician exam does not satisfy the I-693 requirement. This includes K-1 fiancé visa holders adjusting status after marriage, immigrant visa holders who entered the U.S. and then filed I-485, and most other applicants who had a consular processing exam before entering.

USCIS requires Form I-693 completed by a USCIS-designated civil surgeon for adjustment of status. The DS-2053 from a panel physician is not accepted in place of I-693.

• K-1 fiancé visa holders adjusting status: new civil surgeon exam required
• Immigrant visa holders filing I-485: generally need new civil surgeon exam
• Nonimmigrant visa holders adjusting status: new civil surgeon exam required
• DS-2053 is not accepted in place of Form I-693

When the Overseas Exam MAY Be Sufficient

Refugees who were admitted to the United States after completing an overseas medical examination through the refugee processing pipeline may not need a full new civil surgeon exam when filing I-485. USCIS may accept the overseas exam results in certain circumstances, particularly if the exam was recent and complete.

Additionally, some applicants who entered on an immigrant visa and then filed I-485 may be able to use their overseas exam results if the exam was conducted within a specific timeframe and meets USCIS requirements. This is a narrow exception and should be confirmed with an immigration attorney.

TB Follow-Up and the Domestic Exam

Even when an overseas exam is accepted for adjustment of status purposes, applicants with TB-related findings from their overseas exam must complete domestic TB follow-up. This may require a visit to a civil surgeon or a state/local health department to document that TB follow-up has been completed. The civil surgeon can assist with documenting TB follow-up status on Form I-693 if needed.