Overseas Medical Exam for Refugees

Before being admitted to the United States as a refugee, individuals undergo a comprehensive medical examination overseas conducted by a panel physician designated by the U.S. Department of State or the International Organization for Migration (IOM). This exam screens for communicable diseases, mental health conditions, and other health issues.

The overseas exam results in a medical record that is transmitted to the U.S. Centers for Disease Control and Prevention (CDC) and to state and local health departments. Refugees are typically referred to domestic health providers for follow-up care upon arrival.

Adjusting Status: When Is a New Exam Required?

Refugees who file Form I-485 to adjust status to lawful permanent residence one year after admission are generally not required to complete a full new civil surgeon examination if their overseas exam was recent and complete. USCIS may accept the overseas exam results in lieu of a new I-693 in certain circumstances.

However, USCIS may require a civil surgeon examination if the overseas exam is outdated, if there are outstanding medical conditions that were not resolved, or if the refugee has Class A or Class B medical conditions that require follow-up. Refugees should consult with an immigration attorney and a civil surgeon to determine whether a new exam is needed.

• Overseas exam may satisfy I-485 medical requirement in some cases
• New civil surgeon exam required if overseas exam is outdated
• New exam required if Class A or B conditions are unresolved
• TB follow-up requirements must be completed
• Consult an immigration attorney about your specific situation

TB Follow-Up Requirements for Refugees

Tuberculosis screening is a critical component of the refugee medical process. Refugees with positive TB test results or Class B TB conditions from their overseas exam are required to complete domestic TB follow-up with a state or local health department or a qualified healthcare provider.

USCIS and the CDC require documentation that TB follow-up has been completed before a refugee's I-485 can be approved. The civil surgeon may need to document TB follow-up status on Form I-693 if a domestic exam is required.

Vaccination Requirements for Refugees Adjusting Status

Refugees adjusting status must meet the same vaccination requirements as other I-485 applicants. If the overseas exam did not include all required vaccines, or if vaccines have been added to the USCIS required list since the overseas exam, a civil surgeon may need to administer missing vaccines and document them on Form I-693. Refugees should bring all vaccination records from their overseas exam and any domestic vaccinations to their civil surgeon appointment.