USCIS Civil Surgeon Designation Knowledge Assessment — Questions and Answers

Question 1: Who designates Panel Physicians?

The Centers for Disease Control and Prevention (CDC)
The Department of State (Correct answer)
Local health departments
USCIS

Correct answer: The Department of State

Panel Physicians are designated by the Department of State, specifically through U.S. embassies and consulates abroad. This designation ensures that medical examinations for visa applicants conducted overseas meet U.S. health standards and are performed by qualified medical professionals in the applicant's home country.

Question 2: During the physical examination component of the immigration medical exam, which body system is NOT explicitly required to be evaluated?

Cardiovascular system
Dental/oral cavity (Correct answer)
Lymph nodes
Neurological system

Correct answer: Dental/oral cavity

While civil surgeons perform a comprehensive exam, a full dental evaluation is not among the explicitly required body system assessments in the USCIS Technical Instructions for the immigration medical exam.

Question 3: How many doses of MMR (measles, mumps, rubella) vaccine are generally required to meet USCIS vaccination requirements?

2 doses (Correct answer)
3 doses
1 dose
4 doses

Correct answer: 2 doses

USCIS generally requires documentation of 2 doses of MMR vaccine, consistent with the U.S. childhood immunization schedule, unless serologic evidence of immunity is documented.

Question 4: What is the minimum years of professional experience typically required for a physician to apply for civil surgeon designation?

1 year of professional experience
Board certification with no minimum experience years
4 years of professional experience after completing training (Correct answer)
10 years in general practice

Correct answer: 4 years of professional experience after completing training

USCIS generally requires that applicants for civil surgeon designation have at least 4 years of professional experience in the practice of medicine.

Question 5: Which government agency grants civil surgeon designation to physicians in the United States?

Department of Health and Human Services (HHS)
U.S. Citizenship and Immigration Services (USCIS) (Correct answer)
American Medical Association (AMA)
Centers for Disease Control and Prevention (CDC)

Correct answer: U.S. Citizenship and Immigration Services (USCIS)

USCIS designates civil surgeons through its field offices; it is not the CDC or AMA that grants this specific immigration-exam authority.

Question 6: In what manner must Form I-693 be submitted to USCIS?

Mailed directly to USCIS by the civil surgeon
Faxed to the USCIS field office
Scanned and uploaded to the USCIS online portal by the applicant
In a sealed envelope signed by the civil surgeon across the seal (Correct answer)

Correct answer: In a sealed envelope signed by the civil surgeon across the seal

The completed Form I-693 must be given to the applicant in a sealed envelope with the civil surgeon's signature across the seal to maintain confidentiality and integrity.

Question 7: Which type of substance abuse finding is considered a Class A condition for immigration?

Use of prescription medications for pain management
Any past recreational drug use
Current drug abuse or addiction to a controlled substance (Correct answer)
Alcohol use disorder in remission for 2+ years

Correct answer: Current drug abuse or addiction to a controlled substance

Active drug abuse or drug addiction to a controlled substance is a Class A condition; historical abuse in sustained remission is not automatically disqualifying.

Question 8: What is the civil surgeon's responsibility regarding record retention for Form I-693?

No retention required after submission
Retain indefinitely in a USCIS-approved database
Keep a copy of Form I-693 in the applicant's file for at least 2 years (Correct answer)
Send a copy to CDC within 30 days

Correct answer: Keep a copy of Form I-693 in the applicant's file for at least 2 years

Civil surgeons are required to retain a copy of Form I-693 in the applicant's records for a minimum of 2 years.

Question 9: What is the civil surgeon's responsibility if an applicant presents with symptoms of an active communicable disease of public health significance during the exam?

Issue Form I-693 and attach a medical referral note
Report the case to local or state public health authorities and withhold Form I-693 pending full evaluation (Correct answer)
Complete Form I-693 and note the symptoms as Class B
Send the applicant to an emergency room without completing the exam

Correct answer: Report the case to local or state public health authorities and withhold Form I-693 pending full evaluation

Civil surgeons must report notifiable communicable diseases to public health authorities and must not finalize Form I-693 until an appropriate evaluation is completed.

Question 10: Which communicable diseases are classified as 'quarantinable diseases' by executive order and are automatically Class A for immigration?

Measles, mumps, and rubella
HIV, hepatitis B, and hepatitis C
Influenza, hepatitis A, and norovirus
Cholera, plague, smallpox, yellow fever, and viral hemorrhagic fevers (Correct answer)

Correct answer: Cholera, plague, smallpox, yellow fever, and viral hemorrhagic fevers

Executive Order 13295 designates cholera, plague, smallpox, yellow fever, and viral hemorrhagic fevers as quarantinable diseases, all of which are Class A for immigration.

Question 11: When performing the tuberculin skin test (TST), how many hours after placement must the result be read?

1 week after placement
24 hours after placement
Immediately after placement
48–72 hours after placement (Correct answer)

Correct answer: 48–72 hours after placement

The TST must be read between 48 and 72 hours after intradermal placement to accurately measure induration.

Question 12: Which mental health professional credential is acceptable for the specialist evaluation of an immigration applicant referred by a civil surgeon?

Only a board-certified psychiatrist
A licensed psychiatrist or licensed clinical psychologist (Correct answer)
Any licensed social worker
A certified addiction counselor without a doctoral degree

Correct answer: A licensed psychiatrist or licensed clinical psychologist

Referrals for mental health specialist evaluation should go to licensed psychiatrists or licensed clinical psychologists qualified to make DSM-based diagnoses.

Question 13: What action can USCIS take if a civil surgeon is found to be not following required exam protocols?

Require the physician to retake the designation exam
Issue a warning letter with no further action for first offense
Refer the case to the state medical board only
Revoke or suspend the physician's civil surgeon designation (Correct answer)

Correct answer: Revoke or suspend the physician's civil surgeon designation

USCIS has the authority to revoke or suspend a civil surgeon's designation for failure to follow required protocols or for other violations of USCIS policies.

Question 14: What is the civil surgeon required to do if an applicant is a child under age 11 and cannot complete the standard TB screening protocol?

Follow age-appropriate USCIS Technical Instructions for pediatric TB evaluation (Correct answer)
Skip TB screening entirely for children under 11
Require the parent or guardian to sign a TB exposure waiver
Refer the child to an infectious disease specialist before completing the exam

Correct answer: Follow age-appropriate USCIS Technical Instructions for pediatric TB evaluation

Civil surgeons must follow age-specific protocols outlined in the USCIS Technical Instructions, which provide modified TB screening approaches for young children who may not be appropriate candidates for standard adult protocols.

Question 15: What is the significance of the civil surgeon's signature and date on Form I-693 for validity purposes?

The form is valid from the date the applicant submits it to USCIS
The date only affects the vaccination record section
The signature and date start the 2-year validity clock for the form (Correct answer)
USCIS determines validity from the date of the blood draw, not the signature

Correct answer: The signature and date start the 2-year validity clock for the form

The 2-year validity period of Form I-693 begins on the date the civil surgeon signs the form, making the signature date critical for determining expiration.

Question 16: What is the purpose of the mental disorder and substance abuse section on Form I-693 in relation to public safety?

To assess insurance eligibility for mental health services post-admission
To screen for any diagnosed psychiatric condition, regardless of behavior
To ensure all applicants receive mental health treatment before admission
To identify conditions linked to harmful behavior that may pose a risk to public safety in the US (Correct answer)

Correct answer: To identify conditions linked to harmful behavior that may pose a risk to public safety in the US

The mental health section of Form I-693 is designed to identify whether an applicant's condition is associated with harmful behavior, thereby protecting public safety.

Question 17: What information must the civil surgeon include when completing the examination findings section of Form I-693 for a healthy applicant with no findings?

Leave all medical fields blank to indicate normal exam
Document normal findings for each required examination area and affirm no Class A or B conditions (Correct answer)
Write 'see attached records' without completing the form directly
Only complete the vaccination section and sign the form

Correct answer: Document normal findings for each required examination area and affirm no Class A or B conditions

Civil surgeons must affirmatively document normal or negative findings for each required examination category on Form I-693 and attest that no Class A or Class B conditions were identified.

Question 18: What is the purpose of the medical examination performed by a Panel Physician?

To assess the applicant's mental health
To check for communicable diseases and general health (Correct answer)
To evaluate the applicant's fitness for military service
To determine the applicant's financial stability

Correct answer: To check for communicable diseases and general health

The medical examination performed by a Panel Physician is crucial for identifying health-related grounds of inadmissibility. Its purpose is to check for communicable diseases of public health significance, certain physical or mental disorders, and to ensure the applicant meets general health requirements for U.S. immigration.

Question 19: What is the required syphilis test used in immigration medical exams?

Only a treponemal-specific test (FTA-ABS)
A nontreponemal test (RPR or VDRL) followed by a treponemal confirmatory test if reactive (Correct answer)
ELISA for syphilis antibodies
Darkfield microscopy

Correct answer: A nontreponemal test (RPR or VDRL) followed by a treponemal confirmatory test if reactive

Syphilis screening uses a nontreponemal test (RPR or VDRL), and any reactive result must be confirmed with a treponemal test.

Question 20: What follow-up is required after an immigration applicant is treated for Class A syphilis before their case is adjudicated?

Immediate re-examination by a second civil surgeon
A waiting period of one year before reapplying
Submission of a waiver application to USCIS
Documentation of completed treatment and follow-up serologic testing to confirm response (Correct answer)

Correct answer: Documentation of completed treatment and follow-up serologic testing to confirm response

After treatment for Class A syphilis, the applicant must provide documentation of completed treatment and serologic evidence of treatment response.

Question 21: Which laboratory tests are required to be documented in Part 3 of Form I-693?

Syphilis serology (RPR or VDRL) (Correct answer)
Complete blood count
Urinalysis
Lipid panel

Correct answer: Syphilis serology (RPR or VDRL)

Part 3 of Form I-693 requires documentation of syphilis serology, specifically the RPR or VDRL test result.

Question 22: Which of the following describes the appropriate action when a civil surgeon identifies a Class B tuberculosis condition?

Issue a vaccination waiver for all TB-related vaccines
Deny the applicant and report to CDC immediately
Complete Form I-693 with the finding noted and recommend follow-up treatment (Correct answer)
Refuse to complete the exam until the condition is fully treated

Correct answer: Complete Form I-693 with the finding noted and recommend follow-up treatment

For Class B TB conditions, the civil surgeon completes Form I-693 documenting the finding, and the applicant may be admitted with the condition noted, requiring follow-up evaluation and treatment after arrival.

Question 23: Which document accompanies Form I-693 when a civil surgeon finds a Class B condition?

A CDC quarantine order
A mandatory denial letter from USCIS
A mandatory surgical pre-authorization form
A written medical follow-up recommendation or notation on the form itself (Correct answer)

Correct answer: A written medical follow-up recommendation or notation on the form itself

For Class B conditions, the civil surgeon notes the condition on Form I-693 and may include a recommendation for follow-up care, but no separate denial document is issued.

Question 24: What must a civil surgeon do if an applicant has a documented history of prior varicella disease?

Order a varicella titer test only
Defer the decision to USCIS
Administer the varicella vaccine regardless
Document the history and waive the varicella vaccine (Correct answer)

Correct answer: Document the history and waive the varicella vaccine

A reliable history of prior varicella disease is considered acceptable evidence of immunity, and the civil surgeon may document this to waive the vaccine.

Question 25: What notation must the civil surgeon include when documenting a finding of active tuberculosis disease on Form I-693?

Class A – Tuberculosis, Active Disease, with supporting diagnostic results (Correct answer)
Class B1 – Tuberculosis, Pulmonary
Class C – Inactive Tuberculosis
Class D – Potential Tuberculosis

Correct answer: Class A – Tuberculosis, Active Disease, with supporting diagnostic results

Active tuberculosis disease must be classified as a Class A condition on Form I-693, with diagnostic findings documented to support inadmissibility.

Question 26: What is the civil surgeon's obligation if an applicant cannot afford the cost of required vaccinations?

Administer vaccines at no cost as required by USCIS
Direct the applicant to public health clinics or programs that may provide low-cost or free vaccines (Correct answer)
Waive vaccination requirements for financial hardship cases
Report the applicant to USCIS as non-compliant

Correct answer: Direct the applicant to public health clinics or programs that may provide low-cost or free vaccines

While USCIS does not require civil surgeons to provide free vaccines, civil surgeons may refer applicants to public health resources for low-cost vaccination options.

Question 27: A Civil Surgeon must be a licensed physician with at least how many years of experience in practice?

1 year
4 years (Correct answer)
10 years
5 years

Correct answer: 4 years

Civil Surgeons typically need to have a minimum of 4 years of professional experience in their field.

Question 28: A physician has been designated as a civil surgeon but moves to a different city. What must they do to continue performing immigration exams at the new location?

Obtain a new state medical license only
Notify USCIS of the change of address to update their designation information (Correct answer)
Reapply for civil surgeon designation from scratch
No action is needed; the designation is valid nationwide

Correct answer: Notify USCIS of the change of address to update their designation information

Civil surgeons must keep their contact information with USCIS current, including notifying USCIS of address changes, to maintain accurate designation records.

Question 29: Where are Panel Physicians usually located?

Any healthcare facility
Only in U.S. embassies
Only in academic hospitals
In designated clinics in the applicant's home country (Correct answer)

Correct answer: In designated clinics in the applicant's home country

Panel Physicians are usually located in designated clinics within the applicant's home country or country of residence, outside of the United States. This arrangement allows visa applicants to complete their required medical examinations locally before their visa interview at a U.S. embassy or consulate.

Question 30: What is the civil surgeon's responsibility after USCIS adjudicates an applicant's case?

Only retain records if the applicant's case was denied
Retain the applicant's medical records for the required period (at least 2 years) regardless of adjudication outcome (Correct answer)
Destroy the medical records once USCIS notifies of approval
Transfer all records to USCIS upon adjudication

Correct answer: Retain the applicant's medical records for the required period (at least 2 years) regardless of adjudication outcome

Civil surgeons must retain copies of Form I-693 and supporting medical records for at least 2 years regardless of the adjudication outcome.

Question 31: Which entity publishes the list of required vaccines for immigration purposes?

Department of State only
CDC, based on ACIP recommendations (Correct answer)
HHS Secretary without advisory input
USCIS independently

Correct answer: CDC, based on ACIP recommendations

CDC, drawing on ACIP recommendations, publishes the vaccination requirements that USCIS adopts for the immigration medical examination.

Question 32: Which professionals can serve as Panel Physicians?

MDs, DOs, and certain other licensed health professionals (Correct answer)
Only MDs
Only DOs
Any healthcare worker

Correct answer: MDs, DOs, and certain other licensed health professionals

Panel Physicians are typically Medical Doctors (MDs) or Doctors of Osteopathic Medicine (DOs). However, in some locations, other licensed health professionals, such as those with equivalent medical degrees recognized by the U.S. government, may also be designated to perform these specific immigration medical examinations.

Question 33: Under what circumstances does a mental disorder constitute a Class A condition for immigration purposes?

Whenever any DSM-5 diagnosis is present
Only when the applicant has been hospitalized for psychiatric care
When the applicant takes any psychotropic medication
When the disorder is associated with harmful behavior or a history of harmful behavior (Correct answer)

Correct answer: When the disorder is associated with harmful behavior or a history of harmful behavior

A mental disorder is a Class A condition only when it is associated with harmful behavior (to self or others) or there is a history of such behavior.

Question 34: Can an applicant receive a waiver for a Class A mental health or substance abuse condition?

No, Class A mental health conditions are never waivable
Yes, waivers may be granted by USCIS under specific circumstances (Correct answer)
Only if the applicant agrees to mandatory treatment in the US
Only if the condition is in complete remission for 10 years

Correct answer: Yes, waivers may be granted by USCIS under specific circumstances

USCIS may grant waivers for Class A mental health and substance abuse conditions, taking into account factors such as remission, treatment history, and public safety.

Question 35: When can a civil surgeon delegate portions of the immigration physical examination to another health professional?

The entire exam may be delegated to a nurse practitioner
Any portion can be delegated to any licensed healthcare worker
Only for specific components (like phlebotomy or vision screening), not for the overall exam or certification (Correct answer)
Civil surgeons cannot delegate any part of the exam

Correct answer: Only for specific components (like phlebotomy or vision screening), not for the overall exam or certification

Civil surgeons may delegate specific clinical tasks (such as blood draws) to qualified staff, but the overall examination and Form I-693 certification must be done by the civil surgeon personally.

Question 36: Which type of documentation may a civil surgeon request to verify an applicant's identity before conducting the immigration medical exam?

No identification is required by USCIS
Government-issued photo identification such as a passport or state ID (Correct answer)
Social Security number only
USCIS receipt notice alone

Correct answer: Government-issued photo identification such as a passport or state ID

Civil surgeons should verify the applicant's identity using government-issued photo identification to ensure the exam is conducted for the correct individual.

Question 37: At what age does pediatric care typically begin?

At age 2
At age 10
At age 16
At birth (Correct answer)

Correct answer: At birth

Pediatric care typically begins at birth, with pediatricians often providing initial assessments and care for newborns in hospitals. They then continue to monitor growth, development, and overall health through regular check-ups throughout childhood and adolescence.

Question 38: What must a civil surgeon document on Form I-693 if an applicant refuses a required vaccination?

Defer the exam until the applicant agrees to vaccination
Note the refusal and the reason, and advise the applicant to obtain a waiver (Correct answer)
Leave the vaccination section blank
Mark the applicant as inadmissible immediately

Correct answer: Note the refusal and the reason, and advise the applicant to obtain a waiver

If an applicant refuses a required vaccine, the civil surgeon must document the refusal and reason on Form I-693, and the applicant must apply for a waiver of the vaccination requirement.

Question 39: What standard diagnostic manual does USCIS instruct civil surgeons to use when classifying mental disorders?

DSM (Diagnostic and Statistical Manual of Mental Disorders) (Correct answer)
NIMH Diagnostic Guidelines
WHO Classification of Mental Disorders
ICD-10 only

Correct answer: DSM (Diagnostic and Statistical Manual of Mental Disorders)

Civil surgeons are instructed to use DSM criteria when classifying mental disorders for the immigration medical evaluation.

Question 40: Who retains the original completed Form I-693 — the civil surgeon, the applicant, or USCIS?

A copy goes to all three parties simultaneously
The civil surgeon retains the original
The applicant retains and submits it to USCIS (Correct answer)
USCIS receives it directly from the civil surgeon

Correct answer: The applicant retains and submits it to USCIS

The applicant receives the sealed Form I-693 from the civil surgeon and submits it to USCIS with their adjustment of status application.

Question 41: What is the definition of 'drug addiction' for immigration medical exam purposes?

Use of marijuana in states where it is not legally permitted
Any use of drugs more than once per month
A pattern of pathological substance use causing impaired functioning or distress, meeting DSM criteria for substance use disorder (Correct answer)
Physical dependence on any prescription medication

Correct answer: A pattern of pathological substance use causing impaired functioning or distress, meeting DSM criteria for substance use disorder

Drug addiction for immigration purposes means a substance use disorder meeting DSM diagnostic criteria, involving pathological use patterns and functional impairment.

Question 42: Which tuberculosis test is considered an acceptable alternative to the tuberculin skin test (TST) in immigration medical exams?

Chest X-ray alone
Interferon-Gamma Release Assay (IGRA) (Correct answer)
Sputum culture
QuantiFERON-TB skin patch

Correct answer: Interferon-Gamma Release Assay (IGRA)

IGRA (such as QuantiFERON-TB Gold or T-SPOT.TB) is an acceptable blood-based alternative to the TST for detecting latent TB infection.

Question 43: What must the mental health evaluation during the immigration medical exam assess for?

Workplace fitness and employability
Intelligence quotient and cognitive ability
History of depression and anxiety disorders only
Physical or mental disorders with associated harmful behavior, and substance abuse (Correct answer)

Correct answer: Physical or mental disorders with associated harmful behavior, and substance abuse

The mental health evaluation must assess for physical or mental disorders associated with harmful behavior and for substance abuse or addiction, which are Class A conditions grounds of inadmissibility.

Question 44: Which category of medical conditions found during a USCIS immigration medical exam renders an applicant inadmissible?

Class B conditions
Class A conditions (Correct answer)
Class D conditions
Class C conditions

Correct answer: Class A conditions

Class A medical conditions are grounds of inadmissibility under U.S. immigration law and include communicable diseases of public health significance, failure to have required vaccinations, and physical or mental disorders with harmful behavior.

Question 45: Which of the following physicians CANNOT perform immigration medical exams in the United States?

A family physician designated as a civil surgeon
A licensed US physician who has not been designated by USCIS as a civil surgeon (Correct answer)
A USCIS-designated civil surgeon with a D.O. degree
A board-certified internist who is also a designated civil surgeon

Correct answer: A licensed US physician who has not been designated by USCIS as a civil surgeon

Only USCIS-designated civil surgeons may perform immigration medical exams; a licensed physician who lacks USCIS designation is not authorized.

Question 46: Which sexually transmitted infection, when in its infectious stage, is classified as a Class A condition for immigration?

Herpes simplex virus (HSV)
Chlamydia
Syphilis, infectious stage (primary or secondary) (Correct answer)
Human papillomavirus (HPV)

Correct answer: Syphilis, infectious stage (primary or secondary)

Primary and secondary syphilis (infectious stages) are classified as Class A communicable diseases of public health significance for immigration purposes.

Question 47: For which population is a chest X-ray required as part of the tuberculosis evaluation during immigration exams?

All applicants regardless of age or TST results
Only applicants with respiratory symptoms
Applicants aged 15 and older with a positive TST or IGRA (Correct answer)
Only applicants born in high-TB-burden countries

Correct answer: Applicants aged 15 and older with a positive TST or IGRA

A chest X-ray is required for applicants aged 15 and older who have a positive TST or IGRA result to evaluate for pulmonary tuberculosis disease.

Question 48: For which group of applicants is the TST or IGRA waived during the immigration medical exam?

Applicants with documented prior BCG vaccination
Children under 2 years of age (Correct answer)
Applicants from low-TB-burden countries
All children under 18

Correct answer: Children under 2 years of age

TB skin testing is generally deferred for children under 2 years old; instead, clinical evaluation and history are used.

Question 49: What action should a civil surgeon take if an applicant discloses current use of an illegal controlled substance?

Report the disclosure to local law enforcement
Classify as Class A – Drug Abuse on Form I-693 (Correct answer)
Note it as Class B and recommend treatment
Counsel the applicant and schedule a follow-up exam

Correct answer: Classify as Class A – Drug Abuse on Form I-693

Current drug abuse of a controlled substance is a Class A condition and must be so documented on Form I-693.

Question 50: Which of the following is a common role of a Pediatrician?

Diagnosing geriatric conditions
Performing adult surgeries
Conducting physical exams for adults
Prescribing medication for chronic illnesses (Correct answer)

Correct answer: Prescribing medication for chronic illnesses

A common role of a Pediatrician is to diagnose and treat a wide range of acute and chronic illnesses specific to children. This includes prescribing appropriate medications, managing long-term conditions like asthma or diabetes, and providing guidance on preventive care.

Question 51: Who is authorized to perform the immigration medical examination for applicants adjusting status inside the United States?

Any licensed physician
Any board-certified internist
State health department physicians
USCIS-designated civil surgeons only (Correct answer)

Correct answer: USCIS-designated civil surgeons only

Only USCIS-designated civil surgeons are authorized to perform immigration medical examinations for applicants adjusting their status within the United States.

Question 52: How is remission from drug addiction assessed in the immigration medical context?

Completion of any drug rehabilitation program
A letter from the applicant's attorney
A single negative urine drug screen
No current abuse and a documented period of sustained remission, assessed by the civil surgeon or specialist (Correct answer)

Correct answer: No current abuse and a documented period of sustained remission, assessed by the civil surgeon or specialist

Sustained remission from drug addiction is evaluated based on the absence of current use and documented history of recovery, not a single test.

Question 53: What must a civil surgeon include when documenting a Class A medical condition on Form I-693?

The applicant's insurance information
The specific diagnosis, supporting test results, and a statement of inadmissibility (Correct answer)
A referral letter to a specialist
Only the diagnosis name

Correct answer: The specific diagnosis, supporting test results, and a statement of inadmissibility

A Class A condition requires the civil surgeon to document the specific diagnosis, supporting evidence (test results), and indicate that the condition renders the applicant inadmissible.

Question 54: What is a key obligation civil surgeons have to maintain their USCIS designation?

Maintain board certification in infectious disease
Perform a minimum of 50 immigration exams per year
Comply with CDC Technical Instructions and USCIS policies for conducting immigration medical exams (Correct answer)
Submit annual reports to USCIS listing all exams performed

Correct answer: Comply with CDC Technical Instructions and USCIS policies for conducting immigration medical exams

Designated civil surgeons must follow CDC Technical Instructions and USCIS policies; failure to do so can result in loss of designation.

Question 55: What is the primary focus of a Pediatrician's practice?

Child and adolescent health (Correct answer)
Adult medicine
Pediatric surgery
Geriatric care

Correct answer: Child and adolescent health

A Pediatrician's primary focus is on the physical, mental, and emotional health of infants, children, and adolescents. They specialize in the unique healthcare needs of this age group, from birth through young adulthood, providing comprehensive medical care.

Question 56: Which form is used by the civil surgeon to document vaccination history during an immigration medical exam?

Form I-693 (Correct answer)
Form I-797
Form I-131
Form DS-5540

Correct answer: Form I-693

Form I-693 (Report of Medical Examination and Vaccination Record) is the official document used to record vaccination history.

Question 57: Under USCIS immigration law, which of the following would NOT be a Class A mental health condition?

Bipolar disorder with a recent history of self-harm
Generalized anxiety disorder with no history of harmful behavior (Correct answer)
Schizophrenia with documented history of violent outbursts
Active methamphetamine addiction

Correct answer: Generalized anxiety disorder with no history of harmful behavior

Generalized anxiety disorder without any harmful behavior history does not meet the Class A threshold, which requires a link to harmful behavior.

Question 58: What does 'harmful behavior' mean in the context of immigration mental health evaluation?

Any behavior requiring emergency psychiatric intervention
Any behavior that violates local laws
Behavior that results in arrest or criminal charges only
Behavior that poses a threat to the property, safety, or welfare of the applicant or others (Correct answer)

Correct answer: Behavior that poses a threat to the property, safety, or welfare of the applicant or others

USCIS defines harmful behavior as behavior that is or has been a threat to the property, safety, or welfare of the individual or others.

Question 59: Which document provides the authoritative guidelines that civil surgeons must follow when performing immigration medical examinations?

USCIS Technical Instructions for Civil Surgeons (Correct answer)
The INA Section 212 regulations only
American College of Physicians Clinical Guidelines
CDC Yellow Book for International Travel

Correct answer: USCIS Technical Instructions for Civil Surgeons

The USCIS Technical Instructions for Civil Surgeons provide the authoritative, detailed requirements for conducting immigration medical examinations, including examination procedures, testing protocols, and documentation standards.

Question 60: Alcohol use disorder is evaluated in which section of the immigration medical examination?

Part 3 – Sexually Transmitted Infections
Part 4 – Tuberculosis Evaluation
Part 5 – Mental Disorders and Substance Abuse (Correct answer)
Part 2 – Medical History

Correct answer: Part 5 – Mental Disorders and Substance Abuse

Alcohol use disorder falls under substance abuse and is evaluated and documented in Part 5 of Form I-693.

Question 61: If a civil surgeon identifies possible mental health concerns beyond their expertise, what should they do?

Defer the entire exam until the applicant provides psychiatric records
Complete the form based on their initial impression only
Refer the applicant to a licensed mental health professional for further evaluation before completing Part 5 of Form I-693 (Correct answer)
Automatically classify the applicant as Class A

Correct answer: Refer the applicant to a licensed mental health professional for further evaluation before completing Part 5 of Form I-693

Civil surgeons who identify mental health concerns requiring expert assessment should refer to a mental health professional before completing the mental health portion of Form I-693.

Question 62: What should a civil surgeon do if an adult applicant has no vaccination records and no serologic evidence of immunity?

Skip vaccinations if the applicant is over 18
Vaccinate according to the catch-up immunization schedule (Correct answer)
Defer vaccination to the applicant's personal physician
Mark the applicant as inadmissible pending vaccination

Correct answer: Vaccinate according to the catch-up immunization schedule

Without documentation or serologic proof of immunity, the civil surgeon must administer vaccines per the ACIP catch-up schedule.

Question 63: Which USCIS form is used by civil surgeons to document the results of an immigration medical examination?

Form I-765
Form I-693 (Correct answer)
Form I-485
Form I-131

Correct answer: Form I-693

Form I-693, Report of Medical Examination and Vaccination Record, is the official USCIS form completed by civil surgeons to document immigration medical examination findings.

Question 64: How frequently does the USCIS civil surgeon designation need to be renewed?

Every year with an annual attestation
Every 2 years
Every 5 years
Designation does not automatically expire but must be maintained through ongoing compliance (Correct answer)

Correct answer: Designation does not automatically expire but must be maintained through ongoing compliance

Civil surgeon designation does not have a fixed expiration date but can be revoked for non-compliance; USCIS periodically reviews designations.

Question 65: What is the definition of a Class B medical condition in the context of USCIS immigration medical examinations?

A physical or mental health condition that is of public health significance but does not meet Class A criteria (Correct answer)
A condition that automatically makes an applicant inadmissible
A condition that permanently bars an applicant from obtaining a waiver
A condition requiring immediate hospitalization before immigration approval

Correct answer: A physical or mental health condition that is of public health significance but does not meet Class A criteria

Class B conditions are physical or mental health conditions that are of public health significance but do not rise to the level of a Class A condition and do not by themselves render an applicant inadmissible.

Question 66: What should a civil surgeon do if an applicant refuses to be tested for syphilis?

Document the refusal on Form I-693 and note that the required test was not performed (Correct answer)
Reschedule the exam and require compliance before proceeding
Cancel the entire exam and notify USCIS
Complete the exam without syphilis testing and submit the form

Correct answer: Document the refusal on Form I-693 and note that the required test was not performed

If an applicant refuses mandatory testing, the civil surgeon must document the refusal on Form I-693, which will affect the completeness of the exam record.

Question 67: What additional evaluation is required if an applicant has a positive IGRA or TST result during the immigration medical examination?

Chest X-ray to evaluate for active pulmonary tuberculosis (Correct answer)
Bronchoscopy and sputum culture
Immediate deportation proceedings
HIV testing and CD4 count

Correct answer: Chest X-ray to evaluate for active pulmonary tuberculosis

A positive IGRA or TST result requires a chest X-ray to evaluate for signs of active pulmonary tuberculosis, which is a communicable disease of public health significance and a Class A condition.

Question 68: How long is a completed Form I-693 valid from the date of the civil surgeon's signature?

5 years
1 year
6 months
2 years (Correct answer)

Correct answer: 2 years

A completed Form I-693 is generally valid for 2 years from the date the civil surgeon signs it, provided it is submitted to USCIS within that period.

Question 69: At what age does the rubella vaccination requirement become waived for female applicants in the USCIS immigration medical examination?

50 years
60 years
45 years (Correct answer)
55 years

Correct answer: 45 years

The rubella vaccination requirement is waived for female applicants who are 45 years of age or older, as they are generally past childbearing age and the primary concern is congenital rubella syndrome.

Question 70: What does USCIS require a civil surgeon to do before examining a minor applicant without a parent or legal guardian present?

Ensure a parent or guardian provides written consent and ideally is present, or follow applicable legal requirements (Correct answer)
Contact USCIS for special authorization
Proceed with the exam if the minor is over age 14
Refuse to conduct the examination

Correct answer: Ensure a parent or guardian provides written consent and ideally is present, or follow applicable legal requirements

Minors generally require parental or guardian consent before a medical examination; civil surgeons should follow applicable legal and ethical consent requirements.

Question 71: Which condition found during the immigration medical examination is an absolute Class A bar to admissibility with no waiver available?

Latent tuberculosis infection (LTBI)
History of alcohol use disorder in remission
Active tuberculosis that is contagious (Correct answer)
Controlled schizophrenia without harmful behavior

Correct answer: Active tuberculosis that is contagious

Active, contagious tuberculosis is a Class A communicable disease of public health significance that renders an applicant inadmissible, and treatment and proof of cure are required before a waiver can be considered.

Question 72: How must a completed Form I-693 be handled by the civil surgeon before being given to the applicant?

Laminated and given to the applicant for safe keeping
Submitted directly to USCIS by the civil surgeon
Emailed securely to the applicant's attorney
Sealed in an envelope and signed across the seal by the civil surgeon (Correct answer)

Correct answer: Sealed in an envelope and signed across the seal by the civil surgeon

The civil surgeon must place the completed Form I-693 in an envelope, seal it, and sign across the seal before providing it to the applicant to submit to USCIS.

Question 73: Which body issues technical instructions guiding civil surgeons on mental health evaluations for immigration?

Department of Justice
USCIS directly via Form I-693 instructions only
American Psychiatric Association
CDC Division of Global Migration and Quarantine (DGMQ) (Correct answer)

Correct answer: CDC Division of Global Migration and Quarantine (DGMQ)

CDC's Division of Global Migration and Quarantine publishes the Technical Instructions that guide civil surgeons on all aspects of the immigration medical exam, including mental health.

Question 74: What CDC schedule do civil surgeons use as the basis for required vaccinations?

American Academy of Pediatrics (AAP) schedule
World Health Organization (WHO) schedule
Advisory Committee on Immunization Practices (ACIP) schedule (Correct answer)
Department of Defense immunization schedule

Correct answer: Advisory Committee on Immunization Practices (ACIP) schedule

Civil surgeons must follow the ACIP-recommended immunization schedule, which is endorsed by CDC for all required vaccines.

Question 75: What information must be documented when a civil surgeon determines an applicant has a Class A mental health condition?

The applicant's self-reported psychiatric history
The specific diagnosis, the nature of the harmful behavior, and supporting clinical observations (Correct answer)
Only the diagnosis name
A referral to a psychiatrist and a follow-up appointment date

Correct answer: The specific diagnosis, the nature of the harmful behavior, and supporting clinical observations

A Class A mental health finding requires the diagnosis, a description of the harmful behavior that qualifies it as Class A, and clinical observations supporting the determination.

Question 76: How do Designated Physicians contribute to the immigration process?

By approving visa applications
By providing legal advice on immigration
By conducting initial visa interviews
By evaluating applicants’ health and reporting findings (Correct answer)

Correct answer: By evaluating applicants’ health and reporting findings

Designated Physicians contribute to the immigration process by conducting thorough medical examinations and reporting their findings to USCIS. Their evaluations help determine if an applicant has any health conditions that could pose a public health risk or make them inadmissible, playing a critical role in the adjudication of immigration benefits.

Question 77: If a civil surgeon's designation expires while an applicant's Form I-693 is still valid, is the form still acceptable?

Yes, as long as the form was signed while the civil surgeon's designation was active (Correct answer)
No, the form becomes invalid when the civil surgeon's designation expires
Only if USCIS issues a waiver
Only if the applicant can prove they cannot access another civil surgeon

Correct answer: Yes, as long as the form was signed while the civil surgeon's designation was active

A Form I-693 remains valid if it was properly completed and signed while the civil surgeon held an active USCIS designation, even if the designation later expires.

Question 78: What does a Class B1 tuberculosis designation mean in the immigration context?

Latent TB with no chest X-ray abnormality
TB that is fully cured with no follow-up needed
Pulmonary TB, active but not suspected infectious, or TB requiring follow-up evaluation (Correct answer)
Extrapulmonary TB only

Correct answer: Pulmonary TB, active but not suspected infectious, or TB requiring follow-up evaluation

Class B1 TB designates pulmonary TB that is active but not currently suspected to be infectious, or cases that require further evaluation.

Question 79: If an applicant denies substance abuse history but exhibits signs of impairment during the exam, what should the civil surgeon do?

Contact USCIS immediately for guidance
Document the clinical observations and consider ordering drug toxicology screening if clinically warranted (Correct answer)
Refuse to complete the examination
Accept the denial and complete the form without further inquiry

Correct answer: Document the clinical observations and consider ordering drug toxicology screening if clinically warranted

When objective signs contradict the applicant's denial, the civil surgeon should document findings and may pursue additional clinical evaluation, including toxicology testing.

Question 80: What language assistance must a civil surgeon provide to an applicant who does not speak English?

Require the applicant to bring their own interpreter
Use an interpreter or other language assistance to ensure the applicant understands the exam and provides accurate history (Correct answer)
Decline the examination if no English is spoken
Proceed with written communication only

Correct answer: Use an interpreter or other language assistance to ensure the applicant understands the exam and provides accurate history

Civil surgeons are expected to provide or arrange language assistance to ensure accurate history-taking and that applicants understand the examination process.

Question 81: What happens if an applicant's Form I-693 expires before USCIS adjudicates their case?

The applicant must submit an affidavit explaining the delay
The civil surgeon can re-sign the existing form
The applicant must undergo a new medical examination with a civil surgeon (Correct answer)
USCIS automatically extends the validity

Correct answer: The applicant must undergo a new medical examination with a civil surgeon

If Form I-693 expires, the applicant must schedule a new immigration medical exam with a civil surgeon to obtain a current form.

Question 82: For meningococcal vaccine, at what age does it become required for immigration exams?

16 years
11 years (Correct answer)
21 years
18 years

Correct answer: 11 years

Meningococcal vaccine (MenACWY) is required beginning at age 11 as part of the adolescent immunization schedule.

Question 83: What should a civil surgeon do if an applicant presents with documented proof of prior vaccination series completed abroad?

Require all vaccinations to be repeated regardless of prior documentation
Accept valid written documentation and record it on Form I-693 without repeating vaccines (Correct answer)
Disregard foreign vaccination records and start the series fresh
Refer the applicant to the CDC for verification of foreign vaccination records

Correct answer: Accept valid written documentation and record it on Form I-693 without repeating vaccines

Civil surgeons may accept valid written documentation of vaccinations completed abroad and record them on Form I-693, avoiding unnecessary repeat vaccinations when records meet acceptability standards.

Question 84: Which tuberculosis testing method is preferred by USCIS Technical Instructions for the immigration medical examination?

Chest X-ray alone
Sputum culture for Mycobacterium tuberculosis
Interferon-Gamma Release Assay (IGRA) such as QuantiFERON-TB Gold (Correct answer)
Tuberculin Skin Test (TST/Mantoux) only

Correct answer: Interferon-Gamma Release Assay (IGRA) such as QuantiFERON-TB Gold

IGRA tests such as QuantiFERON-TB Gold are preferred over TST in the USCIS Technical Instructions because they have higher specificity and are not affected by prior BCG vaccination.

Question 85: What serological test is required for applicants 15 years of age and older during the immigration medical examination?

Hepatitis B surface antigen
Syphilis serology (RPR or VDRL) (Correct answer)
Gonorrhea culture
HIV antibody test

Correct answer: Syphilis serology (RPR or VDRL)

Syphilis serology using RPR or VDRL testing is required for all applicants 15 years of age and older as part of the USCIS immigration medical examination.

Question 86: What is the civil surgeon's role when evaluating an applicant for mental health conditions during the immigration exam?

Conduct formal neuropsychological testing for all applicants
Screen for mental disorders and assess whether harmful behavior is present or likely to recur (Correct answer)
Diagnose all DSM-5 conditions and report them to USCIS
Provide full psychiatric treatment

Correct answer: Screen for mental disorders and assess whether harmful behavior is present or likely to recur

The civil surgeon screens for mental disorders and evaluates whether any identified disorder is associated with harmful behavior, not to provide treatment or diagnose all conditions.

Question 87: At what age does the hepatitis A vaccine become required for immigration medical exams?

2–5 years
6–10 years
12–23 months (Correct answer)
11–12 years

Correct answer: 12–23 months

Hepatitis A vaccination is required beginning at 12–23 months of age as part of the standard childhood immunization schedule.

Question 88: For influenza vaccination during immigration exams, what is the correct requirement?

Required only for applicants over 65
Optional for all applicants
Required only during influenza season (October–March) (Correct answer)
Required year-round regardless of season

Correct answer: Required only during influenza season (October–March)

Influenza vaccine is required only during the flu season, typically from October through March in the US.

Question 89: What is the minimum age for the HPV vaccine requirement in immigration medical exams?

9 years (Correct answer)
11 years
16 years
13 years

Correct answer: 9 years

HPV vaccine is required starting at age 9 per ACIP guidelines incorporated into USCIS medical exam requirements.

Question 90: What distinguishes a Class A medical condition from a Class B medical condition in immigration exams?

Class A is curable; Class B is chronic
Class A conditions make an applicant inadmissible; Class B conditions are notable but not automatically disqualifying (Correct answer)
Class A requires surgery; Class B requires medication only
Class A is for adults and Class B is for children

Correct answer: Class A conditions make an applicant inadmissible; Class B conditions are notable but not automatically disqualifying

Class A conditions render an applicant inadmissible to the US, while Class B conditions are medically significant departures from normal health that do not automatically bar admission.

Question 91: What resource can applicants use to locate a USCIS-designated civil surgeon near them?

The USCIS civil surgeon locator tool on the USCIS website (Correct answer)
State medical board directories
American Medical Association physician finder
CDC clinic locator

Correct answer: The USCIS civil surgeon locator tool on the USCIS website

USCIS maintains a searchable locator tool on its official website that allows applicants to find designated civil surgeons by zip code.

Question 92: Which CDC publication provides civil surgeons with the detailed protocols for conducting immigration medical examinations?

CDC Technical Instructions for Civil Surgeons (Correct answer)
USPSTF Clinical Guidelines
MMWR Weekly Report
CDC Pink Book (Epidemiology and Prevention of Vaccine-Preventable Diseases)

Correct answer: CDC Technical Instructions for Civil Surgeons

The CDC Technical Instructions for Civil Surgeons is the definitive guide outlining all procedures, tests, and documentation requirements for immigration exams.

Question 93: A past history of drug abuse that is now in full sustained remission should be documented as which class on Form I-693?

Class B – Drug Abuse, in Remission (Correct answer)
Class A – Drug Abuse
No notation needed if fully resolved
Class C – Drug History, Resolved

Correct answer: Class B – Drug Abuse, in Remission

A history of drug abuse in sustained remission is classified as Class B on Form I-693, which is notable but not grounds for inadmissibility.

Question 94: What is one reason an applicant might need to see a Designated Physician?

To file an immigration application
To get a visa interview
To receive financial counseling
To address a specific medical concern or condition (Correct answer)

Correct answer: To address a specific medical concern or condition

An applicant might need to see a Designated Physician (civil surgeon) when applying for adjustment of status to become a lawful permanent resident while in the U.S. This examination is required to ensure the applicant does not have any medical conditions that would render them inadmissible under immigration law, addressing any specific health concerns relevant to their application.

Question 95: Which federal law requires USCIS to mandate vaccinations for immigration medical exams?

Public Health Service Act
Affordable Care Act
Immigration and Nationality Act (INA) (Correct answer)
Homeland Security Act

Correct answer: Immigration and Nationality Act (INA)

The Immigration and Nationality Act (INA) requires applicants to receive vaccinations against vaccine-preventable diseases as a condition of admission.

Question 96: What is the primary purpose of Form I-693 in the immigration process?

To request a waiver of medical inadmissibility
To report the results of the immigration medical examination to USCIS (Correct answer)
To apply for a green card
To document an applicant's work history

Correct answer: To report the results of the immigration medical examination to USCIS

Form I-693 is the official Report of Medical Examination and Vaccination Record submitted to USCIS documenting all findings from the immigration medical exam.

Question 97: Which part of Form I-693 addresses mental disorders and substance abuse history?

Part 2 – Medical History
Part 7 – Civil Surgeon Certification
Part 1 – Applicant Information
Part 5 – Mental Disorders and Substance Abuse (Correct answer)

Correct answer: Part 5 – Mental Disorders and Substance Abuse

Part 5 of Form I-693 is specifically designated for documenting findings related to mental disorders and substance abuse.

Question 98: Who is authorized to conduct the immigration medical examination and complete Form I-693?

A state health department physician
Any licensed US physician
A USCIS-designated civil surgeon (Correct answer)
A foreign-licensed doctor with US work authorization

Correct answer: A USCIS-designated civil surgeon

Only a physician specifically designated by USCIS as a civil surgeon is authorized to conduct the immigration medical exam and complete Form I-693.

Question 99: Which section of Form I-693 records the results of the tuberculosis evaluation?

Part 4 – Tuberculosis (TB) Evaluation (Correct answer)
Part 1 – Applicant Information
Part 2 – Medical History
Part 6 – Vaccination Record

Correct answer: Part 4 – Tuberculosis (TB) Evaluation

Part 4 of Form I-693 is dedicated to recording all tuberculosis evaluation findings, including TST and IGRA results.

Question 100: What must a civil surgeon certify by signing Form I-693?

That the examination was performed and the results are accurate and complete to the best of their knowledge (Correct answer)
That the applicant has received all required vaccinations
That all laboratory tests were personally performed by the civil surgeon
That the applicant is admissible to the United States

Correct answer: That the examination was performed and the results are accurate and complete to the best of their knowledge

By signing Form I-693, the civil surgeon certifies that they performed the examination and that all information recorded is accurate and complete to their best knowledge.

USCIS Civil Surgeon Designation Knowledge Assessment

Evaluates physician knowledge of USCIS immigration medical examination requirements, including Form I-693 completion, infectious disease screening, mental health evaluation, vaccination requirements, and CDC Technical Instructions for civil surgeons.

100

Questions

120 min

Time Limit

70%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds