USCIS Civil Surgeon Designation Knowledge Assessment — Questions and Answers

Question 1: Which CDC publication provides civil surgeons with the detailed protocols for conducting immigration medical examinations?

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

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

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

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 3: What is the primary role of a Designated Physician in the immigration process?

Conduct medical examinations for immigration benefits (Correct answer)
Perform surgeries on immigrants
Provide legal advice
Approve visa applications

Correct answer: Conduct medical examinations for immigration benefits

Designated Physicians, also known as civil surgeons, conduct medical examinations for individuals applying for immigration benefits while *within* the United States. Their primary role is to assess the applicant's health to determine if they have any medical conditions that would make them inadmissible under U.S. immigration law, similar to Panel Physicians but for domestic applicants.

Question 4: What does 'harmful behavior' mean in the context of immigration mental health evaluation?

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

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 5: Which vaccine is specifically required for applicants aged 11–12 years during the immigration medical exam?

HPV
Hepatitis A
Rotavirus
Tdap (tetanus, diphtheria, pertussis) (Correct answer)

Correct answer: Tdap (tetanus, diphtheria, pertussis)

Tdap is the recommended booster for preteens aged 11–12, and it is required during immigration medical exams for that age group.

Question 6: Who is authorized to conduct the immigration medical examination and complete Form I-693?

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

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 7: Can an applicant review their completed Form I-693 before it is sealed by the civil surgeon?

Yes, the applicant has the right to review and ask questions before sealing (Correct answer)
Only if the applicant requests a copy in writing
Only the applicant's attorney may review it
No, the form is confidential and cannot be shown to the applicant

Correct answer: Yes, the applicant has the right to review and ask questions before sealing

The civil surgeon should review the findings with the applicant prior to sealing the form, allowing the applicant to ask questions about their results.

Question 8: What language assistance must a civil surgeon provide to an applicant who does not speak English?

Decline the examination if no English is spoken
Use an interpreter or other language assistance to ensure the applicant understands the exam and provides accurate history (Correct answer)
Require the applicant to bring their own interpreter
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 9: Hansen's disease (leprosy) is a Class A communicable disease for immigration purposes. Which form of the disease triggers inadmissibility?

Non-infectious (tuberculoid) leprosy
Only leprosy with documented transmission
Infectious (lepromatous) leprosy (Correct answer)
Any form of leprosy regardless of infectivity

Correct answer: Infectious (lepromatous) leprosy

Only infectious (lepromatous) leprosy is classified as a Class A condition; non-infectious forms are classified as Class B.

Question 10: How do Pediatricians typically approach treatment?

With a focus on physical health only
With a one-size-fits-all approach
By considering the family and social context (Correct answer)
By treating only the symptoms

Correct answer: By considering the family and social context

Pediatricians typically approach treatment holistically, considering not only the child's physical health but also their family dynamics, social environment, and developmental stage. This comprehensive approach ensures that care plans are tailored to the child's unique circumstances and support their overall well-being.

Question 11: Which tuberculosis testing method is preferred by USCIS Technical Instructions for the immigration medical examination?

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

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 12: Which of the following is included as a Class A medical condition that makes an applicant inadmissible?

Type 2 diabetes mellitus
Controlled hypertension
Seasonal allergies
Drug addiction or abuse (Correct answer)

Correct answer: Drug addiction or abuse

Drug addiction or abuse is classified as a Class A medical condition, making an applicant inadmissible to the United States under INA section 212(a)(1).

Question 13: 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
Refuse to complete the examination
Document the clinical observations and consider ordering drug toxicology screening if clinically warranted (Correct answer)
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 14: Which part of Form I-693 addresses mental disorders and substance abuse history?

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

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

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

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

45 years (Correct answer)
55 years
50 years
60 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 17: When performing the tuberculin skin test (TST), how many hours after placement must the result be read?

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

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

U.S. Citizenship and Immigration Services (USCIS) (Correct answer)
Department of Health and Human Services (HHS)
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 19: How long is a completed Form I-693 valid after the civil surgeon signs it?

6 months from the date of filing
Indefinitely until USCIS requests a new one
1 year from the date of the exam
2 years from the date of the civil surgeon's signature (Correct answer)

Correct answer: 2 years from the date of the civil surgeon's signature

Form I-693 is valid for 2 years from the date the civil surgeon signs and dates the form.

Question 20: What standard diagnostic manual does USCIS instruct civil surgeons to use when classifying mental disorders?

WHO Classification of Mental Disorders
DSM (Diagnostic and Statistical Manual of Mental Disorders) (Correct answer)
NIMH Diagnostic Guidelines
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 21: What is the primary focus of a Pediatrician's practice?

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

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

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

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 23: 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 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
The date only affects the vaccination record section

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

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

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

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

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 26: At what age does pediatric care typically begin?

At age 10
At age 2
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 27: Which professionals can serve as Panel Physicians?

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

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 28: What serologic test can substitute for MMR vaccination if a civil surgeon suspects prior immunity?

Measles, mumps, and rubella IgG antibody titers (Correct answer)
CBC and differential count
Skin prick allergy test
HbsAg surface antigen test

Correct answer: Measles, mumps, and rubella IgG antibody titers

Positive IgG antibody titers for measles, mumps, and rubella are acceptable laboratory evidence of immunity that can substitute for vaccination.

Question 29: What resource can applicants use to locate a USCIS-designated civil surgeon near them?

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

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

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

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

American Academy of Pediatrics (AAP) schedule
Department of Defense immunization schedule
Advisory Committee on Immunization Practices (ACIP) schedule (Correct answer)
World Health Organization (WHO) 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 32: How should a civil surgeon handle an applicant who provides a foreign vaccination record?

Accept it if it meets ACIP standards and is adequately documented (Correct answer)
Only accept US-issued vaccination records
Forward records to CDC for verification before accepting
Reject all foreign vaccination records and revaccinate

Correct answer: Accept it if it meets ACIP standards and is adequately documented

Foreign vaccination records may be accepted if they document vaccines that meet ACIP standards and the records appear reliable.

Question 33: What is the primary purpose of Form I-693 in the immigration process?

To report the results of the immigration medical examination to USCIS (Correct answer)
To apply for a green card
To request a waiver of medical inadmissibility
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 34: Which of the following physicians CANNOT perform immigration medical exams in the United States?

A board-certified internist who is also a designated civil surgeon
A USCIS-designated civil surgeon with a D.O. degree
A licensed US physician who has not been designated by USCIS as a civil surgeon (Correct answer)
A family physician designated as a 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 35: What must the mental health evaluation during the immigration medical exam assess for?

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

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

Deny the applicant and report to CDC immediately
Issue a vaccination waiver for all TB-related vaccines
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 37: 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
Only applicants born in high-TB-burden countries
Applicants aged 15 and older with a positive TST or IGRA (Correct answer)

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

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

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 39: 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
Refer the case to the state medical board only
Revoke or suspend the physician's civil surgeon designation (Correct answer)
Issue a warning letter with no further action for first offense

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 40: 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
Emailed securely to the applicant's attorney
Submitted directly to USCIS by the civil surgeon
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 41: How is remission from drug addiction assessed in the immigration medical context?

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)
A letter from the applicant's attorney
Completion of any drug rehabilitation program

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

Perform a minimum of 50 immigration exams per year
Maintain board certification in infectious disease
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 43: Which type of professionals can serve as Designated Physicians?

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

Correct answer: MDs, DOs, and other licensed healthcare professionals

Designated Physicians, or civil surgeons, must be licensed medical doctors (MDs) or doctors of osteopathic medicine (DOs). They are also required to complete specific training and adhere to guidelines set by the Centers for Disease Control and Prevention (CDC) to ensure the quality and consistency of immigration medical examinations.

Question 44: What is the recommended interval between two doses of MMR vaccine if given as a catch-up?

At least 90 days
At least 60 days
At least 6 months
At least 28 days (Correct answer)

Correct answer: At least 28 days

The minimum interval between two doses of MMR vaccine is 28 days (4 weeks) when given as a catch-up series.

Question 45: 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
Only for specific components (like phlebotomy or vision screening), not for the overall exam or certification (Correct answer)
Any portion can be delegated to any licensed healthcare worker
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 46: Which laboratory tests are required to be documented in Part 3 of Form I-693?

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

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

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

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

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

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

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

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 50: 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?

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

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

Required only during influenza season (October–March) (Correct answer)
Optional for all applicants
Required only for applicants over 65
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 52: Who is authorized to perform the immigration medical examination for applicants adjusting status inside the United States?

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

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

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

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 54: Who designates Designated Physicians?

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

Correct answer: USCIS

Designated Physicians (civil surgeons) are designated by U.S. Citizenship and Immigration Services (USCIS). USCIS maintains a list of approved physicians who can perform immigration medical examinations for applicants residing in the United States, ensuring they meet specific criteria and follow established guidelines.

Question 55: Which mental health professional credential is acceptable for the specialist evaluation of an immigration applicant referred by a civil surgeon?

A licensed psychiatrist or licensed clinical psychologist (Correct answer)
Any licensed social worker
Only a board-certified psychiatrist
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 56: 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?

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

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

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

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

Every 5 years
Every 2 years
Every year with an annual attestation
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 59: 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?

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

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

Send a copy to CDC within 30 days
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)

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

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

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 62: Which of the following vaccines is NOT currently required for immigration medical exams in the US?

Hepatitis B vaccine
Varicella vaccine
Typhoid vaccine (Correct answer)
MMR vaccine

Correct answer: Typhoid vaccine

Typhoid vaccine is not on the USCIS/ACIP required list for immigration medical exams, unlike hepatitis B, MMR, and varicella.

Question 63: Which type of substance abuse finding is considered a Class A condition for immigration?

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

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

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

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

Form I-485
Form I-765
Form I-693 (Correct answer)
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 66: Which condition found during the immigration medical examination is an absolute Class A bar to admissibility with no waiver available?

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

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

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

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 68: 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 69: How do Designated Physicians contribute to the immigration process?

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

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

Automatically classify the applicant as Class A
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)
Defer the entire exam until the applicant provides psychiatric records

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 71: Which disease classification applies to an applicant found to have active, infectious tuberculosis?

Class B1 – TB, Pulmonary, Active, Not Suspected Infectious
Class B2 – TB, Extrapulmonary
Class C – TB, No Current Disease
Class A – Communicable Disease of Public Health Significance (Correct answer)

Correct answer: Class A – Communicable Disease of Public Health Significance

Active, infectious TB is classified as a Class A communicable disease of public health significance, rendering the applicant inadmissible.

Question 72: What does USCIS require a civil surgeon to do before examining a minor applicant without a parent or legal guardian present?

Proceed with the exam if the minor is over age 14
Contact USCIS for special authorization
Ensure a parent or guardian provides written consent and ideally is present, or follow applicable legal requirements (Correct answer)
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 73: Civil Surgeons perform immigration medical exams for which form?

Form I-693 (Correct answer)
Form I-130
Form I-140
Form I-94

Correct answer: Form I-693

Form I-693 is the Report of Medical Examination and Vaccination Record used by Civil Surgeons.

Question 74: What must a civil surgeon certify by signing Form I-693?

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

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.

Question 75: What is the definition of 'drug addiction' for immigration medical exam purposes?

Use of marijuana in states where it is not legally permitted
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
Any use of drugs more than once per month

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 76: At what age does gonorrhea testing become required during immigration medical exams?

All ages
18 years and older
21 years and older
15 years and older (Correct answer)

Correct answer: 15 years and older

Gonorrhea testing is required for all applicants aged 15 and older as part of the mandatory communicable disease screening.

Question 77: For which group of applicants is the TST or IGRA waived during the immigration medical exam?

Children under 2 years of age (Correct answer)
Applicants with documented prior BCG vaccination
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 78: What follow-up is required after an immigration applicant is treated for Class A syphilis before their case is adjudicated?

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)
Immediate re-examination by a second civil surgeon

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

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

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

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

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 81: What action should a civil surgeon take if they discover they made an error on a sealed Form I-693?

Contact USCIS to request a correction without a new exam
Complete a new Form I-693 with the corrected information and re-seal it (Correct answer)
Simply cross out the error on the sealed form
Ask the applicant to note the correction in their cover letter

Correct answer: Complete a new Form I-693 with the corrected information and re-seal it

Errors on Form I-693 require completing a new, corrected form rather than altering the sealed document.

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

11 years (Correct answer)
21 years
16 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: During the physical examination component of the immigration medical exam, which body system is NOT explicitly required to be evaluated?

Lymph nodes
Dental/oral cavity (Correct answer)
Neurological system
Cardiovascular 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 84: Which type of documentation may a civil surgeon request to verify an applicant's identity before conducting the immigration medical exam?

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

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

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

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

To ensure all applicants receive mental health treatment before admission
To assess insurance eligibility for mental health services post-admission
To screen for any diagnosed psychiatric condition, regardless of behavior
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 87: What distinguishes a Class A medical condition from a Class B medical condition in immigration exams?

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

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

1 dose
2 doses (Correct answer)
3 doses
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 89: What is the primary role of a Panel Physician?

Approve immigration applications
Conduct immigration medical examinations for applicants (Correct answer)
Perform surgeries on immigrants
Provide legal advice to visa applicants (Correct answer)

Correct answer: Conduct immigration medical examinations for applicants

Panel Physicians are specifically authorized by the U.S. government to conduct medical examinations for individuals applying for U.S. visas from outside the United States. Their primary role is to assess the applicant's health to ensure they do not have conditions that would make them inadmissible under U.S. immigration law, such as certain communicable diseases or mental health disorders.

Question 90: Under USCIS immigration law, which of the following would NOT be a Class A mental health condition?

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

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

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
Administer vaccines at no cost as required by USCIS

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

Leave the vaccination section blank
Note the refusal and the reason, and advise the applicant to obtain a waiver (Correct answer)
Defer the exam until the applicant agrees to vaccination
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 93: What must a civil surgeon include when documenting a Class A medical condition on Form I-693?

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

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

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

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

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

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

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

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 97: A civil surgeon discovers that an applicant received a live virus vaccine 3 days ago. What is the correct action regarding tuberculosis testing?

Use the blood-based IGRA test instead without delay
Proceed with TB test immediately
Skip TB testing entirely
Defer the TB test for at least 4 weeks since live vaccines can suppress tuberculin reactivity (Correct answer)

Correct answer: Defer the TB test for at least 4 weeks since live vaccines can suppress tuberculin reactivity

Live vaccines can suppress tuberculin skin test reactivity, so the TST should be deferred at least 4 weeks after a live vaccine is given.

Question 98: What is the civil surgeon's role when evaluating an applicant for mental health conditions during the immigration exam?

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
Conduct formal neuropsychological testing for all applicants
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 99: Under what circumstances does a mental disorder constitute a Class A condition for immigration purposes?

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

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

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

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.

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

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