If you are applying for a Green Card, a mandatory medical examination is required to prove you are not inadmissible to the United States on health-related grounds. However, the specific process, the doctor you see, and the forms you submit depend entirely on where you are applying from. If you are already in the U.S. and filing Form I-485 to adjust status, you will undergo a Green Card medical exam completed by a USCIS-designated civil surgeon using Form I-693. If you are outside the U.S. applying for an immigrant visa at a U.S. embassy or consulate, you will undergo a visa physical performed by a Department of State-authorized panel physician using a set of DS forms (including DS-2053, DS-3025, and others). The purpose of both exams is the same—to screen for communicable diseases, verify vaccinations, and identify physical or mental disorders with harmful behavior—but the execution, documentation, and validity rules differ significantly. This guide breaks down every difference so you know exactly what to expect and how to prepare.
Key Rule: The Green Card medical exam (I-693) is for applicants inside the U.S. and must be performed by a USCIS-designated civil surgeon. The visa physical is for applicants outside the U.S. and must be performed by a Department of State-authorized panel physician. You cannot use one exam for the other process—they are not interchangeable, and the forms are different.
What Is the Green Card Medical Exam (Form I-693)?
The Green Card medical exam is documented on Form I-693, Report of Immigration Medical Examination and Vaccination Record. This form is required for anyone applying for lawful permanent residence (a Green Card) through adjustment of status from within the United States. The exam must be performed by a USCIS-designated civil surgeon—a physician who has been officially authorized by USCIS to conduct immigration medical exams. There are approximately 5,000 civil surgeons across the U.S..
The civil surgeon will review your medical history, perform a physical examination, conduct required tests (including a tuberculosis screening, blood tests for syphilis, and a urine test for gonorrhea for applicants 15 and older), and verify that you have received all required vaccinations. The results are documented on Form I-693, which the civil surgeon signs and places in a sealed envelope. For paper filings, this envelope must remain sealed when submitted with your Form I-485. For online filings, you must open the envelope, upload the form, and keep the original for your records.
Forms I-693 signed by a civil surgeon on or after November 1, 2023, are considered valid indefinitely while USCIS adjudicates the application. However, the exam itself must meet the health requirements at the time of filing.
What Is the Visa Physical (Panel Physician Exam)?
The visa physical is the medical examination required for applicants applying for an immigrant visa outside the United States through consular processing. This exam must be performed by a panel physician—a doctor authorized by the U.S. Department of State to conduct immigration medical exams abroad. There are more than 760 panel physicians worldwide, selected by the Department of State.
The panel physician follows the CDC's Technical Instructions for Panel Physicians and documents the results on a set of Department of State forms, including DS-2053 (the medical examination report), DS-3025 (the Vaccination Documentation Worksheet), and others. The exam includes a medical history review, physical examination, tuberculosis screening, blood tests, and vaccination verification. The panel physician provides the completed medical report in a sealed envelope, which you must bring to your visa interview at the U.S. embassy or consulate.
The visa physical is generally valid for six months from the date of the exam. If your visa is not issued within that period, you may need to repeat the exam.
Key Differences at a Glance
To help you quickly understand the distinctions, here is a side-by-side comparison of the two exams:
| Feature | Green Card Medical Exam (I-693) | Visa Physical (Panel Physician) |
|---|---|---|
| Where you apply | Inside the United States (adjustment of status) | Outside the United States (consular processing) |
| Doctor type | USCIS-designated civil surgeon | Department of State-authorized panel physician |
| Primary form | Form I-693 (Report of Immigration Medical Examination and Vaccination Record) | DS-2053 (Medical Examination Report) and DS-3025 (Vaccination Documentation Worksheet) |
| Governing authority | USCIS | Department of State |
| Technical instructions | CDC Technical Instructions for Civil Surgeons | CDC Technical Instructions for Panel Physicians |
| Validity period | Indefinite (if signed on or after Nov. 1, 2023) while USCIS adjudicates | Generally 6 months |
| Cost range | $200 – $500+ (plus vaccines and lab tests) | Varies by country and provider |
| Sealed envelope | Submitted with Form I-485 (paper filing) or opened and uploaded (online filing) | Brought to visa interview |
The Special Case of K-1 Visa Holders: DS-3025 vs. I-693
If you entered the U.S. on a K-1 fiancé(e) visa, you already completed a medical exam abroad with a panel physician and received a DS-3025 Vaccination Documentation Worksheet. When you file Form I-485 to adjust status, you may be able to use your DS-3025 instead of completing a full I-693 medical exam—but only under specific conditions.
Your DS-3025 can serve as your valid medical exam proof if: (1) it is marked as complete, meaning you completed all required vaccinations abroad, and (2) you file your I-485 within one year of the overseas medical exam date. If your DS-3025 is complete, you do not need to submit a full Form I-693. Instead, you submit a photocopy of your DS-3025 with your I-485 package.
However, if your DS-3025 is not complete (meaning you did not receive all required vaccines abroad), or if you file your I-485 more than one year after the overseas exam, you must complete a new I-693 medical exam with a USCIS-designated civil surgeon in the U.S.. The civil surgeon will transcribe your vaccination history onto Form I-693 and administer any missing vaccines.
It is important to understand that DS-3025 and I-693 are not the same form. A DS-3025 is a vaccination documentation worksheet; an I-693 is a full report of immigration medical examination. You can have a DS-3025 be part of an I-693 package, but they serve different purposes.
Validity Periods and Expiration Rules
One of the most critical differences between the two exams is how long each remains valid. Understanding these rules is essential to avoid having to repeat an expensive and time-consuming exam.
For the Green Card medical exam (I-693), the rules changed significantly in November 2023. Forms I-693 signed by a civil surgeon on or after November 1, 2023 are considered valid indefinitely while USCIS adjudicates the application. This means you do not need to worry about the exam expiring while your case is pending. However, the exam must still meet the health requirements at the time of filing.
For the visa physical (panel physician exam), the validity period is much shorter. The exam is generally valid for six months from the date it is performed. If your visa is not issued within that six-month window, you will likely need to repeat the entire medical examination. This is a crucial consideration for consular processing applicants, especially if there are delays in scheduling the visa interview.
For K-1 visa holders using a DS-3025, the exam is valid for one year from the date of the overseas medical exam. You must file your I-485 within that one-year window to avoid needing a new I-693.
Step-by-Step Process for Each Exam
Here is the complete workflow for both exams, so you know exactly what to expect at each stage.
Green Card Medical Exam (I-693) – Adjustment of Status:
- Find a USCIS-designated civil surgeon using the USCIS "Find a Civil Surgeon" tool. Schedule your appointment.
- Gather your documents: vaccination records, government-issued photo ID, medical history, and Form I-693 (Parts 1 and 2 completed but not signed).
- Attend the exam: The civil surgeon will perform a physical exam, order required tests (TB screening, blood tests, urine test), and review your vaccination records.
- Receive any missing vaccines during the exam or schedule follow-up doses.
- Sign Form I-693 in the presence of the civil surgeon after the exam is complete.
- Receive the sealed envelope containing your completed Form I-693.
- Submit the envelope with your Form I-485 (paper filing) or open it to upload the form (online filing).
Visa Physical (Panel Physician) – Consular Processing:
- Find a Department of State-authorized panel physician in your country. The U.S. embassy or consulate website will have a list of approved doctors.
- Schedule your exam at least seven days before your visa interview.
- Gather your documents: vaccination records, government-issued photo ID, and any medical history records.
- Attend the exam: The panel physician will perform a physical exam, order required tests, and review your vaccination records.
- Receive any missing vaccines as needed.
- Receive the sealed envelope containing your completed medical report (DS-2053, DS-3025, and other forms).
- Bring the sealed envelope to your visa interview at the U.S. embassy or consulate.
Frequently Asked Questions
Q: Can I use my visa physical (panel physician exam) for my Green Card application if I am already in the U.S.?
A: No. If you are applying for adjustment of status from within the U.S., you must complete a new medical exam with a USCIS-designated civil surgeon and submit Form I-693. The panel physician exam performed abroad is not valid for adjustment of status unless you are a K-1 visa holder with a complete DS-3025 filed within one year.
Q: Can I use my Green Card medical exam (I-693) for a visa interview abroad?
A: No. If you are applying for an immigrant visa outside the U.S., you must see a Department of State-authorized panel physician. A civil surgeon in the U.S. cannot perform an exam for consular processing.
Q: What is the difference between a civil surgeon and a panel physician?
A: A civil surgeon is a physician designated by USCIS to perform medical exams for applicants inside the U.S. for adjustment of status. A panel physician is a physician authorized by the Department of State to perform medical exams for applicants outside the U.S. for consular processing. They follow different technical instructions and use different forms.
Q: How long is the Green Card medical exam (I-693) valid?
A: Forms I-693 signed by a civil surgeon on or after November 1, 2023, are considered valid indefinitely while USCIS adjudicates the application. The exam must still meet the health requirements at the time of filing.
Q: How long is the visa physical (panel physician exam) valid?
A: The visa physical is generally valid for six months from the date of the exam. If your visa is not issued within that period, you may need to repeat the exam.
Q: I entered on a K-1 visa and have a DS-3025. Do I need a new I-693?
A: If your DS-3025 is marked complete and you file your I-485 within one year of the overseas medical exam date, you do not need a new I-693. You submit a photocopy of your DS-3025 with your I-485. If your DS-3025 is incomplete or you file after one year, you need a new I-693.
Q: Are the medical tests the same for both exams?
A: The core tests are similar—both include a medical history review, physical exam, tuberculosis screening, blood tests for syphilis, and vaccination verification. However, the specific technical instructions may differ between civil surgeons and panel physicians.
Q: Can I get vaccinated during the medical exam?
A: Yes. Both civil surgeons and panel physicians can administer required vaccines during the exam. This is a common and convenient option for applicants who do not have prior vaccination records.