It is unbelievable to witness a county with so many faces from different origin, culture, food, artifacts like the way we see in USA, the gateway to millions of people eagerly waiting to enter their fantasy world.

Out of all the other countries, why do we get to see more number of immigrants in this country? The fundamental fact lies that the country has made it very resourceful and developed, especially the life of a common man’s. Every country has pros and cons but the intensity of having a decent life is something that every man dreams of and this is the result of Immigration. Some other factors like economic and/or political reasons, family re-unification, natural disasters or the wish to change one’s surroundings voluntarily contribute to immigration.

In order to get immigrated to US, one has to go through a lot of process which takes years for them to get a Green card and one important and nearing step to get through that process is the I-693 form as also called Immigration Medical exam.

In order to protect the health of their public, the US government has reinforced some strict rules on immigrants who are applying for Green card and one such rule is getting a complete medical screening for specific diseases like mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, Haemophilus influenzae type B, and hepatitis B, and vaccinations against vaccine-preventable diseases as recommended by the Advisory Committee on Immunization Practices.

As per their law, if any alien is not able to furnish documents of received vaccination against “Vaccine preventable diseases and other diseases as mentioned in CDP, then the applicant will lose the eligibility to get a Green card.

Overview of the Immigration Medical exam form

I-693 form consists of 4 parts which runs in 5 pages.

Part1 – A generic personal detail about oneself, that needs to be typed by the applicant in Capital letter with black ink only.

Information to be filled is:

• Applicants’ complete name, middle name and last name
• Complete home address with zip code
• Gender
• Date of Birth
• The most important is do not sign or date the form anywhere unless and until said by the civil surgeon.

Part 2 – Applicant medical examination Synopsis by Civil surgeon

• As per INA 212(a) law the diseases are classified as below
• Communicable disease of public health significance
• Physical or mental disorder associated with harmful behavior
• Drug abuse or addiction
• Vaccination details
• Communicable Diseases there are two disease that are tested

1-Tuberculosis (TB) – Initial screening test or Interferon Gamma Release Assay is conducted for all applicant 2 years of age and older. If any sign or symptom of TB is seen, Chest X-ray is done

2- Syphilis – Applicants of 15 years and older need to appear for Serologic test for Syphilis.

Physical or Mental disorders related with harmful behavior

The civil surgeons review the past history of the applicant and assess the mental status. During the screening of medical exam, or while taking medical history of the mental disorder,  a surgeon will be able to diagnose if an applicant is facing any kind of physical or mental disorder that results in harmful behavior like major depression, bipolar disorder, schizophrenia, mental retardation

Surgeon also checks for harmful behavior that is associated with a mental or physical disorder that results in:

n  Serious psychological or physical injury to the applicant or others (e.g. suicide attempt or pedophilia)

n  A serious threat to health or safety (e.g. driving while intoxicated or verbally threatening to kill someone)

Drug Abuse/ Drug Addiction

Using American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria, surgeons see if the applicant is under drug addiction or not. They also check if an applicant is under Substance abuse or Substance dependence.

If substance abuse or dependence is found, the civil surgeon (or specialist, if referred) will document the applicant’s pattern of use and behavioral, physical, and psychological effects associated with the substance use or cessation of use.

Part 3 – Medical Certification of the Civil Surgeon

After completion of the medical test the doctor will put his comments and results in the form with his official stamp or seal along with date and signature

Part 4- Vaccination Record

 All applicants applying for adjustment of status must provide with relevant Vaccination details that are specifically required by statue or as listed by CDC documents. The applicant’s age at the time of the medical examination is used to determine which vaccines are age-appropriate to administer.

• Note that all vaccines can be given on the same day as a TST or any time after TST is applied. However, if MMR, varicella, or live attenuated intranasal influenza vaccine (LAIV) is given before TST, at least 4 weeks is recommended before administering the TST. With that verification the civil surgeon will see if any additional vaccine needs to be given or not.
• An immigrant having lived so long and dreaming of becoming part of U.S should make his mind not to get depressed and wait for some more years only to see a better tomorrow to make their dream come true. So every immigrant should make sure that they documents are not fake, try to get vaccinated if needed and try to leave in a healthy environment.