Immigration
What Is a Civil Surgeon? Finding a USCIS-Designated Civil Surgeon Near Washington, DC
By Dr. Rachel Gougian, DO, FAAFP, D-ABOM
Updated September 2026
If you are applying for a green card or adjusting your immigration status in the United States, you will need to complete a medical examination on Form I-693. This exam can only be performed by a civil surgeon, a physician specifically designated by U.S. Citizenship and Immigration Services (USCIS) to conduct immigration medical exams.
This guide explains what a civil surgeon is, how the designation works, how to verify that a provider is authorized, and what to expect during the exam itself.
What Is a Civil Surgeon?
A civil surgeon is a licensed physician designated by USCIS to perform immigration medical examinations in the United States. The term comes from immigration law and has been in use for decades. It describes a federal authorization, separate from any medical specialty or board certification. Any physician who wants to conduct these exams must apply for and receive that designation.
Only a designated civil surgeon can complete and sign Form I-693, which is the medical examination form required as part of the green card application process. An exam performed by a non-designated physician will not be accepted by USCIS, regardless of the physician's qualifications.
This distinction matters because not every doctor can conduct this exam. Finding a legitimate, designated civil surgeon is one of the first steps in the immigration medical exam process.
How Does a Doctor Become a Designated Civil Surgeon?
To become a designated civil surgeon, a physician must meet several requirements set by USCIS. The physician must hold an active, unrestricted medical license in the state where they practice. They must have experience performing physical examinations and be willing to follow USCIS technical instructions for the I-693 exam.
The physician applies directly to USCIS, and if approved, receives a designation that is valid for a set period. The designation must be renewed periodically, and USCIS maintains a public directory of all currently designated civil surgeons.
Not all physicians choose to pursue this designation. The process involves familiarity with immigration-specific vaccination requirements, CDC guidelines for immigration medical exams, and USCIS procedures. Physicians who regularly perform these exams develop significant expertise in navigating the requirements efficiently.
How to Verify a Civil Surgeon Is Designated
USCIS maintains a public online directory of all currently designated civil surgeons. You can search by city, state, or zip code to find designated providers near you. The directory is the official source for verification. If a physician's name does not appear in the directory, they are not authorized to complete the I-693.
When choosing a civil surgeon, consider asking how many immigration exams they perform. A physician who completes these exams regularly will be more familiar with the current requirements and less likely to make errors that could delay your application. Turnaround time matters as well. Some offices can complete the exam and return the sealed envelope within a few days, while others may take weeks.
Dr. Rachel Gougian at Pandora Family Medicine is a USCIS-designated civil surgeon who has completed thousands of immigration medical exams. You can verify her designation through the USCIS directory by searching for University Park, MD.
What Does the Civil Surgeon Do During the Exam?
USCIS requires the immigration medical exam to follow a specific protocol. Your civil surgeon reviews your medical history, performs a physical examination, checks your vaccination records, and orders any lab tests or vaccinations required based on your age and immunization history.
The physical exam checks for Class A and Class B medical conditions as defined by immigration law. Class A conditions are those that may make an applicant inadmissible to the United States. Class B conditions are noted but do not affect admissibility.
The vaccination review is often the most involved part of the exam. USCIS requires that applicants be vaccinated according to the CDC's recommended immunization schedule. At Pandora Family Medicine, we run immunity testing (titers) before administering vaccinations. This means you only receive the vaccines you actually need, not a blanket list. If your blood work shows existing immunity, you skip that vaccine.
Once the exam is complete, the civil surgeon fills out Form I-693 and places it in a sealed envelope. You submit this envelope as part of your green card application. The form is valid for two years from the date the civil surgeon signs it.
Finding a Civil Surgeon in the Washington, DC Area
The Washington, DC metropolitan area has a large immigrant population, and there are multiple designated civil surgeons throughout DC, Maryland, and Virginia. When choosing a provider, proximity and experience both matter.
Pandora Family Medicine is located at 6300 Baltimore Ave in University Park, MD, directly accessible from DC, Hyattsville, College Park, Silver Spring, Takoma Park, and the surrounding Prince George's County and Montgomery County communities. The office is close to public transit and has parking available.
Exams are conducted in both English and Spanish. Dr. Gougian understands that the immigration process can be stressful, and she approaches the exam with patience. The goal is to complete the exam thoroughly and correctly the first time so there are no delays in your application.
The exam costs $200. Vaccinations and lab work are billed separately based on what you actually need. You only pay for the vaccines you receive.