Civil surgeons for immigration medical examination - centralized designation process

A foreign national can be denied admission to the United States for health-related reasons.  In fact, all permanent residence applicants must undergo a medical examination to confirm that they don't have any contagious deceases and have complied with all  vaccination requirements.  Immigration medical examinations conducted inside the United States must be performed by a civil surgeon who has been designated by USCIS.

Current Local Designation Process
Currently the application process is handled by the local USCIS local office. Physicians interested in performing immigration-related medical examination apply for designation by submitting informal written requests to the local USCIS District Director.  The USCIS District Director then decides whether or not to grant designation based on the documentary evidence and professional qualifications of the physicians.

New Centralized Designation Process
Starting March 11, 2014, USCIS will replace the current informal civil surgeon application process with a formal, centralized process.  The new process will require centralized filing of the Application for Civil Surgeon Designation (Form I-910), at a Lockbox facility.  Further, the Director of the National Benefits Center (NBC) will be responsible for granting, denying, and revoking civil surgeon designation.  The goals of these changes are "to improve the application intake process, enhance case management, promote consistency and uniformity in decision-making, and improve the overall efficiency and integrity of the program."

Applying to become a civil surgeon
Physicians generally must make an application for civil surgeon designation with USCIS unless they qualify under a blanket designation as a health department or military physician. In addition to the Application for Civil Surgeon Designation (Form I-910) and the required filing fee, the application must also submit evidence that establishes that the physician meets the eligibility requirements for a designated civil surgeon.

Specifically, the application must include (1) proof  of legal status or work authorization in the United States, (2) a copy of the physician’s state medical license, (3) a copy of the physician’s medical degree, and a certified copy of the physician’s medical school transcript, verifying he or she is an medical doctor (M.D.) or doctor of osteopathy (D.O.), and (4) evidence of at least four (4) years of professional experience, not including internships, residencies or other training experiences.

USCIS will issue formal Request for Evidence (RFE) if the application is incomplete or additional information is needed.  Once a physician's application is approved, her information will be added to the listing of designated civil surgeons, including her full name, name of medical practice, address, and telephone number.

How to deal with denials?
USCIS will deny an Application for Civil Surgeon Designation if the legal requirements are not met or there are discretionary reasons for an unfavorable decision.  For instance, if the physician was found to have been involved in immigration fraud, his application will likely be denied.  A physician may not appeal a denied application.  However, motions can be filed to reopen or reconsider the negative decision based on new evidence or legal arguments.

Civil Surgeons’ Responsibilities
Civil surgeons are required to perform the immigration medical examination according to the Technical Instructions for the Medical Examinations of Aliens in the United States (TI), including any updates published by the Centers for Disease Control and Prevention (CDC). The Technical Instructions and updates can only be obtained online from CDC's website.  Failure to comply the requirements of the Technical Instructions can result in the revocation of the physician's civil surgeon designation.