Technical Instructions for Civil Surgeons
- Introduction and Background
- Medical History and Physical Examination
- Other Sexually Transmitted Diseases
- Hansen’s Disease
- Physical or Mental Disorders with Associated Harmful Behaviors and Substance-related Disorders
- Other Physical or Mental Abnormality, Disease or Disability
On October 6, 2008, HHS/CDC posted an Interim Final Rule (IFR) regarding regulations that establish requirements for the medical examination of aliens. The IFR does not currently affect the required medical examination performed by civil surgeons. Civil surgeons should continue to follow the procedures outlined in the current Technical Instructions for Civil Surgeons.
Updates for Civil Surgeons
- DSM-5 is now available. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is now available. Civil surgeons should obtain a copy of the DSM-5 and become familiar with it. Civil surgeons should also ensure that their identified mental health specialist does the same. CDC will be issuing an update to the 2010 Technical Instructions for Physical or Mental Disorders with Associated Harmful Behaviors and Substance-Related Disorders (MH TIs) based on the DSM-5. Consistent with the time frame that U.S. insurance companies are using to implement the DSM-5 changes, the update to the MH TIs will have an effective date no later than January 1, 2014. Until the update to the MH TIs is provided, civil surgeons should continue to follow the 2010 MH TIs and use the DSM-4.
- April 2013 Update for Civil Surgeons: Regarding Current Nationwide TUBERSOL® Shortage. See more »
- April 2013 Update to the Technical Instructions for treatment of Other Sexually Transmitted Diseases (chancroid, gonorrhea, granuloma inguinale, and lymphogranuloma venereum). See more »
- Effective January 1, 2013, the 2013 Technical Instructions for Syphilis and Hansen’s Disease replace the 1991 Technical Instructions for these components. For more information, see the Frequently Asked Questions for the 2013 Technical Instructions for Syphilis and Hansen’s Disease.
- Guidance based on 2010 Recommendations for the Seasonal Influenza (Flu) Vaccine.
- On January 4, 2010, HIV infection was removed from the list of inadmissible conditions for immigration purposes and from the scope of the immigrant medical examination. See Guidance for HIV for Civil Surgeons.
- Guidance for Option of Using Interferon Gamma Release Assay in Place of Tuberculin Skin Test for Civil Surgeons.
New I-693 Form
The I-693 is available on the U.S. Citizenship and Immigration Services (USCIS) website [PDF - 5 pages]; the I-693 form is not distributed by CDC.
USCIS is creating a series of podcasts for civil surgeons which are available on the USCIS website. Continue to visit this site for more podcasts.