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Immigrant and Refugee Health

Technical Instructions for Civil Surgeons

These are the Technical Instructions for Medical Examination of Aliens used by the Civil Surgeons in the medical examinations conducted in the United States.

Updates for Civil Surgeons

  • CDC released updated Tuberculosis Technical Instructions. CDC provides clarifications on laboratory testing procedures and the roles of civil surgeons when interacting with health departments. There are no major changes to the screening algorithm or treatment requirements.
  • On January 13th, 2017, CDC published a Morbidity and Mortality Weekly Report (MMWR) article documenting a change in guidance for the assessment of poliovirus vaccination status of children who have received the poliovirus vaccine outside of the United States. The report states that documentation of poliovirus vaccination given outside of the United States is now valid only when documentation indicates receipt of either IPV or tOPV. Please note this change as it relates to the vaccination component of the medical examination for those seeking adjustment of status within United States.

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