New! Tuberculosis (TB) Medical Consultation Service for U.S. Panel Physicians who are currently using the Culture and DOT Technical Instructions for TB Screening and Treatment is now available online.
These are the Technical Instructions for Medical Examination of Aliens used by the Panel Physicians in the medical examinations conducted outside of the United States.
- 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. This change applies only to those physicians assessing children within the United States and does not affect the validity of the panel physician examination. Panel physicians should continue to follow the Technical Instructions for Vaccination.
- The Technical Instructions have been updated regarding the scope of the medical examination for all applicants. For details, please see the Syphilis, Gonorrhea, and Medical History and Physical Examination Technical Instructions for Panel Physicians.
- The Other Sexually Transmitted Diseases Technical Instructions were replaced with the Gonorrhea Technical Instructions. The Gonorrhea Technical Instructions are to be followed by panel physicians for gonorrhea screening and treatment as soon as possible and no later than October 1, 2016.
- As of March 28, 2016, chancroid, lymphogranuloma venerum, and granuloma inguinale are removed from the list of communicable diseases of public health significance. Therefore, evaluation for these three diseases is no longer required as part of the U.S. immigration medical screening process as of March 28, 2016. For additional information, please see Part 34 Final Rule issued on January 26, 2016.
- Updated Requirements for Panel Physicians to screen for severe acute respiratory syndromes based on Executive Order 13674 signed by the President of the United States on July 31, 2014.
- CDC has updated the 2010 Technical Instructions for Physical or Mental Disorders with Associated Harmful Behaviors and Substance-Related Disorders (MH TIs).
- All U.S. Panel Physician Sites Required to Use Digital Radiography for Chest Radiographs of Applicants for U.S. Immigration by October 1, 2014.
- 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 Panel Physicians.
Designated Incident Technical Instructions
Information about the Technical Instructions for Designated Incidents is included in the Revision of 42 CFR Part 34 (Medical Examination of Aliens) Updated Screening for Communicable Diseases of Public Health Signifiance -Interim Final Rule (IFR) which was posted by HHS/CDC on October 6, 2008. Additional information regarding the IFR is available on the Laws and Regulations page.
Note: The IFR does not currently affect the required medical examination performed by civil surgeons. Civil surgeons should continue to follow the procedures as provided in the current Technical Instructions for Civil Surgeons.
July 15, 2014 – Addendum to Technical Instructions for Panel Physicians for Vaccinations: Technical Instructions for Polio Vaccination for Applicants for U.S. Immigration
The International Health Regulations Emergency Committee met in May 2014 regarding the international spread of wild polioviruses in 2014 and declared that the current conditions are a Public Health Emergency of International Concern (PHEIC).
2014 Addendum to Technical Instructions for Panel Physicians for Vaccinations: Technical Instructions for Polio Vaccination for Applicants for U.S. Immigration is to be followed for polio vaccination among applicants for U.S. immigration from the states currently exporting wild poliovirus (Pakistan, Cameroon, Syrian Arab Republic, and Equatorial Guinea) and the states infected with wild poliovirus but currently not exporting (Afghanistan, Ethiopia, Iraq, Israel, Somalia, and Nigeria). These Technical Instructions are effective from the date of issuance until the Centers for Disease Control and Prevention (CDC) determines these Technical Instructions are no longer needed to prevent the importation and spread of wild poliovirus (WPV). These Technical Instructions may also be modified as states in the two above categories change.