Does a J-1 Visa Holder Need an Immigration Medical Exam for a Green Card?
Quick Answer
Yes — J-1 exchange visitors adjusting status to a green card through Form I-485 must complete an immigration medical exam with a USCIS-designated civil surgeon and submit Form I-693. The J-1 two-year home residency requirement must also be addressed before adjustment of status is possible.
The J-1 Visa and the Two-Year Home Residency Requirement
The J-1 exchange visitor visa is used for a wide range of programs including research scholars, professors, physicians, au pairs, camp counselors, and summer work travel participants. Many J-1 visa holders are subject to the two-year home residency requirement under Section 212(e) of the Immigration and Nationality Act, which requires them to return to their home country for at least two years before they can apply for certain immigration benefits, including a green card.
J-1 holders subject to the two-year home residency requirement must either fulfill the requirement by residing in their home country for two years, or obtain a waiver of the requirement before they can adjust status to permanent residence. Waivers are available on several grounds, including a no-objection statement from the home country government, a request by a U.S. government agency, hardship to a U.S. citizen or permanent resident spouse or child, persecution in the home country, or a Conrad 30 waiver for foreign medical graduates who agree to practice medicine in an underserved area.
When the Medical Exam Is Required
The immigration medical exam is not required to obtain or renew a J-1 visa. It is required when you file Form I-485, Application to Register Permanent Residence or Adjust Status. At that point, USCIS requires all applicants to submit Form I-693, Report of Medical Examination and Vaccination Record, completed and signed by a USCIS-designated civil surgeon.
J-1 holders who have obtained a waiver of the two-year home residency requirement and are eligible to file I-485 must complete the medical exam just like any other adjustment of status applicant. There are no exemptions for exchange visitors, researchers, or physicians.
What the Immigration Medical Exam Covers
The immigration medical exam covers a complete physical examination, tuberculosis (TB) screening, required laboratory tests, and a vaccination review. The physical exam assesses your general health and screens for conditions that could make you inadmissible on health-related grounds under the Immigration and Nationality Act.
TB screening typically involves a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA) blood test. If the initial test is positive, a chest X-ray is required. Required laboratory tests include syphilis serology for applicants age 15 and older and gonorrhea testing for applicants age 15 and older. The civil surgeon will also review your vaccination records and administer any vaccines required by USCIS that you have not already received.
J-1 Physicians and the Conrad 30 Waiver
Foreign medical graduates on J-1 visas who complete their medical training in the United States are typically subject to the two-year home residency requirement. The Conrad 30 waiver program allows J-1 physicians to obtain a waiver if they agree to practice medicine for at least three years in a Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA). Each state can recommend up to 30 Conrad waivers per fiscal year.
J-1 physicians who obtain a Conrad 30 waiver typically transition to H-1B status to fulfill their service obligation, and then apply for a green card after completing the required service period. At the I-485 stage, the immigration medical exam is required. J-1 physicians who are themselves physicians should note that the civil surgeon conducting the exam must be a USCIS-designated civil surgeon — not a colleague or supervisor.
Timing the Exam Relative to I-485 Filing
Form I-693 is valid for two years from the date the civil surgeon signs it, provided it is submitted to USCIS within that period. Schedule your medical exam 2 to 4 weeks after you receive your I-485 receipt notice. This ensures the I-693 is ready before your USCIS interview and remains valid throughout the processing period.
J-1 holders who have been in the United States for extended periods may have received some U.S. vaccinations. Bring all vaccination records — including records from your home country and any vaccines received during your exchange program — to the exam appointment.
What to Bring to Your Appointment
To complete your immigration medical exam, bring your valid passport or government-issued photo ID, your I-485 receipt notice (if available), your J-1 waiver approval notice (if applicable), all vaccination records you have (including records from your home country and from your exchange program), and any relevant medical records.
J-1 researchers and scholars often have health records from their sponsoring institution. Bring these records to the appointment — they may help reduce the number of vaccines you need. Call ImmigrationMedicalExams.com at 714-760-4538 to schedule your exam.
Frequently Asked Questions
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