Does Someone on STEM OPT Need an Immigration Medical Exam for a Green Card?
Quick Answer
Yes — STEM OPT workers who file Form I-485 to adjust status to a green card must complete an immigration medical exam with a USCIS-designated civil surgeon and submit Form I-693. Your STEM OPT authorization does not exempt you from this requirement.
STEM OPT and the Path to a Green Card
STEM OPT (Optional Practical Training) is a 24-month extension of post-completion OPT available to F-1 students who have earned a degree in a STEM field and are employed by an E-Verify employer in a job directly related to their degree. STEM OPT allows international students to gain practical work experience in the United States for up to three years total (12 months of standard OPT plus 24 months of STEM OPT extension).
The most common pathway from STEM OPT to a green card is through employer sponsorship. Many STEM OPT workers transition to H-1B status through the annual H-1B lottery, and their employer then sponsors them for a green card through the EB-2 or EB-3 employment-based preference categories. Some STEM OPT workers may also qualify for EB-1A (extraordinary ability) or EB-2 NIW (national interest waiver) self-petition. Once an I-140 petition is approved and a visa number is available, the worker can file Form I-485 to adjust status.
When the Medical Exam Is Required
The immigration medical exam is not required during the STEM OPT period itself. 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.
STEM OPT workers who are still on STEM OPT when they file I-485 must complete the medical exam just like any other adjustment of status applicant. Your STEM OPT authorization, your employer's E-Verify participation, or your STEM degree does not exempt you from the medical exam requirement.
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.
Transitioning from STEM OPT to H-1B to Green Card
The most common STEM OPT to green card pathway involves transitioning to H-1B status first. H-1B status provides a more stable immigration status for the duration of the green card process, which can take several years for workers born in high-demand countries such as India or China due to per-country visa backlogs in the EB-2 and EB-3 categories.
During the H-1B period, the employer typically files a PERM labor certification application (for EB-2 or EB-3), followed by an I-140 immigrant petition. Once the I-140 is approved and a visa number becomes available, the worker files Form I-485. The medical exam is required at the I-485 stage, regardless of whether the worker is still on H-1B, has an approved I-140, or has been waiting for a visa number for many years.
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.
STEM OPT workers who are still on STEM OPT when they file I-485 should be aware that their STEM OPT authorization will expire at the end of the authorized period. Once the I-485 is filed, the pending application generally protects you from removal. Consult your immigration attorney about maintaining authorized stay during the transition.
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), all vaccination records you have (including records from your home country and from your university health center), and any relevant medical records.
International students who have been in the United States for several years may have received some U.S. vaccinations through their university health center. 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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