The Complete Guide to the Medical Exam You Must Complete Before Your U.S. Embassy Interview

In the U.S. immigration process, the medical examination is a step just as important as the embassy interview.
Many applicants think, "It's probably just a required step where the hospital does a quick check and submits it," but in reality it's a legal review process designed very precisely to comply with U.S. public health regulations.

The U.S. Centers for Disease Control and Prevention (CDC) updates its immigrant and nonimmigrant medical screening standards every year, and every green card applicant must be evaluated according to those standards. In particular, between 2023 and 2025 the U.S. has further strengthened screening for tuberculosis (TB), measles, and mental health-related risks.

This article organizes the medical exam into an in-depth column based on the questions clients ask most often: "where?", "what?", and "why is it done this way?"

1. Why Does the U.S. Require a Medical Exam?

The purpose is "protecting public health," not ranking people's health.

The green card medical exam is not designed to evaluate an applicant's overall health or to judge suitability for U.S. immigration.
Its sole purpose is to identify and manage in advance specific diseases that carry a risk of spreading within the United States.

The CDC defines the following four areas as ones that "immigrants must be reviewed for":

- Whether a communicable disease is present
- Mental health-related safety (risk of harm to self or others)
- Drug abuse/addiction status
- Whether required vaccinations have been completed

If even one of these criteria isn't met, the visa can be held or delayed — not because of the specific medical history itself, but because of the potential risk it poses to American society.

2. Where Can You Get the Exam?

The U.S. Embassy does not accept exams from ordinary hospitals.
The reason is simple: examination standards must be kept consistent worldwide.

Therefore, for the immigrant visa (DS-260) medical exam in Korea, only specific designated hospitals are authorized to perform the official green card medical exam:

- Gangnam Severance Hospital
- Yeouido St. Mary's Hospital
- Sinchon Severance Hospital
- Busan Haeundae Paik Hospital

These hospitals must maintain examination protocols according to the international standards set by the CDC, and they undergo training and audits from the U.S. government every year.

When is the best time to schedule?
- 2 to 3 weeks before the interview is the most stable timing
- Results are generally completed within 5 to 7 days
- Since the validity period is 6 months, getting it too early can cause problems at either the interview or entry stage.

3. What Order Does the Medical Exam Follow?

The specific flow varies slightly by hospital, but the overall process is nearly identical.

Step 1: Registration and Medical History Interview

- Passport verification
- Interview letter verification
- Photo submission
- Medical history interview (TB, psychiatric, surgical history, etc.)

What matters at this stage is being honest about your medical history. The U.S. views hiding medical history as the most serious problem of all.
There's no need to hide anything, and there's no benefit to doing so.

Step 2: Physical Examination

This is performed directly by a doctor and includes the following items.
- Basic vital signs (blood pressure, pulse, temperature, etc.)
- Full-body examination (heart, lungs, abdomen, skin, nervous system, musculoskeletal)
- Mental health evaluation
· Schizophrenia, severe depression, risk of harm to self or others
· A past history of psychiatric treatment is not itself a problem. What matters is "whether there is a current risk"

Many applicants mistakenly think this is "a psychological test like an interview," but its real purpose is a safety evaluation to determine whether the person could pose a risk of harm to themselves or others after entering the country.

Step 3: Chest X-ray (Tuberculosis Test)

The U.S. has one of the strictest tuberculosis standards in the world. Korea in particular is classified as a moderate-TB-incidence country, so it's reviewed even more closely.
- X-rays are mandatory for those age 15 and older
- If there's a history of past TB treatment, records must be submitted
- Having scarring alone doesn't automatically cause a problem
- If active TB is suspected, additional testing and a visa hold are possible

In recent years, the CDC has tightened requirements for past treatment records in order to verify recent infection status and adequacy of treatment.

Step 4: Blood Test

The following two infectious diseases are subject to mandatory testing.
- HIV
- Syphilis

The era when testing positive for HIV automatically led to visa denial is already in the past. What matters is whether the person is currently receiving treatment and whether there's a public health risk.

Step 5: Vaccination Assessment

This is the step that takes the most time and creates the most misunderstandings in the whole process.
The list of vaccines required by the CDC is as follows:

Key required vaccines
- MMR
- Tdap or Td
- Varicella (chickenpox)
- Influenza (for those examined October through March)
- Other age-specific vaccines (HPV, polio, etc.)

What if you don't have vaccination records?
This is a common situation in Korea.
- Without records, the hospital determines that "vaccination status cannot be confirmed"
- In this case, you'll need to get vaccinated again
- Some vaccines (such as MMR) can be substituted with an antibody test

Strategic tip:
People who were educated abroad or served in the military often have scattered records, so gathering all records in advance as much as possible greatly helps save cost and time.

4. How Are the Exam Results Submitted?

The hospital provides the exam results in one of the following two ways.

Method A: Sealed Packet

- The applicant brings it directly to the embassy interview
- Must never be opened
· If opened, it's considered "contaminated" and retesting is required

Method B: eMedical (Electronic Submission System)

The hospital sends the results directly to the U.S. Embassy.
The applicant only needs to bring the receipt.
In Korea, submission methods vary by hospital, so simply follow the instructions given on-site.

5. What Health Reasons Ultimately Lead to Visa Denial?

Many applicants ask, "Could my green card be impossible because of a condition I have?"
The actual reasons for denial are only the following four, and they're very clear.

① Active tuberculosis (Active TB)
The visa can be issued without problems after treatment.

② Untreated infectious syphilis
Processing proceeds normally after being cured.

③ Drug abuse/addiction
Simple past use isn't a problem — what matters is whether there is current addiction.

④ Refusal of required vaccinations
For immigrant visas, the U.S. does not recognize refusing vaccination for "religious or philosophical reasons."

6. Common Problems in the Medical Exam and How to Solve Them

From an immigration expert's perspective, the issues largely boil down to the following three categories.

① Missing vaccination records
Since vaccines can be fairly costly, most clients find advance preparation the most difficult part.
The solution is simple.
- Prepare all available past vaccination records in English
- If unavailable, use an antibody test instead
- If there's nothing at all, simply get vaccinated at the hospital

② TB scarring or past treatment
This is a common situation in Korea.
- Scarring alone does not result in denial
- A sputum test can be requested if necessary
- In this case, results can take 8 weeks or longer
So it's best to confirm your medical history and prepare records well before your interview is scheduled.

③ History of psychiatric treatment
Many applicants try to hide this.
But the U.S. standard is as follows:
- A past history alone is not a problem
- Review is only triggered if there has been risk of harm to self or others, or a serious disorder, within the past year
Hiding medical history actually becomes a reason for visa denial.

7. The Validity Period of Exam Results — "The 6-Month Rule"

In most cases, the medical exam is valid for 6 months. However, it may be shortened to 3 months if additional TB-related testing was required.

So for cases where the NVC stage takes a long time, such as EB-3 unskilled, the timing of the medical exam must be coordinated carefully with your agent.

8. The Medical Exam Isn't a Simple Check — It's "a Legal Review Process That Meets Public Health Standards"

Hundreds of thousands of people immigrate to the U.S. every year.
The U.S. maintains a strict process so that every applicant is evaluated according to the same standards.

So the medical exam isn't just a hospital visit — it's a sophisticated procedure based on U.S. immigration law and CDC regulations, and preparing ahead of time can significantly reduce cost and time.

In particular, organizing vaccination records, TB history, and psychiatric history in advance can significantly reduce delays in your interview schedule.