Children adopted from abroad come from diverse cultural backgrounds and living conditions. For this reason, prospective adoptive families should request a comprehensive medical evaluation of their adoptive child and be aware of the unique medical, nutritional, environmental, and psychological issues such children may face. NOTE: The medical examination required by the Department of State for the child's immigrant visa is NOT a comprehensive evaluation.
All immigrants, including adopted children, undergo a physical examination by a doctor who has been approved by the Department of State. The U.S. Embassy or Consulate can provide a list of such physicians, called "panel physicians," within the foreign country.
The medical examination focuses primarily on detecting certain serious infectious or contagious diseases, or medical disabilities that may be a basis for visa ineligibility. It consists of a brief physical exam and a medical history. A chest X-ray for tuberculosis and blood test for syphilis are required for immigrants 15 years of age and older.
Per CDC’s new technical instructions, panel physicians are required to screen children for tuberculosis using an Interferon Gamma Release Assay (IGRA) test – in lieu of a Tuberculin Skin Test (TST) – for children between the ages of two and 14 living in countries with a WHO-estimated TB incidence rate of 20 per 100,000 or greater, if there is an FDA-approved IGRA test licensed for use in that country. WHO-estimated TB incidence rates for each country are located on WHO’s website: http://www.who.int/tb/country/data/profiles/en/.
If the panel physician or the consular officer learns that the child has a serious condition or disability that affects visa eligibility, the parents will be notified. The consular officer will also confirm that the parents are aware of any medical or developmental conditions noted by the panel physician. If a child is found to have any of these illnesses or disabilities (generally referred to as "ineligibilities"), he or she may still receive a visa after the illness has been successfully treated, or after U.S. Citizenship and Immigration Services (USCIS) approves a waiver of the ineligibility, if available.
Prospective adoptive parents should not rely on this medical examination to detect all possible medical conditions and may wish to arrange an additional private medical examination if they have concerns about the child's health. The scope of the panel physician's medical examination is, by law, limited; its purpose is to enable the U.S. Government to identify persons with serious infectious or contagious diseases. It is not designed to evaluate the child's overall health, provide medical care for the child, or give adequate information on the child's short-term and long-term medical needs.
See the Department of State's Office of Visa Services web pages for more information and frequently asked questions on the medical exam. The Centers for Disease Control and Prevention (CDC) also offers adoptive parents valuable information on follow-up medical examinations, screening for infectious diseases, and vaccinations.