Chapter 4 – Termination and Revocation
A. Voluntary Termination
A civil surgeon who no longer wishes to be designated as a civil surgeon should request, in writing, that USCIS terminate the designation.  See www.uscis.gov/i-910 for more information on where to send a request to terminate one’s designation.
A physician who voluntarily terminates his or her civil surgeon designation must re-apply with USCIS if he or she wishes to be designated as a civil surgeon again.
Current regulations do not contain specific revocation provisions; however, the law does not preclude revocation, especially when the physician no longer qualifies for civil surgeon designation.
1. Grounds for Revocation
USCIS may revoke a physician’s civil surgeon designation if he or she:
•Fails to comply with the Technical Instructions, Form I-693 Instructions, or fails to fulfill other responsibilities of a civil surgeon consistently or intentionally;
•Falsifies or conceals any material fact in the application for civil surgeon designation, or provides any false documents or information to obtain the designation;
•Knowingly falsifies or conceals any material fact on Form I-693, or includes any false documents or information to support any findings in the record;
•Fails to maintain a currently valid and unrestricted license to practice as a physician in any state in which the physician conducts immigration medical examinations, unless otherwise excepted or exempted from this requirement;
•Is subject to any court or disciplinary action that revokes, suspends, or otherwise restricts the physician’s authority to practice as a physician in any state in which the physician conducts immigration medical examinations; or
•Has failed to meet any of the professional qualifications for a civil surgeon at any time during the period of a physician’s designation as a civil surgeon, unless USCIS finds both that the physician has corrected any gap in eligibility and that the physician refrained from conducting immigration medical examinations during any period in which the physician was not eligible for designation as a civil surgeon.
2. Initiating Revocation
The file should be well-documented before USCIS takes any steps to revoke a physician’s civil surgeon designation. When the proposed revocation is based on allegations of misconduct reported by an adjustment of status applicant, the officer should take a sworn statement to support the allegations. The officer should also retain any other available evidence of the alleged misconduct.
The NBC may request the assistance of other USCIS offices to collect evidence if such evidence is not otherwise available to the NBC and if resources allow. For instance, if the NBC is unable to reach or communicate with a particular civil surgeon, the NBC may request assistance from the local office to contact the civil surgeon.
In instances where the civil surgeon may be involved in fraud, USCIS Fraud Detection and National Security Directorate (FDNS) should be notified per the standard fraud referral operating procedures and the civil surgeon’s record should be annotated to reflect that suspected fraud played a factor in initiating revocation. Depending on the nature and severity of the allegations, it may also be necessary to consult with CDC to obtain expert medical advice.
USCIS counsel must review any proposed revocation, unless the intended revocation is based on evidence that the civil surgeon is no longer licensed to practice medicine in the state where he or she is performing immigration medical examinations. When referring the case to USCIS counsel, the officer should include the reasons for the intended revocation and copies of the supporting evidence.
Once the decision has been made to initiate the revocation, the officer must serve the physician with a notice of intent to revoke by Certified Mail/Return Receipt Requested or other method that provides proof of delivery. The notice must clearly state the exact grounds for the intended revocation and include copies of any relevant evidence.  USCIS may redact certain sensitive or identifying information. The officer must give the physician 30 days from the date of the notice to respond with countervailing evidence. The physician may be represented by private counsel at his or her own expense.  Notice of Entry of Appearance as Attorney or Accredited Representative (Form G-28) must also be filed in this case.
3. Allegations of Malpractice, Breaches of Medical Ethics, and Other Improper Conduct
The authority to designate civil surgeons does not give USCIS authority to regulate the practice of medicine. For this reason, the process for revoking designation as a civil surgeon is not the proper forum for adjudicating complaints against a physician concerning malpractice, breach of medical ethics, or other improper conduct. If USCIS receives a complaint of this kind, USCIS should advise the complainant to make the complaint with the proper medical licensing authority for the State or territory in which the physician practices.
Once the period for the physician’s response to the notice of intent to revoke has expired, USCIS will review the record and decide whether to revoke the physician’s designation as a civil surgeon. Any response from the physician will be included in the record of proceeding. USCIS must notify the physician in writing of the decision.
There is no administrative appeal from a decision to revoke a physician’s designation as a civil surgeon. The physician may, however, file a motion to reopen or reconsider.  As permitted in 8 CFR 103.5. To file a motion to reopen or reconsider, a physician should file a Notice of Appeal or Motion (Form I-290B), with fee. Forms and fee information can be found at www.uscis.gov. A decision revoking a physician’s designation as a civil surgeon must notify the physician of the right to file a timely motion to reopen or reconsider.
Similarly, USCIS may reopen and reconsider a decision on its own motion. A physician whose civil surgeon designation is revoked is not precluded from reapplying for civil surgeon designation, but the ground(s) upon which revocation is based should be considered as part of the adjudication of a subsequent application for civil surgeon designation. A physician, however, whose prior civil surgeon designation was revoked based on confirmed involvement in an immigration benefits fraud scheme will be denied civil surgeon designation upon reapplication.
If USCIS revokes a physician’s designation as a civil surgeon, the public civil surgeon list should be updated immediately to remove the civil surgeon’s information.  As specified in Chapter 5, Civil Surgeon List [8 USCIS-PM C.5].
If an officer reviewing Form I-693 has a concern about the sufficiency of an immigration medical examination performed by a physician who was designated at the time of the medical exam but subsequently had his or her designation revoked, the officer may reorder the medical exam to be performed by a civil surgeon to address the concern.  In general, an officer may order or reorder an immigration medical examination, in part or in whole, at any time if he or she has concerns regarding an applicant’s inadmissibility on health-related grounds. See Volume 8, Admissibility, Part B, Health-Related Grounds of Inadmissibility [8 USCIS-PM B].
See www.uscis.gov/i-910 for more information on where to send a request to terminate one’s designation.
USCIS may redact certain sensitive or identifying information.
Notice of Entry of Appearance as Attorney or Accredited Representative (Form G-28) must also be filed in this case.
As permitted in 8 CFR 103.5. To file a motion to reopen or reconsider, a physician should file a Notice of Appeal or Motion (Form I-290B), with fee. Forms and fee information can be found at www.uscis.gov.
In general, an officer may order or reorder an immigration medical examination, in part or in whole, at any time if he or she has concerns regarding an applicant’s inadmissibility on health-related grounds. See Volume 8, Admissibility, Part B, Health-Related Grounds of Inadmissibility [8 USCIS-PM B].
POLICY ALERT – Civil Surgeon Designation and Centralization of the Designation Process at the National Benefits Center
January 28, 2014
U.S. Citizenship and Immigration Services (USCIS) is issuing policy guidance in the USCIS Policy Manual to centralize the civil surgeon designation process at the National Benefits Center, effective March 11, 2014.