The medical examinations for Form I-485 application are conducted by "Civil Surgeons". Civil surgeons are physicians approved by the U.S. Citizenship and Immigration Services (USCIS) to perform the required medical tests and evaluations of foreign nationals present in the United States and seeking permanent resident ("Green Card") status. The medical examination is submitted with the I-485 application. A similar procedure is followed outside of the United States, for those applying for permanent immigration benefits at a U.S. consulate abroad. These individuals undergo the same type of medical examination, conducted by panel physicians approved by the U.S. Department of State (DOS).