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Curbside Consultation

Documenting US Citizenship Examination Exemption for Medically Qualified Refugees

This is a corrected version of the article that appeared in print.

Sommer Aldulaimi, MD, FAAFP
Suzanne Teeple, JD

American Family Physician. 2024;110(5):539-541.

Author disclosure: No relevant financial relationships.

SOMMER ALDULAIMI, MD, FAAFP, and SUZANNE TEEPLE, JD, University of Arizona, Tucson, Arizona

Address correspondence to Sommer Aldulaimi, MD, FAAFP, at Sommer.Aldulaimi@bannerhealth.com.

Author disclosure: No relevant financial relationships.

  1. 1.Department of State Bureau of Population, Refugees, and Migration Office of Admissions. Refugee Processing Center summary of refugee admissions. August 31, 2024. Accessed September 30, 2024. https://www.wrapsnet.org/documents/PRM%20Refugee%20Admissions%20Report%20as%20of%2031%20Aug%202024.xlsx
  2. 2.Baird K, Lintz M, Schlander D, et al. Caring for refugees with mental health problems: difficulties encountered by providers requesting exemptions from United States citizenship examinations. J Health Care Poor Underserved. 2023;34(4):1466-1478.
  3. 3.Mölsä M, Kuittinen S, Tiilikainen M, et al. Mental health among older refugees: the role of trauma, discrimination, and religiousness. Aging Ment Health. 2017;21(8):829-837.
  4. 4.U.S. Citizenship and Immigration Services. 8 U.S.C. 1612.a.2.A.i: limited eligibility of qualified aliens for certain federal programs. January 3, 2024. Accessed April 22, 2024. https://www.govinfo.gov/content/pkg/USCODE-2010-title8/pdf/USCODE-2010-title8-chap14-subchapI-sec1612.pdf
  5. 5.U.S. Citizenship and Immigration Services. 8 CFR 312: educational requirements for naturalization. Accessed October 8, 2024. https://www.ecfr.gov/current/title-8/chapter-I/subchapter-C/part-312
  6. 6.U.S. Citizenship and Immigration Services. 8 CFR 312.2.b.2: educational requirements for naturalization: knowledge of history and government of the United States: exceptions: medical certification. Accessed October 8, 2024. https://www.ecfr.gov/current/title-8/chapter-I/subchapter-C/part-312#p-312.2(a)
  7. 7.U.S. Citizenship and Immigration Services. Naturalization test performance. Updated October 5, 2023. Accessed April 22, 2024. https://www.uscis.gov/citizenship-resource-center/naturalization-related-data-and-statistics/naturalization-test-performance
  8. 8.Kumar GS, Beeler JA, Seagle EE, et al. Long-term physical health outcomes of resettled refugee populations in the United States: a scoping review. J Immigr Minor Health. 2021;23(4):813-823.
  9. 9.Blackmore R, Boyle JA, Fazel M, et al. The prevalence of mental illness in refugees and asylum seekers: a systematic review and meta-analysis. PLoS Med. 2020;17(9):e1003337.
  10. 10.U.S. Department of Veterans Affairs. PTSD: National Center for PTSD: PTSD Checklist for DSM-5 (PCL-5). Accessed April 15, 2024. https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp
  11. 11.Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2014.
  12. 12.Storey JE, Rowland JTJ, Basic D, et al. The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. Int Psychogeriatr. 2004;16(1):13-31.
  13. 13.Rami F, Searight HR, Morrissey MB, et al. Health inequities and social determinants of health in refugee and immigrant communities. Am Psychol. 2023;78(2):160-172.
  14. 14.Rodgers M. Assisting naturalization applicants who have disabilities by using form N-648: understanding the disability exception. May 2018. https://www.ilrc.org/sites/default/files/resources/n648_advisory-1of2-20180509v2.pdf
  15. 15.Department of Homeland Security, U.S. Citizenship and Immigration Services. Instructions for Medical Certification for Disability Exceptions: USCIS form N-648. August 19, 2022. Accessed April 22, 2024. https://www.uscis.gov/sites/default/files/document/forms/n-648instr.pdf

Case scenarios are written to express typical situations that family physicians may encounter; authors remain anonymous. Send scenarios to afpjournal@aafp.org. Materials are edited to retain confidentiality.

This series is coordinated by Caroline Wellbery, MD, associate deputy editor.

A collection of Curbside Consultation published in AFP is available at https://www.aafp.org/afp/curbside.

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