ORLANDO | As the U.S. bishops continue to call for comprehensive immigration reform, one doctor seeks to demystify an important part of the green card application process.

Dr. Rebecca Pirela is a U.S. Citizenship and Immigration Services (USCIS)-designated civil surgeon. She began doing immigration medical examinations in 2003 as a Catholic Charities of Central Florida volunteer.

“A lot of people don’t understand what that means because it sounds kind of weird,” Pirela said. “So, I’m a civil surgeon, not a military surgeon.” This does not mean she is a surgeon. She is an Orlando-based family medical doctor.

She provides a “service to the federal government to do the screening of the applicants who wish to stay here on a permanent basis.” According to USCIS, “the immigration medical examination must be performed by certain doctors designated by USCIS (known as civil surgeons) to perform the immigration medical examination most green card applicants need.”

Born and raised in Venezuela, Pirela immigrated to the United States when she was 21. Although she was already a U.S. citizen because her mother is American, it took time to adjust to speaking a different language and navigating the education system. She understands what it is like to move to another continent and start over.

“This is a country of opportunities,” she said. “I’m very blessed to be here.”

After operating her own family practice for many years, she began to do more immigration medical examinations. “I just became so busy with all the immigration physicals that it’s become a big part of my practice,” Pirela said, who explained the whole point of the immigration medical examination is security.

“The federal government wants to make sure that the people that are going to come to our home, (the) United States are good people, people (who) are not going to be a public threat,” she explained. “The most important part is their behavior. They want people that don’t have antisocial tendencies.”

She also checks individuals for infectious diseases.

In addition to a basic physical exam, Pirela interviews clients about their history. “We want good people in our home, and we are open arms to people that want to be productive.”

“I’m mostly focused on the medical part, but we know the applicants need a lot of help, and a lot of times I get to see them more than once,” explained Pirela. She will often help clients throughout their integration into the United States. “We have to do everything in our power to help when we can.”

“Imagine having to, you know, move or relocate your family to a new country, not knowing anybody and not knowing how the system works. You need all the help you can get,” said Pirela.

“You see families who fall prey of organizations or people who don’t have their best interests at heart.”

Because of her longstanding relationship serving Catholic Charities of Central Florida in this capacity, CCCF asked Pirela to give a presentation to a group of about 25 immigrants on the I-693 form, the report of immigration medical examination and vaccination record filed when immigrants apply to adjust their status to lawful permanent resident.

“It’s intimidating,” Pirela said. “Families come with a lot of anxiety. They don’t know what to expect, what is going to be required.” In addition, policies change over time. For instance, the government no longer requires the COVID vaccine and allows HIV positive immigrants to enter the country.

Karen Kanashiro, case management employment manager, said Catholic Charities of Central Florida has seen a drop in the number of immigrants seeking assistance.

“With the past administration, we used to see around 400 people a month,” Kanashiro said. Now, she estimates they see around 40 people per month. “What we’ve seen by now is an increase of refugees from South Africa.”

Under Executive Order 14204, President Donald Trump directed the Secretaries of State and Homeland Security “to prioritize humanitarian relief, including admission and resettlement through the United States Refugee Admissions Program, for Afrikaners in South Africa who are victims of unjust racial discrimination.”

Through her presentation, she breaks down what is required during the exams and how to properly fill out the corresponding forms, so immigrants know what to expect. “They want all those questions answered so they can prepare a little better.”

Emmie Deysel, a refugee from South Africa, attended Pirela’s presentation. Deysel said she sought assistance from Catholic Charities six months ago.

“I’m part of a community of 14 families by now that they have supported in so many ways, apart from the legal service and helping us find answers… giving us a home to come to, a door to knock on, and building (this) trust has been amazing.”

“Reflecting on her work with Catholic Charities of Central Florida, Pirela is grateful for the continued efforts to support immigrants. “What Catholic Charities does for people… it’s a saving grace, it’s amazing.”

“Most people, like you see here (at) Catholic Charities, are refugees,” Pirela continued. “I love partnering with Catholic Charities, This organization has been a safe haven for migrants throughout the years.”

By Lucas Blackwell of the Florida Catholic staff, November 5, 2026