FSO Medical Clearance Process

FSO Medical Clearance Process

What is a FSO Medical Clearance

The FSO Medical Clearance process can be extremely confusing. It is briefly mentioned in the FSOT guidelines and although the State Department describes the logistical and administrative process thoroughly, there really isn’t any helpful guidance to assist potential FSOs in answering questions or give advice on how to prepare their medical record prior to beginning the FSO selection process.

The key mistake that potential FSOs make during their medical clearance portion is that they don’t understand the severity of their responses. In most cases, everyone applying does not have some major disease like aids, cancer or something else that would obviously preclude them from becoming a FSO. But what most don’t realize is things like asthma, headaches, ADD, and diabetes, if not discussed in the right manner or handle correctly can also preclude you from passing the medical board.

Therefore, this article hopes to break down the medical process, and give the reader the right perspective in which to address any issues and prepare themselves for their medical board before it is too late.

The Basics of a Medical Clearance Board

A medical clearance is a signed document that in essence says that a full review of your health record and medical needs has been conducted, and that a medical team believes that you can serve in any country in the world without special medical requirements or attention.

They do this by analyzing your medical needs and situation and comparing that to the medical requirements of a country with the lowest amount of medical facilities and poor living condition. The idea is that if the medical board finds you suitable to thrive in the worst situation, then it can be assumed that you can take any assignment in the world.

So, as you can see, even the smallest of ailments can cause you to fail this portion of the review. You asthma, or diabetes may not be a problem in the U.S., however, in a country that has a problem with medical supplies or poor air quality, you will quickly become a concern.

To understand this more, let’s breakdown the board’s perspective into two main categories: Environmental Conditions and Medical Requirements. The ability to live in a country, as per the medical board, is based on your ability to cope with its environment and its lack and medical support.

Environmental Conditions

Many countries in the world have large amounts of pollution and have environmental conditions that we are not used to. Because of this, simple resources and supplies are thinned and there can be an increased stress on a human body.

When it comes to environmental changes, there are a couple of ailments that can be severely affected by this: Asthma, headaches, stomach problems, and weakened immune systems.

Therefore, when looking at your medical record and your responses, the doctor will want to know that you can handle polluted air, contaminated water or other environmental challenges.

Medical Facilities

In many countries around the world, their medical system is archaic and behind the times. Although they may have hospitals and doctors within reach, the U.S. embassy will have to send you to another country just to get the medical attention you need. It is because of this, that the State Department doesn’t want you having a preconceived ailment that may require a dependency on an already failed medical system.

Small things like insulin shots, headache medicine, rynolyn or another order medication that you might depend on can hurt your chances of passing the medical board.

So What Can You Do

Sadly, if you have any major maladies in your record, then there isn’t much that you can do. The review board will see this and depending on the severity, they will make their judgement.

But there are ways in which you can start to clean up your record as you prepare for the medical board.

Reduce the Recorded Severity

When it comes to sickness and their severity, there are those that you can measure and those that you can only describe. Those with a specific measurement like red blood cell count, blood pressure, etc, you have no control over. If they get marked on your medical record, then they will be there for the board to see. However, the severity of other maladies without a specific measuring medium are subject to your own account. Example:

  • Headaches and migraines are determined by your description and the level of pain reliever that you request or need to make it go away.
  • Asthma is based on your use of the inhaler and it description/frequency of the attacks.

So, if you have a specific non-measureable malady, you might want to look for alternative ways of reducing the symptoms or dependency for medication. By doing this, the doctors will see that it is minimal and see that your dependency on a specific type of medication or facility is negligible.

Your Responses in the Interview

When you are doctors starts asking about your record or anything you have had, try not to respond in a way that would give them concern. Some people are very concervative in this portion and will respond “yes” to a question, even if they aren’t sure. Before you say “yes” to something in the questionnaire or in the medical review, ensure that it is something you really do have or really are concerned with. Example questions:

      • Have you been to the Hospital in the last 2 years
      • Have you had a loss of appetite recently?
      • Have you been under stress?

While most of us could answer yes to some of these, understand that during the board, you only want to answer yes, if it was absolutely serious and can’t be helped. If you were treated for depression, had a major disease that caused you to lose your appetite, or got surgery, then answer yes, but not for something like you had a cold, our you had a bad week at work.

Don’t Forget About the Family

If you have a wife or kids, understand that they will need to pass the Medical exam too before they can go with you anywhere. This doesn’t mean that you won’t be selected because you wife has severe asthma, but instead it means that if you get selected to go work in India, she might not be able to go and you will now have to do a “geo-bachelor” tour without her and consequently the kids too.

This is something that you must consider because the State Department expects you to take all assignments that you are given and you can’t just back out because your family cannot come.


So make sure you understand what the board is really looking for: Are you capable of handling a bad environment with poor medical facilities? It doesn’t necessarily mean that you will be sent to that place, but only assures the Department of State that you can go anywhere they send you.


The point of this article is not to advise you to lie, but to give you better context so that you don’t make a mistake and bring light to something that you don’t necessarily need to bring up. When it comes to your health, you should be honest. But makes sure that you fully understand the question before you mark yes, or incriminate yourself with something that you didn’t intend to do.


  1. Dustin
    September 28, 2017 at 00:37

    What about service connected disabilities like PTSD or TBI? Hearing loss?

  2. Garet
    July 22, 2019 at 21:27

    I read an article from 2013 where two young men with type 1 diabetes passed everything but the medical exam on the FSOT and as a result were denied the position. In turn they brought a case against the State Department and won. Both became foreign service officers and I believe both are still currently serving as one. So there is hope for those with manageable ailments.

  3. Eric
    August 29, 2019 at 06:31

    Thanks for your informative post!

    Will those with bipolar disorder be rejected?


    • Chris
      October 16, 2020 at 00:26

      Regarding bipolor disorder – the answer is that you will probably be rejected.

      I made it all the way through the selection process, got a conditional offer, passed the security clearance, but failed the worldwide availability requirement due to a history of depression which is currently stable and asymptomatic, but for which I still take medication.

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