@Hawagiri02 Basically this means since Nov'18 they made policy where after doing I693 medical exam, it needs to be submitted within 60 days to USCIS, just make sure if it was filed within 60 days. Not to be confused with two year validity of exam once it is submitted to USCIS within 60 days. Excerpt "USCIS is now requiring I-693 medicals to be filed within 60 days of the date the Civil Surgeon signs the medical exam".