Approximately one quarter of the country’s physicians are foreign medical graduates. Physician immigration is one of the most complex areas of U.S. immigration law, requiring coordination between multiple government agencies. Due to the complex nature of physician immigration, any mistakes in the immigration process can result in significant delays or even the inability to practice medicine in the U.S. at all. Regardless of the care taken in the process, problems may occur. However, knowing some of the most common immigration mistakes that foreign medical graduates make, can be helpful.

The most common nonimmigrant visa options for physicians entering for training.

Physicians coming to the U.S. for graduate medical training usually enter on either an H-1B or a J-1 nonimmigrant visa, with over 80% of the foreign medical graduates entering on a J-1. The J-1 is a popular choice for training programs mostly because the Education Commission for Foreign Medical Graduates (“ECFMG”) does the work of determining the physician’s eligibility to work in the U.S. and is authorized by the Department of State to sponsor J-1 physicians enrolled in accredited graduate medical education programs.

The J-1 visa option

Those physicians entering on a J-1 have two options after completing their training if they wish to practice in the U.S. They can return to their home country for a two-year period and then apply for re-entry. Alternatively, they can apply for a J-1 visa waiver, which waives the two-year home residency requirement. In order to obtain a J-1 waiver, the physician usually must commit to working in an underserved area, typically rural, for three years. For many J-1s, neither returning home nor practicing at a rural center are particularly appealing options.

The H-1B visa option

If the goal of the physician is to live and work in the U.S. after training, entering on an H-1B is usually preferable. First, the physician avoids the home residency requirement after training. Second, many medical specialties do not lend themselves to a rural practice setting, making a J-1 waiver implausible. For instance, you are not likely to find a radiation oncologist practicing in rural Kansas.

Although preferable for many physicians, H-1Bs can be more difficult to obtain and are only valid for a maximum of six years. However, some training programs last longer than six years and physicians seeking subspecialty training may use up most of their six years in training. If the physician is considering a lengthy fellowship, the J-1 may be the more appropriate visa.

In Conclusion

Frequently, training programs have already determined the type of visa that will be offered to foreign medical graduates. Because of this, physicians are advised to consider their long-term goals when deciding which programs to apply. Finally, consulting with an immigration attorney that understands the complexities of physician immigration can help foreign medical graduates meet those long-term goals. In Dayton, physicians seeking a green card should meet with an immigration attorney, who understands the value that foreign medical graduates bring to our community.