Most physicians/International Medical Graduates (IMGs) seeking to enter the United States to practice medicine must initially engage in training before they can actually move into private, academic, or other clinically oriented practice areas. This is largely because licensing requirements in each state require training in the United States and, without a license, a visa is not an option. Therefore, for the vast majority of physicians, the first step to coming to the United States will be to get accepted into a residency or fellowship program.

Physicians seeking to enter the United States to engage in graduate medical training can normally enter on either an H-1B or J-1 nonimmigrant visa. Most physicians enter with J-1 exchange visitor visas in a J-1 category specifically carved out for graduate medical training. ECFMG (the Educational Commission on Foreign Medical Graduates) is the sole sponsor of physicians coming in to the United States for graduate medical training.