Non-Immigrant Visa Categories
J-1 Visa
A. J-1 visa categories
Specifically includes foreign medical graduates receiving graduate medical training in the United States
- Training can be clinical or non-clinical
- Period of stay up to seven years
- Foreign medical graduates must be sponsored by the Educational Commission on Foreign Medical Graduates (ECFMG)
- J-1 physicians always subject to the two-year foreign residence requirement
B. Basic J-1 visa requirements
Standard nonimmigrant visa requirements must be satisfied
- Maintenance of home/residence in foreign country
- Temporary intent/will return home upon completion of training program
- To qualify for ECFMG sponsorship, foreign medical graduates must satisfy specific testing requirements
- If graduate of either U.S. or Canadian medical medial school accredited by the Liaison Committee on Medical Education – exempt from above-mentioned testing requirement
- Training program will not exceed “standard” time
- Must return home unless two-year foreign residence requirement is waived
H-1B Visa
A. Basic Requirements
- Applicant possesses, at a minimum, a bachelor’s degree in a directly relevant academic discipline
- Position requires, at a minimum, a bachelor’s degree
- H-1B visa category not limited to direct patient care. Can also conduct research, teach and receive graduate medical training
- A better visa option for foreign medical graduates who wish to receive medical training – as there is no two-year home residence requirement
B. Additional requirements for foreign physicians
- FLEX Examination or designated equivalent
i. Previously NBME (Parts 1-3) or USMLE (Steps 1-3)
ii. Currently only USMLE (Steps 1-3) - ECFMG English language certificate (TOEFL)
i. Does not apply to graduates of U.S. medical schools - M.D. diploma (in foreign state) or full unrestricted license to practice medicine in foreign state
- License or other authorization required by that state to practice medicine in that state. Can be, in some states, a provisional or training license
- Exemptions for Canadian nationals:
Most states in the U.S. recognize the Canadian Licensure Exam (LMCC) for licensure purposes - B. Graduates of Canadian medical schools accredited by LMCC also need not establish English competency
- Graduates from an LMCC accredited medical school in Canada are still required to satisfy the FLEX examination/credentialing requirement
- Exemptions for Canadian nationals:
C. Licensure and credentialing/examination are two totally different requirements and must be approached accordingly
TN Visa
- Applicable only to citizens/nationals of Canada or Mexico
- Authorizes only research-related duties, i.e. not clinical medicine
- Basic requirements:
- Medical degree
- Job offer from U.S. employer
- Performing research duties only
- Admission procedures for Canadian nationals
- Documentation submitted directly at airport/port of entry
- Admission period is one year (can be renewed)
- Admission procedures for Mexican nationals
- Unlike Canadian citizens, requires pre-filing with the Citizenship and Immigration Service (CIS)
- Also requires submission of other typical H-1B documents
- Once Approval Notice is secured, seek admission at applicable port of entry
- Although no statutory/regulatory maximum authorized period of stay, “temporary, non-immigrant intent” is a requirement
- Stays beyond three years in TN visa status can be problematic
O-1 VISA
- Individuals of extraordinary ability or achievement
- The O-1 category is for highly talented or acclaimed foreign nationals who may not qualify in other work-related nonimmigrant categories such as H, L or J.
- Those individuals who have entered the United States in the J-1 classification may be able to obtain the O-1 classification without first seeking a waiver of the two-year home residency requirement.
- Foreign nationals who have entered the United States in the J-1 classification “to receive graduate medical education or training are not eligible to apply for an immigrant visa, permanent residence, or a nonimmigrant visa under the H or L classifications until they have met the two-year home residency requirement or have obtained an appropriate waiver. This prohibition does not bar an individual from applying for an O-1 visa abroad.