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

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



  • 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.