Immigration Options for International Medical Graduates

Klasko Immigration Law Partners, LLP
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Klasko’s EB-1 immigration lawyers are extremely experienced and supported with a dedicated team with industry-leading approval rates for foreign nationals that qualify in the EB-1 preference category. H-1B immigration attorneys have dedicated their careers to immigration law. Healthcare immigration attorneys work with hospitals and residency programs to assist them in sponsoring foreign national healthcare workers for temporary visas and green cards. All of these attorneys have extensive experience in assisting international medical graduates in obtaining work authorization, nonimmigrant and immigrant visas, and green cards as they bring their medical talent to serve communities in the U.S.

Who Are International Medical Graduates?

International Medical Graduates, or IMGs, are physicians who have studied medicine and graduated from a recognized and accredited medical school abroad (excluding Canadian schools). These physicians must go through a unique credentialing process through the Educational Commission on Foreign Medical Graduates (ECFMG), so they may become licensed physicians or start their residencies. Note that IMGs who already hold permanent residence (a green card) through other means, such as being sponsored by a family member, need to be credentialed by ECFMG but do not require visa sponsorship.

IMGs are vital additions to the field of medicine as they seek to enhance their learning and establish their careers in the United States while also filling much-needed healthcare roles in local communities across the country.

The Three Common Visas for IMGs

When International Medical Graduates look for residencies in the U.S., they usually fall into one of three categories: J-1 Exchange Visitor, H-1B Professional Worker, and O-1 Extraordinary Ability. IMGs should note that some residency programs do not consider IMGs needing temporary visa sponsorship for residency spots at all, and some programs limit IMGs needing sponsorship to the J-1 visa. These decisions are normally made at a policy level by Graduate Medical Education leadership and IMGs should not expect exceptions to be made.

J-1 EXCHANGE VISITOR

This category is reserved for IMGs who are accepted into a residency program expressly sponsored by the ECFMG. The physician is required to obtain an ECFMG certification that includes satisfactory scores on the USMLE Step 1, Step 2 Clinical Skills, and Step 2 Clinical Knowledge. J-1 status is only held by IMGs for the duration of the residency program with a maximum limit of seven years. Finally, J-1 Exchange Visitors who received graduate medical education must return to their home country for two years before achieving eligibility for H status or permanent residence.

H-1B PROFESSIONAL WORKER

Similar to the J-1 status above, H-1B status can only be achieved by physicians with an ECFMG certificate who have successfully completed all three USMLE examination steps. However, they also require a valid training license in the state in which they intend to train. H-1B applicants must have sponsorship from the hospitals of their residencies, but they can only hold this status for a maximum of six years.

There is a petition filing fee of $325, and the employer must pay over $2,000 in U.S. Worker Training Fees” and “Anti-Fraud Fees.” Generally, the petition process takes from 12 to 16 weeks, but a $1,225 fee would bump adjudication to only two weeks.

O-1 EXTRAORDINARY ABILITY

O-1 status is reserved for those IMGs who have achieved significant recognition, internationally or in their countries of origin, and prominence in their field. These physicians have built and reinforced their reputations for excellence in medicine, and they can receive sponsorship for O-1 status, even if it is for a residency. For more information on what it takes to successfully acquire an O-1 visa, read this blog by our EB-1 team.

The Uncommon Strategy for IMGs

F-1 INTERNATIONAL STUDENT

International Medical Graduates – who include both foreign nationals needing visa sponsorship for residency, and also US citizens and permanent residents educated at medical schools outside the United States — face higher barriers than US-educated physicians to match into many residency programs. In light of the additional hurdle presented by the need to match with a program that offers visa sponsorship, IMGs who are not US citizens or green card holders may turn to an unusual strategy: attending (or even repeating) medical school in the United States.

Many medical schools are willing to offer spots to international students, who are able to attend on F-1 student visas. After graduation, these physicians are able to match as US graduated physicians. While they still will require visa sponsorship in the longer term, for their initial year of residency they are able to use work permission granted to graduating F-1 students, called OPT or Optional Practical Training. OPT allows the physician to work for one year without direct sponsorship by the program, which may help the physician’s long term planning for fellowships and employment in the United States.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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