Green Card

Visa

Visa is the biggest and the most important issue that scares most of the IMGs and plays a major role in getting a residency position. With many programs not sponsoring visas for residency training and few sponsoring J1 visa and very few sponsoring H1B visa makes the residency application more complicated for the IMG. So it becomes a critical question to resolve whether the program would sponsor a visa for IMG or not if yes than which one a J1 or a H1B. H1B is the most desired and ideal visa for most of the International Medical Graduates. IMG friendly programs are generally immigration-conscious and will offer H1-B and attract more qualified physicians and thereby improve their programs. We have tried to give a comprehensive overview of different visas their advantages and disadvantages. The most common visas available for IMGs are B-1, B-2, F-1, H-1, J-1, O-1 and Green Card (Permanent Residence). In 1998 the most popular visa amongst international medical graduates was J-1 (33 % of IMG resident physicians), which is second to IMGs with Green Card comprising of about 35 % of the IMG resident physicians. The least common visas were F-1 and B-1/B-2 visa constituting 0.2 and 0.3 percent of IMGs.

The first issue that concerns IMG is entry to US on a visitor (B-2) or any other kind of visa for taking CSA or any of the USMLE exams. The general tip for the visa is one should establish that you have strong ties to her or his home country. This evidence can include proof of home country investments, proof of home or business ownership, and immediate family (who are not accompanying the IMG). On entry in US an IMG is issued a I-94 form at the port of entry which states the duration of stay allowed to the person entering United States. While leaving the country the alien is expected to surrender the I-94 form. After completing the basic requirements i.e. exams, interview and match the next question arises is to get the valid visa to start the residency training. Here is basic information about the visas available for IMGs.

J 1 Visa – Exchange Visitor Program

The J-1 visa is the most common visa amongst IMGs. The Exchange Visitor Program is intended to foster international social, scientific and cultural exchange. Many if not most program sponsors are universities, where the environment for such exchange is acknowledged highly rewarding and productive. It is primarily used to bring students, trainees, teachers, professors, research scholar, and international visitors to the US. This program is administered by the US information agency (USIA), a division of the Department of State. J-1 visa issues concerning the IMGs have been discussed below.

Eligibility

· Research scholars for research and teaching that involve no patient care.

· Clinical Research Fellows who hold ECFMG certificate and will have limited patient contact under supervision.

· Residency training programs.

Steps to obtain a J1Visa:

1. Request a statement from Ministry of Health of your country to issue a letter stating that there is a need in that country for individuals with the medical skills you propose to acquire by joining a US residency program.

2. This letter has to be sent to the ECFMG

3. Obtain a certificate from the ECFMG indicating that you are eligible for a residency program

4. Once the residency program agrees to offer a position it issues an IAP 66

5. Go to US consulate for the issuance of the Visa with IAP 66 and affirmation of leaving the U.S. upon completion of the program.

LENGTH OF VISA: The duration of the Visa is limited to the time normally required to complete such a program. The maximum amount for participation in a training program is ordinarily limited to seven years unless the IMG involved has demonstrated to the satisfaction of the USIA director that his or her home country has an exceptional need for further training.

HOME COUNTRY RESTRICTIONS: The law requires that a J1 visa holder, upon completion of the training program, leave the US and reside in the home country for a period of at least two years. The visitor has to return to his home country and not any other country like Canada or United Kingdom. The 2-year rule may not always be applied to a J-1 researcher or scholar. Physicians wishing to pursue medical career in US fear that on returning to home country, they might fall seriously behind their peers in the rapidly progressing field of medicine and might find it difficult to get a job after 2 years. This requirement also extends to relatives holding J-2 dependent visas.

TRANSFERRING VISA

Ordinarily an IMG on a J1 visa is not allowed to change from J1 to other types of visas like H1 or to permanent residence (Green Card). However, IMG may obtain a waiver from the two-year home residence requirement under the following circumstances:

If you can demonstrate a "well founded fear of political or religious persecution" if forced to return to your country. You may be able to obtain a "Refugee", "Asylum", or "Persecution" status.

If you can prove that returning to your home country would result in "exceptional hardship" to you or to members of your immediate family (spouse or children) who are US citizens or permanent residents;

If you practice medicine in an underserved community and is essential for the well being of the United States than a waiver may be sponsored by an "interested governmental agency."

The Department of Health and Human Services (HHS)
Veterans Administration (VA)

WORK RESTRICTIONS ON DEPENDENTS: Dependents on J2 visas may apply for work permits.

PROCESSING TIME: 4-6 weeks (if change of status is requested from INS within the U.S.) Otherwise, the potential J-1 would travel to his/her home country with the form IAP-66 from the sponsoring institution, obtain the J-1 visa in the passport and re-enter the U.S. in J-1 visa status.

TRANSFERRING VISA TO NEW EMPLOYER:

J-1s may transfer under the following circumstances:

1. Remain in the same category as before (i.e.., Student, Professor, Research Scholar etc.)

2. They have not used up the time available

3. They have maintained good standing with their previous J program sponsor

4. Their previous J sponsor is willing to allow the transfer.

	J-1 visa holders can only receive stipends from their institution. No "moonlighting" allowed.
	All medical graduates on J-1 visa must file annual reports with their local INS office on Form -I- 644
	No limitations on the number of visas issued i.e. not subjected to any “cap”.

United States Information Agency

Attn: Exchange Visitor Program Services (GC/V)

Waiver Review Branch

301 4th Street, S.W., FEMA 200

Washington, D.C. 20547

Visa information request

Exchange Visitor Department

ECFMG 3624, Market St

Philadelphia, PA 19104-2685 USA

H-1B Visa

H1B is the most ideal visa for IMGs. It is a 'specialty occupation' visa for temporary employment. Program must demonstrate that the job in question is one that requires special preparation, and that the person for whom the petition is being filed has that education or preparation.

LENGTH OF VISA - 3 years initial request and later it can be extended for another 3 additional years.

HOME COUNTRY RESTRICTIONS: None

WORK RESTRICTIONS ON DEPENDENTS: Dependents may not work.

Steps to Obtain Visa

Employer gets a prevailing wage determination from the state Labor department.

Than employer must file for a "Labor Condition Alteration" forms with the US Department of Labor.

Than employer files a petition on the behalf of the IMG with the documents required to suffice to establish the IMG qualifications. Passing USMLE Step 3 is a prerequisite for a physician in order to get an H1B visa for residency training.

The US consulate of the country where the IMG resides issues the visa. However if the IMG is in the US under some other visa status (such as B-1/B-2, F-1, H4), the approval may be issued in the United States and the IMG's status adjusted to H1-B. The IMG does not have to leave the country to obtain H-1B status.

PROCESSING TIME: The time usually varies depending on the center and averages from 2-3 months from the date of application. The INS in the United States must approve H-1 visas, even if the beneficiary will be applying for the H visa outside the U.S.

TRANSFERRING VISA TO NEW EMPLOYER:

There is no mechanism for transfer of an H-1B petition from one employer to another. The new employer must apply for a new H-1B visa with the Department of Labor with copies of CV, transcripts and other documents.

CAP ON # OF VISA HOLDERS - 115,000 applicants

F-1 Visa – Student visa / practical training visa

It is a student visa issued by INS to foreign nationals to study in a college or universities for studies leading to a degree. Permits part-time work after first year of school or earlier under special circumstances. Few residency programs might sponsor IMG F-1 Visa with work permit.

Steps to obtain F-1 visa:

Obtain a document stating that you have been admitted to a school (I-20)

Proof of available funds necessary to support himself.

Apply to the local INS center

O -1 VISA

The applicants getting the O-1 visa are of outstanding caliber. They must have received national or international endorsement in "science" (medicine). The position that is offered should require a person of extraordinary talent. The individual's curriculum vitae must demonstrate membership in associations that require outstanding talent and achievements, major awards of excellence, authorship of scholarly articles, research achievement, and previous employment in an essential position at a hospital, medical school, or clinical research center. Evidence of a high salary or other "outstanding remuneration" is also required.

Usually ECFMG certificate not required (varies from state to state). The INS requires substantiation of the claim that this individual is "distinguished". Obtain notarized and translated copies of licenses, award certificates, honors, and publications.

Visa specifications:

No limit on length of stay

Cannot change job, if he changes jobs, his visa expire.

Spouse or children cannot work.

Institution may sponsor him for a permanent resident visa (Green Card).

Must leave and apply through any US embassy or consulate outside the US

Green Card / Permanent Residence

There are different categories under which an alien can apply for the permanent residence status.

First Preference

First preference is the category given to foreign national with “extraordinary ability” which is usually demonstrated by sustained national or international acclaim and recognition in his field. A person who fits the first preference category can sponsor him or herself for the permanent residence status. By INS definition, a physician of national or international acclaim is not considered an IMG and therefore is not subjected to the rules and regulations applicable to other IMGs. Does not require a job offer or labor certification. The physician has to continue to work in his area of extraordinary ability.

Documents required proving expertise

The receipt of nationally or internationally recognized prizes or awards for excellence in the field.

Membership in associations in his field that require outstanding achievement for membership.

Material about the individual published in professional or major trade publications or published in other media.

Participation as a judge of other's work in his field of expertise.

Original major scientific or scholarly contributions to the field.

Authorship of scholarly articles appearing in professional publications in his field or appearing in major media.

Leadership in distinguished organizations or establishments.

Receipt of a high salary.

Second Preference

Should have a job offer or obtain a " National Interest Waiver".

Requires a labor certification.

At least three of the following.

a degree relating to the area of exceptional ability
a letter from a current or former employer verifying at least ten years of experience
a license to practice his profession
evidence of a salary commensurate with exceptional ability.
Membership in professional associations
Recognition of his achievements and significant contributions to the field by his peers, governmental entities, or professional organizations.

"DV-1- Diversity" lottery for "Green Cards" that allows about 55,000 lucky individuals to by pass waiting time for immigration visas. Contact INS for more information. Only citizens of few countries are eligible for the lottery.

Facts to Know -Volunteering i.e. working without tangible rewards is unrestricted.

Disclosure : The following are general information given to provide you an easily understandable explanation of various option you may have. Visas and the laws governing them, constantly change therefore it is advisable to consult an experienced immigration attorney.