In order for an International Medical Graduate (IMG) to practice in the United States, IMGs must follow employment-based pathways to gain lawful permanent residence. The road to permanent residency can be long and convoluted, so we have gathered a glossary of terms for physicians beginning to learn about physician visas, whether you’re currently seeking a J-1 or an H-1B visa.
A visa is an endorsement on a passport indicating that the holder is allowed to enter for a specified period of time in a country.
A J-1 visa is a non-immigrant visa issued by the United States to research scholars, professors, and exchange visitors participating in programs that promote cultural exchange, especially to obtain medical or business training within the U.S. J-1 physicians are required to return to their home country for a period of two years after medical training unless they obtain a waiver (J-1waiver) of this home country residency requirement. J-1 physicians who obtain a waiver must usually commit to working at least three years in an HPSA or MUA. Oftentimes, these physicians also apply for permanent residence (“green card”) through the national interest waiver (NIW), which requires an employment contract term of five years in an HPSA or MUA.
The Conrad 30 Waiver program is the most used J-1 waiver program and allows J-1 medical doctors to apply for a waiver for the 2-year residence requirement upon completion of the J-1 exchange visitor program. The program addresses the shortage of qualified doctors in medically underserved areas. For a physician to be eligible, the J-1 doctor must:
- Agree to be employed full-time in H-1B nonimmigrant status at a health care facility located in an area designated by S. Department of Health and Human Services (HHS) as a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP).
- Obtain a contract from the health care facility located in an area designated by HHS as an HPSA, MUA, or
- Agree to begin employment at the health care facility within 90 days of receipt of the waiver, not the date his or her J-1 visa
For more information please visit Conrad 30
The H-1B is a non-immigrant visa in the United States under the Immigration and Nationality Act, section 101(a)(15)(H). It allows U.S. employers to temporarily employ foreign workers in specialty occupations such as medical practice. For more information please visit H-1B.
The H-1B visa has an annual numerical limit “cap” of 65,000 visas each fiscal year. There are an additional 20,000 visas available for petitions filed on behalf of beneficiaries with a U.S. master’s degree or higher. For more information please visit H-1B Cap.
H-1B workers who are petitioned for or employed at an institution of higher education or its affiliated or related nonprofit entities or a nonprofit research organization, or a government research organization are not subject to this numerical cap (“cap-exempt”). Cap exemption also applies to J-1 physicians who obtain a J-1 waiver through a state or government health agency recommendation.
The O-1 nonimmigrant visa is for the individual who possesses extraordinary ability in the sciences, arts, education, business, or athletics, or who has a demonstrated record of extraordinary achievement in the motion picture or television industry and has been recognized nationally or internationally for those achievements. Physicians who have exceptional research and clinical work may qualify for O-1A visas.
For more information please visit O-1.
The EB-1 extraordinary ability classification is a permanent residence (green card) application for people who are recognized as being at the very top of their field and who are coming to the United States to continue work in that field. To establish eligibility, you must demonstrate sustained national or international acclaim and that your achievements have been recognized in the field of expertise.
For more information please visit EB-1.
The EB-2 advanced degree classification is a permanent residence (green card) application for people with a master’s degree or higher. To qualify, the employer must file a labor certification petition with the Department of Labor (PERM). Alternatively, the physician can apply for a national interest waiver (NIW) by agreeing to work for 5 years in an HPSA or MUA.
Shortage Area Designation
Underserved areas, populations, or facilities experiencing a shortage of healthcare services.
Medically Underserved Areas may be whole counties or a group of contiguous counties, a group of county or civil divisions, or census tracts in a particular county.
Medically Underserved Populations can include people facing economic, cultural, or linguistic barriers of healthcare.
Contacting an immigration attorney for legal advice will most likely save you time and money. Please seek an immigration attorney in your area for proper legal consultation.
SJA Physician Visa Series
St. John Associates is honored to work with international medical graduates as they seek employment-based pathways to permanent residency. To ease the job search for physician visa applicants, we are creating a series of content highlighting different facets of the process. For further assistance, please contact one of our physician recruiters.
The information provided here is general in nature and should not be relied on for specific situations. In addition to working with an experienced physician recruiter, St. John Associates recommends that all physician visa candidates consult with an experienced immigration attorney to get the right plan for their specific situation.
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