International Medical Graduates (IMG) seeking U.S. residency training
who do not qualify for permanent resident status in the U.S. usually
seek either of two visas from the Immigration and Naturalization Service
(INS) for U.S. training:
Several recent events affect the use of those two visas by IMGs.
J-1 visa (Exchange visitor)
- The J-1 visa is used for graduate medical education and training (
maximum period of seven years).
- It should be noted that, upon completion of the J-1 stay in the
U.S., the alien will be required to return to his home country for a
period of at least two years.
- This is the most common visa applied by the overseas doctors who
are not planning to settle in the United states permanently.
(It should be noted that many doctors, after obtaining J-1 visa and
completing their training, decide to settle down in the United states.
Please refer the J-1 waiver section.)
Requirements for J-1 Visa
Several requirements apply when an alien physician seeks a J-1 visa.
- He/she must provide a written assurance from the home country
confirming that there is a need for his/her skills in this country.
- There must be also a written agreement from an accredited school
of medicine which will provide the training in the U.S.
- He/she must prove sufficient skills that he/she has already
achieved by having
either: graduated from a medical school accredited by the Liaison
Committee on Medical Education (LCME)
or: possessing ECFMG certification.
- The alien physician must already have prior education/ licensure
- Spouse ( on a J-2 visa ) of an alien having a J-1 visa may obtain
more easily a work permit.
- There are no social security tax requirements
- No labor certification is needed.
- Foreign graduates who wish to settle down in United States
permanently, may prefer this visa, as this can be converted to green
- Unfortunately, H-1B visas are open to all professionals (not just
medical) and the US government has placed a cap of 115,000 on the
number of such visas that can be issued in each fiscal year (October
to September annually).
- Note that the Match takes place in mid-March, and for a July start
you would likely have only short period to secure a state medical
license and submit your H-1B visa application.
Requirements for the H-1 Visa
For alien physicians who will primarily be teaching or performing
research (with incidential patient care only) the following conditions
- He/she must be licensed in the State of intended employment.
- He/she must be a graduate of a foreign or U.S. medical school, or
have a full and unrestricted license to practice medicine in a
Additionally, alien physicians intending to perform patient care
services must have :
Either: graduated from a medical school accredited by the LCME
Or: passed Steps I, II, CSA and III of the United States Medical
Licensing Examination (USMLE), and have competency in written and oral
An exchange visitor holding a J-1 visa cannot remain in the U.S.
beyond the seven year limit to pursue other types of training or for
practice, or for academic activities unless he/she qualifies for a
waiver to the foreign residency requirement.
There are now four statutory justifications for such a waiver.
- A finding by the INS of exceptional hardship for a spouse or child
who is a U.S. permanent resident or citizen;
- A finding by the INS that the alien would face persecution on
- Support of a waiver from a U.S. government agency based on the
- accepting a position that could not be filled by a U.S. citizen.
Typically, the latter have been issued by the U.S. Veterans
Administration or less often, the Appalachian Regional Commission.
In October 1994, Congress approved a fourth important route for a
waiver. This allows the State Department of Public Health to request a
waiver from the United
States Information Agency (USIA) which will make a recommendation to
These waivers will generally be based upon services in medically
For additional information on J-1 waiver on internet
Useful links for visa purposes