Can I go from an OPT F1 visa at a transitional/preliminary year program to an H-1B visa at a different hospital?

[otherstuff12321]

I am an international medical student and a Canadian citizen currently attending medical school in the United States on an F1 visa.

I understand that I will have to do my first year of residency on an OPT visa as I will not have fulfilled my Step 3 requirement until after first year of residency has started.

However, if I were to continue my training in an advanced program at a different hospital that offers H-1B visa support, would I be able to secure an H-1B visa with this process?

In other words, would it be possible for me to work for a transitional/preliminary year program at one hospital on an OPT F1 visa and then move on to an advanced program on an H-1B visa at a different hospital?

I am just wondering about this because I would like to rank my match list in a way that prioritizes chances of obtaining the H-1B visa. Currently, I'm not sure what to do with preliminary/transitional and advanced programs. I have reached out to all of these programs but they have responded with uncertainty and stated that the visa decisions will be made once the time comes.

Thank you!

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[NotAProgDirector]

First, you do not actually have to take S3 to get an H1b if you're graduating from a US medical school. Some programs may "require" it anyway because you can do your PGY=1 on the OPT and you might as well get it out of the way, some concern that the State Dept will get confused, and because that's just the way they have always done it. So although legally you don't need it, practically you do.

Yes, you theoretically can do your PGY-1 on an OPT at one site, and then PGY-2+ on an H at another. But again, the devil is in the details. H visas are employer specific. Your prelim program is almost certainly not going to apply for an H for you given that you have no long term commitment there and it's expensive and time consuming, although that would be their choice. Your new program could apply for an H for you, but timing becomes really, really important.

If you were applying for a capped H visa, the timing is easy. You would be in your internship July-June. Your program would file an H1 application on April 1. While your application is pending you get an OPT extension called the "cap-gap", which extends your OPT end date frum June 30 to Sept 30. If you're granted an H visa, it starts Oct 1. All good, no problems. Of course, the problem with this pathway is that H visas are capped and you may not get one at all.

But with a cap exempt H visa (which is what you will be getting) is that there is no schedule - your employer can apply any time they want. And once approved, the H visa (I believe?) becomes immediately active, and voids your OPT. If this happens during your PGY-1, then you're no longer legally allowed to work at your PGY-1 position.

So, I think what you'd need to ask for is to have your advanced program apply for the H visa late in your PGY-1 year -- late enough that it won't get approved before you switch programs. You then (I think?) would qualify for the cap-gap extension (although it wasn't designed for this issue) and could start your PGY-2 on OPT. Then, you need the H visa to be approved before Sept 30, or your OPT expires. Getting that timing right is complicated (or perhaps impossible) as standard H visa processing takes ~4-6 months, and expedited processing (which is what most programs pay for) is 15 days.

In any case, it's very complicated. You'll need a visa lawyer to sort it out (the program will have one). You are completely at their mercy. If they say "no H visa", there's nothing you can do other than get another visa (J) or waive your match. The reason program staff are being vague about it is that they usually don't manage this stuff -- it's all done centrally by the GME office. They may be vague also, because policies may change over time.

And last thing: I am not a lawyer. So any, or all of this, could be wrong.

 

[otherstuff12321]

Your prelim program is almost certainly not going to apply for an H for you given that you have no long term commitment there and it's expensive and time consuming, although that would be their choice.

Thank you for the extremely thorough response. I honestly really appreciate all the info. I did not realize I could go immediately to an H-1B visa from F1 if the prelim/transitional were to sponsor it without Step 3 as a USMD.

I did interview at a transitional year program which confidently promised to sponsor an H-1B visa for eligible residents. It was the only prelim/transitional year program like that. So I suppose that I should build my rank list to pair my H-1B-sponsoring advanced programs with this transitional year program?

Will it be a much simpler process if the transitional year program sponsors an H-1B visa and that visa status is continued at another hospital?

Thank you once again.

 

[NotAProgDirector]

Yes, it will be infinitely easier if you already have an H1b to move it to another employer.

Getting an H1b for a TY, even if they promised it to you, will not be easy. They can't start the process until you get your degree. At most US schools, that doesn't happen until May. Most programs start onboarding in June -- and you can't do that without a visa. And although it is legal to get an H visa without S3, any program could refuse to do so based upon their own experiences / reading of the rules / policy, and the state department could decline to issue it due to a lack of S3 -- and although you might be able to appeal that and reverse it, the time involved and delay in starting could cost you your spot.

You should probably clarify with them what they mean by "qualifying". Since you qualify for an OPT, they might simply decide to have you continue on that.

Your best bet is to be at the same place for prelim and advanced.

Although a problem for a later day, when your H visa application is being processed and/or you are approved but in a cap-gap extension, you absolutely cannot leave the US. We have had residents miss funerals because of this. There is no guarantee you will be allowed back into the US, and your entire visa process may be cancelled (including your OPT).

Once you match somewhere(s), you need to speak with the GME/Visa offices to start sorting out the plan.

 

[808legit_ownz]

But with a cap exempt H visa (which is what you will be getting) is that there is no schedule - your employer can apply any time they want. And once approved, the H visa (I believe?) becomes immediately active, and voids your OPT. If this happens during your PGY-1, then you're no longer legally allowed to work at your PGY-1 position.

So, I think what you'd need to ask for is to have your advanced program apply for the H visa late in your PGY-1 year -- late enough that it won't get approved before you switch programs. You then (I think?) would qualify for the cap-gap extension (although it wasn't designed for this issue) and could start your PGY-2 on OPT. Then, you need the H visa to be approved before Sept 30, or your OPT expires. Getting that timing right is complicated (or perhaps impossible) as standard H visa processing takes ~4-6 months, and expedited processing (which is what most programs pay for) is 15 days.

Thank you for the informative post @NotAProgDirector . Just had some follow up questions.

​

Will all institutions (residency programs) be giving out cap exempt H visas?
So if I start intern year on OPT July 1 2023 at one institution. And if I wait until mid June 2024 and pay the expedited processing fee (15 days) I should get my H1B visa in time to start at a new institution for my advanced training? Or am I misunderstanding?

 

[NotAProgDirector]

Will all institutions (residency programs) be giving out cap exempt H visas?

In general, yes. Non profits (and VA hospitals) are exempt from the cap and can get an H visa on any schedule. It would be crazy for them to try to get one using the standard cap process / calendar.

So if I start intern year on OPT July 1 2023 at one institution. And if I wait until mid June 2024 and pay the expedited processing fee (15 days) I should get my H1B visa in time to start at a new institution for my advanced training? Or am I misunderstanding?

Not exactly. First, you pay nor file anything. H visas are from the employer, and they do all of the work and pay all of the fees. It is illegal for them to pass the fees on to you, or for you to "volunteer" to pay any fee. It's wildly complicated, requires multiple documents proving the validity of the position, that the wage being paid is fair market value, and a bunch of other stuff. Trying to time this accurately like this is likely doomed to failure. And, if your H visa is approved on June 23rd, your OPT is no longer valid and you can't finish your prelim year -- even if it's vacation that is scheduled then.

 

[mszzeta]

First, you do not actually have to take S3 to get an H1b if you're graduating from a US medical school. Some programs may "require" it anyway because you can do your PGY=1 on the OPT and you might as well get it out of the way, some concern that the State Dept will get confused, and because that's just the way they have always done it. So although legally you don't need it, practically you do.

Yes, you theoretically can do your PGY-1 on an OPT at one site, and then PGY-2+ on an H at another. But again, the devil is in the details. H visas are employer specific. Your prelim program is almost certainly not going to apply for an H for you given that you have no long term commitment there and it's expensive and time consuming, although that would be their choice. Your new program could apply for an H for you, but timing becomes really, really important.

If you were applying for a capped H visa, the timing is easy. You would be in your internship July-June. Your program would file an H1 application on April 1. While your application is pending you get an OPT extension called the "cap-gap", which extends your OPT end date frum June 30 to Sept 30. If you're granted an H visa, it starts Oct 1. All good, no problems. Of course, the problem with this pathway is that H visas are capped and you may not get one at all.

But with a cap exempt H visa (which is what you will be getting) is that there is no schedule - your employer can apply any time they want. And once approved, the H visa (I believe?) becomes immediately active, and voids your OPT. If this happens during your PGY-1, then you're no longer legally allowed to work at your PGY-1 position.

So, I think what you'd need to ask for is to have your advanced program apply for the H visa late in your PGY-1 year -- late enough that it won't get approved before you switch programs. You then (I think?) would qualify for the cap-gap extension (although it wasn't designed for this issue) and could start your PGY-2 on OPT. Then, you need the H visa to be approved before Sept 30, or your OPT expires. Getting that timing right is complicated (or perhaps impossible) as standard H visa processing takes ~4-6 months, and expedited processing (which is what most programs pay for) is 15 days.

In any case, it's very complicated. You'll need a visa lawyer to sort it out (the program will have one). You are completely at their mercy. If they say "no H visa", there's nothing you can do other than get another visa (J) or waive your match. The reason program staff are being vague about it is that they usually don't manage this stuff -- it's all done centrally by the GME office. They may be vague also, because policies may change over time.

And last thing: I am not a lawyer. So any, or all of this, could be wrong.

If the start date of the H1b sponsored by the PGY-2 position is AFTER the PGY-1 year, when would it void the F1 status?

 

[NotAProgDirector]

My (very limited and you absolutely need to review with a visa expert because I could be completely wrong) understanding is that when your employer applies for an H visa, there isn't a specific start date. It starts when it's approved. So there isn't a good way to set the start date after the PGY-1 ends.

 

[mszzeta]

My (very limited and you absolutely need to review with a visa expert because I could be completely wrong) understanding is that when your employer applies for an H visa, there isn't a specific start date. It starts when it's approved. So there isn't a good way to set the start date after the PGY-1 ends.

I have been on 3 different H1b in my life. There is a clear start date. One should not lose their current visa/status before the start date of a new H1b. However, if one leaves US and then re-enters, while the new H1b is in process and the person does not carry the new i-797, things could go wrong (complex i-94 issue......please consult an immigration lawyer if plan for international travel during visa switching period )