H1B and Green Card

[loku]

Hello everyone, I'm currently on H1b visa in residency and going to sign a hospitalist job contract.
Does anyone know that if you're signing a hospitalist contact with a "Physician Group lets say Apogee or Sound physician" at a particular location and then I later decide to switch to a different job at a different location, does that mean I'll need a completely New H1B Visa?

If yes, what about green card. If lets say the company has already started my green card process and I leave the job after 2 years, does that mean my green card process will have to start all over again?

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[loku]

What if I stay in the same group but change the location, does that mean that my green card will start all over again?

 

[NotAProgDirector]

H1b visas are specific to the employer. If you're hired by the same employer but sent to a new site, but your paycheck comes from the same people, then you won't need a new visa. If you just get a new job, then yes you'll need a new visa.

If your employer sponsors you for a GC and then you leave, your prior employer continues the GC process. If they are unhappy with the circumstances of your exit, they can torpedo the process. Whether you can then apply again from a new employer is unclear. Many employers won't file until you've worked with them for 2-3 years for this reason.

 

[marcozecca]

Thank you for the explanation! So how long does it take to have the greencard usually? If I start a job on J1 waiver/H1 visa, after how many years will I have the GC in my hands?

 

[NotAProgDirector]

It depends on your country of origin. The first steps take 6-18 months. Then you need to wait for your priority date to be current. There's a limit by country.

If you're from India, you're in for a long wait. Current priority date is July 2009. So unless something changes, you'll be waiting at least 10 years. China is about 5 years. Every other country is current.

Basic overview: COMPLETE guide to the H1B to green card process [July 2020]

Current Priority dates: The Visa Bulletin

 

[marcozecca]

thanks! What about the j1 waiver? is it 3 years of clinical work in underserved area right? If that’s the case, can one apply for a GC during the waiver? and maybe paradoxically get the GC before the waiver extinction?

 

[NotAProgDirector]

Nope. You complete the 3 year waiver, and then your J is converted to an H. Only then can your employer start the GC process.

In all cases, your employer applies -- not you. You have no control of the process or timing at all.

 

[Raryn]

thanks! What about the j1 waiver? is it 3 years of clinical work in underserved area right? If that’s the case, can one apply for a GC during the waiver? and maybe paradoxically get the GC before the waiver extinction?

Nope. You complete the 3 year waiver, and then your J is converted to an H. Only then can your employer start the GC process.

In all cases, your employer applies -- not you. You have no control of the process or timing at all.

It's complicated - and NotAProgDirector isn't quite right. First you must obtain the J1 waiver.

Then either your employer needs to file for a PERM labor certification OR *you* need to file for an EB-2 green card with a National Interest Waiver. The latter is basically the only path of *you* applying for a green card rather than an employer doing it on your behalf - but getting the it is damn near impossible unless you promise to do >5 additional years working in an underserved location (or for a VA).

The more normal PERM labor certification option can only be done once you've completed the waiver process. It can take 6+ months - so most commonly you switch to a different sort of visa to keep working while that process goes on.

 

[NotAProgDirector]

Happy to be corrected!

 

[Obnoxious Dad]

Happy to be corrected!

It's complicated - and NotAProgDirector isn't quite right. First you must obtain the J1 waiver.

Then either your employer needs to file for a PERM labor certification OR *you* need to file for an EB-2 green card with a National Interest Waiver. The latter is basically the only path of *you* applying for a green card rather than an employer doing it on your behalf - but getting the it is damn near impossible unless you promise to do >5 additional years working in an underserved location (or for a VA).

The more normal PERM labor certification option can only be done once you've completed the waiver process. It can take 6+ months - so most commonly you switch to a different sort of visa to keep working while that process goes on.

The U.S. government through various conduits (Medicare, Medicaid, CHGME & VA) spends about $15 billion per year on residency training. In the 2020 NRMP match about 4,000 FMGs matched into categorical positions. In addition FMGs are heavily represented in the "out of match " pool. Can anyone estimate how many FMG trainees will stay in the U.S. following their training?

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/06/MM_Results_and-Data_2020-1.pdf

 

[Raryn]

The U.S. government through various conduits (Medicare, Medicaid, CHGME & VA) spends about $15 billion per year on residency training. In the 2020 NRMP match about 4,000 FMGs matched into categorical positions. In addition FMGs are heavily represented in the "out of match " pool. Can anyone estimate how many FMG trainees will stay in the U.S. following their training?

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/06/MM_Results_and-Data_2020-1.pdf

Just about all of them.

29% of practicing US physicians were born outside of the US. Now, some proportion of those are people who immigrated prior to medical school and did their schooling in the US (myself included), but that's approximately 300,000 practicing physicians in the US (given that there's roughly a million docs in the country).

In addition, 7% of practicing physicians remain non-US citizens. So about 70,000 people. Even if those were the *only* foreign born physicians, assuming a ~30-year working career and ~4000 non-US citizen FMGs each year, that would be 70/120 - or at a minimum, 60% stay in the US. And to get the numbers that low, it would require that NONE of them became citizens over time, which is just absurd (given that I personally know dozens who did).

 

[Shas72]

iam an international student in my 3rd year of MD in the US. I scored step1 score of 251. How bright are my chances to get into speciality residency program? I am interested in general surgery. How exactly do residency programs sponsor me as iam a non citizen?

 

[Raryn]

iam an international student in my 3rd year of MD in the US. I scored step1 score of 251. How bright are my chances to get into speciality residency program? I am interested in general surgery. How exactly do residency programs sponsor me as iam a non citizen?

I'm trying to understand your exact situation. Are you a non-US citizen going to a US medical school? That is, your school is within the United States?

If so, your odds are decent. Much better than if you were going to school abroad. Your options for training are going to be a J1 visa (still through the ECFMG, but the process is streamlined if you went to school in the states) which doesn't require the program to do much, or an H1 visa which requires the program to sponsor you. I also believe your intern year you'll be able to do a different bridge visa from your student one, but I forget the name.

 

[micromd]

I also believe your intern year you'll be able to do a different bridge visa from your student one, but I forget the name.

I think you are referring to an OPT Optional Practical Training (OPT) for F-1 Students
It's not a visa as such, rather a temporary employment program.

 

[Shas72]

I'm trying to understand your exact situation. Are you a non-US citizen going to a US medical school? That is, your school is within the United States?

If so, your odds are decent. Much better than if you were going to school abroad. Your options for training are going to be a J1 visa (still through the ECFMG, but the process is streamlined if you went to school in the states) which doesn't require the program to do much, or an H1 visa which requires the program to sponsor you. I also believe your intern year you'll be able to do a different bridge visa from your student one, but I forget the name.

Yes iam doing MD in the US medical school. I have heard with J1 I can never get a green card and I have to go back to my country for two years and practice?

 

[Raryn]

Yes iam doing MD in the US medical school. I have heard with J1 I can never get a green card and I have to go back to my country for two years and practice?

Technically, a j1 is a visa without immigration intent. But as the discussion above goes, you can get the go home requirement waived if you take a 3 year job in an underserved area or for the state (such as at a VA).

 

[Shas72]

Technically, a j1 is a visa without immigration intent. But as the discussion above goes, you can get the go home requirement waived if you take a 3 year job in an underserved area or for the state (such as at a VA).

Thanks ! So there is no option of H1B visa offered by residency programs for international students from US medical schools. Its only j 1 visa?

 

[Raryn]

Thanks ! So there is no option of H1B visa offered by residency programs for international students from US medical schools. Its only j 1 visa?

H1b is an option as I mentioned above. It is offered by a much smaller proportion of programs, as it requires considerable paperwork and expense on the programs part. But it's definitely an option.

(and honestly, probably the better option most of the time - if you can get it)

 

[NotAProgDirector]

I highly recommend you read this thread, end to end: Orientation about Visas ??

 

[Shas72]

I highly recommend you read this thread, end to end: Orientation about Visas ??

Thanks a tonne!! Was very helpful!

 

[Shas72]

H1b is an option as I mentioned above. It is offered by a much smaller proportion of programs, as it requires considerable paperwork and expense on the programs part. But it's definitely an option.

(and honestly, probably the better option most of the time - if you can get it)

Thanks!!!

 

[marcozecca]

It's complicated - and NotAProgDirector isn't quite right. First you must obtain the J1 waiver.

Then either your employer needs to file for a PERM labor certification OR *you* need to file for an EB-2 green card with a National Interest Waiver. The latter is basically the only path of *you* applying for a green card rather than an employer doing it on your behalf - but getting the it is damn near impossible unless you promise to do >5 additional years working in an underserved location (or for a VA).

The more normal PERM labor certification option can only be done once you've completed the waiver process. It can take 6+ months - so most commonly you switch to a different sort of visa to keep working while that process goes on.

Thanks for the replies! So either PERM or EB-2 have to be filed AFTER the 3 years of J1 waiver?
I gather from your post that the EB-2 path requires >5 additional years of working in underserved ares? I did not know that...I thought that EB-2 if you have publications would be faster and sured than PERM...could you please provide some links?

Thanks a lot!

 

[Emmet2301]

The U.S. government through various conduits (Medicare, Medicaid, CHGME & VA) spends about $15 billion per year on residency training. In the 2020 NRMP match about 4,000 FMGs matched into categorical positions. In addition FMGs are heavily represented in the "out of match " pool. Can anyone estimate how many FMG trainees will stay in the U.S. following their training?

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/06/MM_Results_and-Data_2020-1.pdf

In general I don't think people would be coming to the US for just medical training and then go back to their respective countries to practice (maybe a few British/Aussie docs do, but that's still rare). Docs make a pittance in other countries as compared to the US.

Have you experienced a lot of FMG trainees going back to their home countries?