Prior posts show that you're applying to neuro.
Prelim medicine is actually more competitive than neuro. The problem is that people applying to Rad, Derm, Ophthal, etc all want prelim IM years, and they tend to be very competitive programs. So it is not uncommon for neuro candidate to have some difficulty getting prelim spots. And you can't do a surgical prelim for neuro.
So, you'll need to apply to many prelim spots, focusing on those that are less competitive. Do not underestimate the competitiveness of the prelim match. If you match into neuro and fail to get a prelim, you will lose your neuro spot.
Needing an H1b for a prelim will make it much more difficult. H1b visas are a pain and are expensive, and many programs won't do them for single year residents.
As I mentioned to you in a prior thread, your best option is to try to get a prelim at programs that offer you a neuro interview if at all possible.
