IMG - J1 Status

[MedStudent28]

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I was wondering if anyone can confirm this. I was told yesterday by someone who is currently doing residency in cardiology that if you do a fellowship after your residency you do not have to work in a underserved area to get your green card. She is an IMG and is currently on a J1 visa. Anyone know? I never came across such information in my reading.

Thanks. I hope this was the right place to post this.
Much appreciated.

 

[NotAProgDirector]

It's completely false. Nothing can get you out of the 2 year home country rule except for a J1 waiver, woirking in an underserved area. Fellowship doesn't count (even if it is in an underserved area).

Getting married to a US citzen doesn't work either, BTW. You still get sent back.

 

[Faebinder]

Yup, that's false... and the waiver if I remember correctly is mainly for primary care, which cardiology definitely doesnt qualify.

 

[calimero]

How about enrolling in grad school after residency (e.g. to pursue a PhD) - is that allowed after being on a J-1 visa?

 

[f_w]

There are a number of ways to get out of the foreign residency requirement, doing a cards fellowship is not one of them.

 

[jolu]

how about if you go back to your home country and do a fellowship there for 2 years?

And for the marriage thing, if they sent you back home, do you need to stay there and work for 2 years or you just stay there long enough for your visa to change?

Thanks!

 

[QuantumX]

how about if you go back to your home country and do a fellowship there for 2 years?

And for the marriage thing, if they sent you back home, do you need to stay there and work for 2 years or you just stay there long enough for your visa to change?

Thanks!

You're basically required to go back to the country of last residency (NOT your country of citizenship) for 2 years. After that, if you were married to a US citizen, only then can you file for adjustment of status.

If you have a US born child while still doing a residency or fellowship, you can apply for a hardship waiver (proving both your wife and child wiull adversely suffer if they return to your home country). Was difficult in the past, but I have a couple of friends who were able to do it.

 

[Faebinder]

how about if you go back to your home country and do a fellowship there for 2 years?

And for the marriage thing, if they sent you back home, do you need to stay there and work for 2 years or you just stay there long enough for your visa to change?

Thanks!

My understanding of the subject... if you went to your country of residency (ie exited the US soils) and married a US citizen, you still need to wait for the 2 years before returning. They wont give you the green card till the time is done (ironically it takes 1.5 years to get the green card through marriage so its a moot point). If you marry a US citizen on US soils before you leave while you are on a J-1 visa... you can apply for change of status be okay to stay.

 

[Llenroc]

My Dad came on a J1 to do Pediatrics and did a fellowship in Allergy & Immunology afterwards. He worked in an underserved urban area doing primary care to get the green card. The J1 was upgraded to an H1 visa right after he got the job. Actually he liked the job so much, he stayed there for an extra few years after receiving the green card. 👍

The only time we left the country was to get the visa stamped at a U.S. embassy in Canada.

 

[f_w]

If you marry a US citizen on US soils before you leave while you are on a J-1 visa... you can apply for change of status be okay to stay.

That is incorrect. Marriage to a citizen doesn't relieve you from the foreign residency requirement. You are blocked from filing for adjustment of status until you either:
- fulfilled the requirements of a particular waiver (Conrad30 underserved area, VA hospital, HHS outstanding researcher)
- remained in your country of last residency for an aggregate of 2 years.

And yes, the immigration service specifically checks for every AOS whether the applicant was ever on a J1/J2.

(you have to go to the country that sponsored you for the J1. So if you are e.g. a ukranian/israeli dual citizen and ukraine sponsors you for the J1, you need to go to ukraine)

 

[jolu]

okay, i got more questions....

I'm Canadian, but US med school graduate...and going into surgery. So if i do my two years of research in Canada in the middle of my residency (usually we do labs between PGY2 and PGY3 years), does that fulfill my 2 years post training requirements?

And for programs which say they "prefer" J-1 visas, will they absolutely not sponsor you the H1 visa even if you agree to take care of all the paper work and financial stuff?

Thanks.

 

[Faebinder]

That is incorrect. Marriage to a citizen doesn't relieve you from the foreign residency requirement. You are blocked from filing for adjustment of status until you either:
- fulfilled the requirements of a particular waiver (Conrad30 underserved area, VA hospital, HHS outstanding researcher)
- remained in your country of last residency for an aggregate of 2 years.

And yes, the immigration service specifically checks for every AOS whether the applicant was ever on a J1/J2.

(you have to go to the country that sponsored you for the J1. So if you are e.g. a ukranian/israeli dual citizen and ukraine sponsors you for the J1, you need to go to ukraine)

I think you are correct and the statement i said applies to F-1 not J-1.

 

[Faebinder]

okay, i got more questions....

I'm Canadian, but US med school graduate...and going into surgery. So if i do my two years of research in Canada in the middle of my residency (usually we do labs between PGY2 and PGY3 years), does that fulfill my 2 years post training requirements?

And for programs which say they "prefer" J-1 visas, will they absolutely not sponsor you the H1 visa even if you agree to take care of all the paper work and financial stuff?

Thanks.

Hmm.. this might be a problem because now you need to drop the J-1 and the program needs to give you an application for the H-1 and you have to go to the embassy and have them approve an H-1 (which is not a big deal for canadian residents). It's in the hands of your program.. are they willing to drop your J-1 and give you an H-1 + wait on you two years (wow nice program)? Then yeah. Usually programs wont do that, money is not the only issue in H-1, they are limited for non-university institutions.

 

[f_w]

I think you are correct and the statement i said applies to F-1 not J-1.

With F1, you are free to seek immigration or any other type of non-immigrant visa. With J1 you are f#)*__#.

 

[jolu]

thanks, Faebinder!

 

[f_w]

I'm Canadian, but US med school graduate...and going into surgery.

H1B OR NOT TO BE.

As a graduate of a US medschool, you can get something called OPT. It is a work permit for one year after graduation for 'practical training'. You can use that to start your internship, in the time until may, your hospital can get you an H1b.
The job market for general surgeons is not particularly good, the people on J1s I know of had a hard time to find professionally fulfilling waiver jobs.

Btw. 'University affiliated' hospitals are exempt from the cap on H1b visas.

And for programs which say they "prefer" J-1 visas, will they absolutely not sponsor you the H1 visa even if you agree to take care of all the paper work and financial stuff?

It is illegal for you to take care of 'financial stuff'. The hospital is the one who sponsors you, they are required to pay all fees.

The 'prefer J1' policy is mostly for FMGs, if you are a competitive US grad programs won't be so orthodox about this. That said, there are some academic institutions that have ironclad 'no H1b' policies. This is difficult to figure out beforehand, residency directors (particularly in surgery with its very low FMG content) are for the most part clueless about the intricacies of immigration law.

 

[jolu]

thanks f_w, that is very helpful info, i did not know this.

 

[f_w]

thanks f_w, that is very helpful info, i did not know this.

Please, nobody get upset:

Look for someone reasonably nice to marry while in medschool. If you have someone right now, get your behinds to the county courthouse asap. Make a simple pre-nup. Don't get (her) pregnant. As a medstudent/resident, you don't have assets, a non-contested 'pro-se' divorce 3-4 years down the line is far cheaper than a single H1b filing fee with USCIS.

 

[buckley]

Please, nobody get upset:

Look for someone reasonably nice to marry while in medschool. If you have someone right now, get your behinds to the county courthouse asap. Make a simple pre-nup. Don't get (her) pregnant. As a medstudent/resident, you don't have assets, a non-contested 'pro-se' divorce 3-4 years down the line is far cheaper than a single H1b filing fee with USCIS.

This made me laugh so hard...because it's probably true! Hahaha! So I guess, I'll stand in the middle of Times Square holding a placard, "Is anyone available?" Teeheeheehee....

Question: If you came for residency on a J1 visa, and you went home for the mandatory 2 years after, how easy is it to get another job to return to the US should you wish too? I mean, would fellowship again be as tough to get on a B1 visa?

 

[f_w]

This made me laugh so hard...because it's probably true!

You think I'm kidding.

Question: If you came for residency on a J1 visa, and you went home for the mandatory 2 years after, how easy is it to get another job to return to the US should you wish too?

Depends on your specialty. I know an orthopod, a gas-man and a couple of pediatricians who left and returned. They kept one of the cheap licenses in the US (e.g. Nebraska) and diligently accumulated CMEs. Ideally of course you can work in your field while abroad and further your career that way.

I mean, would fellowship again be as tough to get on a B1 visa?

Returning into a fellowship is hard. Few fellowships sponsor H1b, and that is the only visa you would want at that point. What tends to work better is to take a job, get your green-card and then go back to fellowship.

 

[buckley]

I just said I think it's probably true!

Would that be on-line CME credits? Hmmm....Or maybe, if you can somehow squeeze in the fellowship in the 7years of residency training afforded by J1, it would be easier to come back...yiiiiiiikes! I'm going for neurology (i hope) and im not sure if there are that many waivers available. I really don't mind coming home (it's the plan right now), but my seniors all tell me, get the h1 coz you just never know...

I believe you and take your advice seriously. Thanks! 👍

 

[Faebinder]

I just said I think it's probably true!

Would that be on-line CME credits? Hmmm....Or maybe, if you can somehow squeeze in the fellowship in the 7years of residency training afforded by J1, it would be easier to come back...yiiiiiiikes! I'm going for neurology (i hope) and im not sure if there are that many waivers available. I really don't mind coming home (it's the plan right now), but my seniors all tell me, get the h1 coz you just never know...

I believe you and take your advice seriously. Thanks! 👍

Neurology doesn't get a waiver, it's not primary care.

 

[f_w]

Neurology doesn't get a waiver, it's not primary care.

You don't have to be in primary care to get a waiver. While individual states may reserve the majority (or like in the case of some large states all) of their 30 slots for primary care providers, there is no requirement in federal law to do so.

In 2005, a senate bill extended the Conrad program and now allows 5 slots per state to be in non-underserved locations if the majority of the patient population is drawn from a underserved service area (this allows hospital based specialists such as intensivists to get waivers).

A recent appeals court decision affirmed that while the availability of primary care providers is the indicator used by the feds, it doesn't restrict availability of immigration benefits to PCPs only.

As a specialist, your odds to get a waiver are higher if you go to a smaller state. Those states rarely ever use their whole quota and are usually open to specialists.

Of the J1s I knew in neuro, most got their waivers through the VA or by going to a place where corn is the mainstay of the local economy.

 

[buckley]

Thanks for the inputs. That visa issue is proving to be one tall hurdle. I actually have 2 good universities asking me to inform them when my visa status changes. That is, they wont interview me on a B1 visa, but will consider me if I suddenly magically pop out a green card. Hahaha...I guess the marriage idea sounds pretty inviting now...heehee...

 

[NotAProgDirector]

Thanks for the inputs. That visa issue is proving to be one tall hurdle. I actually have 2 good universities asking me to inform them when my visa status changes. That is, they wont interview me on a B1 visa, but will consider me if I suddenly magically pop out a green card. Hahaha...I guess the marriage idea sounds pretty inviting now...heehee...

They won't interview you if you get a J visa or they won't sponsor you for an H? Or you don't want a J?

 

[f_w]

That visa issue is proving to be one tall hurdle. I actually have 2 good universities asking me to inform them when my visa status changes. That is, they wont interview me on a B1 visa, but will consider me if I suddenly magically pop out a green card.

They don't seem to have an understanding of the visa process.

Hahaha...I guess the marriage idea sounds pretty inviting now...heehee...

As I said, you think I'm kidding, I'm not.

 

[buckley]

Nope. They want me to be J1 at the time of the interview! 😱 The reason they say is that they dont want to risk their spot in case I dont get the J1. The irritating thing is that their website (and an email inquiry a couple of months ago) said they honor the J1 visa---I never thought that meant, they simply "honor" it and don't want to assist getting it for you. Hayayaya! Right now I just heard this from the PC, would it be brash (or entirely useless) for me to try and email the PD?

Oh I believe you, but even you have to admit marriage for residency convenience is pretty funny. You dont know how may times I have looked myself in the mirror and asked the BIG IMG QUESTION: How much do I really want US training? Fortunately (or unfortunately), the answer is a y-e-s. Residency is pretty great here. ( I know residency is a tough pill to swallow anywhere, but, well, from where I come from, it's pretty great here sans some hospitals who make you mop the floor).

Besides, even if I get married now, I dont thing the GC will be processed in time....as if I have a groom on hand already!

 

[f_w]

The reason they say is that they dont want to risk their spot in case I dont get the J1.

And how do they propose you get the J1 without already being a resident ? (Idiots)

Besides, even if I get married now, I dont thing the GC will be processed in time....as if I have a groom on hand already!

Yeah, but you would have the work permit in time. And once you are officially an immigrant, hospitals risk a couple of 10k in federal fines if they discriminate against you based on the details of your immigration status (once you have a work permit, they aren't even allowed to ask you what the permit is based on, asylum, refugee, marriage, CIA informant)

 

[NotAProgDirector]

The reason they say is that they dont want to risk their spot in case I dont get the J1.

This makes little sense. J1 visas are not capped in any way, so you can almost always get one. The major two holdups are:

1. Diploma -- you can't get your ECFMG cert until you have your diploma. If you are graduating this year, then the whole process can't start until after grad. If you've already graduated, presumably you already have your ECFMG and this is a non-issue.

2. The "Letter of Need" -- some countries are difficult to get this from. Of note, it's the resident's responsibility to do this, so it's no work for me. Ireland and Canada are actually on the list of "difficult" countries. Politcal upheaval (i.e. Pakistan) can cause trouble also, but usually these letters can be obtained from an embassy outside the US which sometimes avoids the political troubles.

We have never had anyone have any trouble obtaining a J visa.

 

[buckley]

And how do they propose you get the J1 without already being a resident ? (Idiots)

Wow, this is exacty what I wanted to tell them...But I know my place and I remained polite and just told them it is impossible for me to get a J1 without a contract on hand. And the PC told me, "Well, that is a problem huh?!" And I'm so glad we were just talking on the phone because my facial expression simply cannot be put into words...God, I hope I match! Technically, I just need one IV right?! 🙄 Success would be the perfect retort😀

Thanks for selling the idea of marriage, believe me if it were possible, I really would consider it 🙂 For 2 seconds I thought about wearing a placard, "Are You Available?" across Times Square. Mwahahahahaha!

APD--hayayayaya! I wish there was a Program Directors Summit or something and you can tell that to everyone. All in all though, I think this issue is just reflective of how competitive the match has become and the surplus of applicants. The sad fact is programs CAN be choosy. During my grandma's time, US hospitals even paid for her airfare from our country to here just to interview...How times have changed!

 

[Faebinder]

Wow, this is exacty what I wanted to tell them...But I know my place and I remained polite and just told them it is impossible for me to get a J1 without a contract on hand. And the PC told me, "Well, that is a problem huh?!" And I'm so glad we were just talking on the phone because my facial expression simply cannot be put into words...God, I hope I match! Technically, I just need one IV right?! 🙄 Success would be the perfect retort😀

Thanks for selling the idea of marriage, believe me if it were possible, I really would consider it 🙂 For 2 seconds I thought about wearing a placard, "Are You Available?" across Times Square. Mwahahahahaha!

APD--hayayayaya! I wish there was a Program Directors Summit or something and you can tell that to everyone. All in all though, I think this issue is just reflective of how competitive the match has become and the surplus of applicants. The sad fact is programs CAN be choosy. During my grandma's time, US hospitals even paid for her airfare from our country to here just to interview...How times have changed!

Now you might be thinking, who in the world would apply to a program if they are already with a J-1 in the country in another program?

Simple, it's the same concept how some programs want USCE that is ACGME approved before you start residency with them as a PGY-1. Basically the program wants you to have taken a prelim PGY-1 somewhere before applying to them. They will happily transfer that J-1 visa and not have to approve it through their system. I am not sure what is the thinking behind that, but it seems their system doesnt like to pay for J-1 visas processing. So if you still didnt get into surgery after one or two prelim years.... or maybe after that prelim medicine you still didnt go anywhere... or lets just say you are tired of Psych or OBGYN and want IM or FM..Or you really wanted neurology all along but snuck into IM cause it was easier.... well there ya go.. change careers and transfer J-1 visas. So plenty of candidates around.

And it's not like they are dying to have candidates apply to their program.. Plenty of candidates out there and not enough positions.

 

[f_w]

Simple, it's the same concept how some programs want USCE that is ACGME approved before you start residency with them as a PGY-1. Basically the program wants you to have taken a prelim PGY-1 somewhere before applying to them. They will happily transfer that J-1 visa and not have to approve it through their system.

A program doing that would shoot itself in the foot by loosing out on funding in the last year of training. Dumb.

I am not sure what is the thinking behind that, but it seems their system doesnt like to pay for J-1 visas processing.

Expense for the program for a J1 visa: 0 (zilch, nada) (it's a signature on a form for the designated institutional official)
Expense to applicant for J1 visa: ~$400 (200 to ECFMG, 200 to the state dept.)

Expense to program for a H1b: ~$2000
Expense to applicant fo H1b: ~$200