International AMG, anxious about the match

[Giovanotto]

1) How can you tell if a program will even accept a medical student for residency on a OPT? Because the assumption then is that the problem is kicked one year down the road. I've looked on FREIDA and it looks like most programs don't accept OPT...

2) Anyone know where I can find a semi updated list of residency programs that offer the H1B? FREIDA seems useless right now.

3) If I start emailing programs as a soon to be 4th year inquiring about visas, do I just simply ask them, do you accept OPT or offer H1Bs? I can't help but presume that most people don't know what OPT is.

Any advice about this issue is very much appreciated. I'm trying my best now to prepare for September when I apply for residency. I don't want to go on interviews at programs that will never consider an F1 student.

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[NotAProgDirector]

Your best option is to review web sites (since many programs will post it there). Failing that, contacting programs is reasonable.

But, this is something that is in flux. We have traditionally happily accepted OPT visas. But this year, all of our OPT visas have been a nightmare, and we are told it may take up to 5 months to get them approved. I expect we will no longer consider them for next year. Hence any list may be out of date.

 

[Giovanotto]

Your best option is to review web sites (since many programs will post it there). Failing that, contacting programs is reasonable.

But, this is something that is in flux. We have traditionally happily accepted OPT visas. But this year, all of our OPT visas have been a nightmare, and we are told it may take up to 5 months to get them approved. I expect we will no longer consider them for next year. Hence any list may be out of date.

 

[Giovanotto]

I've started doing my homework about this, and I've come across this situation which I am hoping someone can clarify for me.

Example (medical school XXX):
"XXX training programs are competitive and do not meet the hard to fill criteria required for Visa (Temporary TN work status, temporary H-1B and J-1) sponsorship"
...a few lines after
"ECFMG certification is not required at the time your application is submitted but is required to start residency."

So, what are they saying? Looks like they do accept J1's if you read the 2nd line, but the first line implies you wouldn't qualify?

 

[Giovanotto]

Also, looking online, not a single program so far has mentioned OPT on their websites. Can I reasonably expect that if they offer a visa (J1 or H1b) that they accept OPT?

edit: 1/6 programs actually mentioned OPT!

 

[NotAProgDirector]

I've started doing my homework about this, and I've come across this situation which I am hoping someone can clarify for me.

Example (medical school XXX):
"XXX training programs are competitive and do not meet the hard to fill criteria required for Visa (Temporary TN work status, temporary H-1B and J-1) sponsorship"
...a few lines after
"ECFMG certification is not required at the time your application is submitted but is required to start residency."

So, what are they saying? Looks like they do accept J1's if you read the 2nd line, but the first line implies you wouldn't qualify?

ECFMG cert has nothing to do with citizenship/visa/ability to work in the US. US citizens who go med school outside the US/Canada will need ECFMG certification.

The top sentence, in short, says "No Visas". They are stretching the truth, since J visas have nothing to do "hard to fill criteria".

Also, looking online, not a single program so far has mentioned OPT on their websites. Can I reasonably expect that if they offer a visa (J1 or H1b) that they accept OPT?

edit: 1/6 programs actually mentioned OPT!

If you're planning on a J, there is no value to an OPT and the process (might) be slower. If you match somewhere that only offers J, then you should plan on getting your J right away.

OPT was a great bridge to H. But this year, a nightmare. Maybe it will get fixed. Not even certain what broke it.

 

[Giovanotto]

What do you think about programs that state:

International Graduates should possess valid ECFMG certificates and have the State of California eligibility letter. We only accept J-1 visas. US clinical experience is required.​

Lots of programs are saying this, and I don't know how to apply it to myself, because technically I'm not an International Graduate. I've yet to see a program address international AMGs. Am I to assume I'll be lumped in with International Graduates as far as visa availability is concerned?

(thank you so much for your replies thus far by the way!)

 

[s5260205]

What do you think about programs that state:

International Graduates should possess valid ECFMG certificates and have the State of California eligibility letter. We only accept J-1 visas. US clinical experience is required.​

Lots of programs are saying this, and I don't know how to apply it to myself, because technically I'm not an International Graduate. I've yet to see a program address international AMGs. Am I to assume I'll be lumped in with International Graduates as far as visa availability is concerned?

(thank you so much for your replies thus far by the way!)

As non-US citizen/PR, you will need a visa to work in US. There are only two visas available for medical residency, J1 or H1.

As American graduate on F1 visa, you have the option of going for OPT for one year then H1 or directly to J1. If you opt for J1, you simply have to call ECFMG to get a certificate (simple process, no need for State of California eligibility letter either since you are AMG). ECFMG is usually only required for IMG (both US citizen and non-citizen), but it would be needed for J1 visa as well. If you opt for H1, apply for OPT at the earliest date possible to bridge into H1 (as the aforementioned problem with OPT processing this year).

Most residencies should offer J1, while fewer and fewer programs now sponsor H1. If programs specifically state they do not accept any visa (as the example you give above), I would not apply to that program unless you are really interested. As an example, in my research while applying to residency, I believe only 2 programs (Duke and Kaiser) specifically do not sponsor any visa. I would make a list of all the programs in your specialty of choice (as everyone does) but also include their visa sponsorship status. I would also strongly suggest avoiding J1 if at all possible due to the 2-year home requirement.

 

[Giovanotto]

As non-US citizen/PR, you will need a visa to work in US. There are only two visas available for medical residency, J1 or H1.

As American graduate on F1 visa, you have the option of going for OPT for one year then H1 or directly to J1. If you opt for J1, you simply have to call ECFMG to get a certificate (simple process, no need for State of California eligibility letter either since you are AMG). ECFMG is usually only required for IMG (both US citizen and non-citizen), but it would be needed for J1 visa as well. If you opt for H1, apply for OPT at the earliest date possible to bridge into H1 (as the aforementioned problem with OPT processing this year).

Most residencies should offer J1, while fewer and fewer programs now sponsor H1. If programs specifically state they do not accept any visa (as the example you give above), I would not apply to that program unless you are really interested. As an example, in my research while applying to residency, I believe only 2 programs (Duke and Kaiser) specifically do not sponsor any visa. I would make a list of all the programs in your specialty of choice (as everyone does) but also include their visa sponsorship status. I would also strongly suggest avoiding J1 if at all possible due to the 2-year home requirement.

1) I know timing the OPT can get a little tricky, I had to use it after undergrad to find work. When do you recommend I apply for OPT in my 4th year? Or rather, when do people usually do it? It's been a while since I've had to do it and I don't remember all the details. I vaguely remember that if I apply too early I end up wasting time on it, too late and programs may not be happy with me.

2) Any exception to their rule you think, was really hoping to rank Kaiser?

3) How would the 2-year home requirement even realistically work? Who would hire me after being gone from clinical medicine for 2 years after residency? How would one even pay back their "american" loans in this situation. Kinda crazy to think about, I'm trying to avoid the J1 at all costs, but damn it's like nobody offers the H1B anymore. I mean at this point I'd even consider switching to a less competitive specialty if it means getting the H1B, because as stated, the J1 is a pretty raw deal for international AMGs....

 

[s5260205]

1) I know timing the OPT can get a little tricky, I had to use it after undergrad to find work. When do you recommend I apply for OPT in my 4th year? Or rather, when do people usually do it? It's been a while since I've had to do it and I don't remember all the details. I vaguely remember that if I apply too early I end up wasting time on it, too late and programs may not be happy with me.

2) Sucks because I auditioned at Kaiser, loved the program, got a letter, and was really hoping on matching there. Any exception to their rule you think?

3) How would the 2-year home requirement even realistically work? Who would hire me after being gone from clinical medicine for 2 years after residency? How would one even pay back their "american" loans in this situation. Kinda crazy to think about, I'm trying to avoid the J1 at all costs, but damn it's like nobody offers the H1B anymore. I mean at this point I'd even consider switching to a less competitive specialty if it means getting the H1B, because as stated, the J1 is a pretty raw deal for international AMGs....

1) Post-completion OPT can be applied up to 90 days before your degree completion date (and up to 60 days after). Most schools award their degree by end of May. This means you should plan to apply by February. You should consult with your international student office regarding the specific details. Since you won't know the match result until March 15th (i.e., you won't know whether the program you matched at sponsor H1 or J1), you should apply for OPT regardless of what visa you end up pursuing. There is another issue with picking a start date. Most orientation starts around mid June (some even earlier). I would do 1st/2nd week of June as your start date just to be safe (but again, consult with your ISO).

2) Call the program to ask. Specify you are AMG and really interested in the program. Also, visa sponsorship may vary by specialty, e.g., FM in one hospital sponsors both H1/J1 but IM only sponsors J1. This is why you should compile the list and talk to program coordinator if you are interested.

3) 2-year home requirement can be waived with J1 waiver (look up this in detail). Only jobs in federally designated underserved areas may be eligible for J1 waiver, meaning you will be severely limited when seeking employment post residency. This is the reason to avoid J1 if at all possible. You are at a much better position as AMG as most programs are more receptive to your application despite needing visa. I would leverage this to apply to all programs in your specialty of choice that sponsor H1 and rank accordingly after interview season.

 

[Giovanotto]

1) Post-completion OPT can be applied up to 90 days before your degree completion date (and up to 60 days after). Most schools award their degree by end of May. This means you should plan to apply by February. You should consult with your international student office regarding the specific details. Since you won't know the match result until March 15th (i.e., you won't know whether the program you matched at sponsor H1 or J1), you should apply for OPT regardless of what visa you end up pursuing. There is another issue with picking a start date. Most orientation starts around mid June (some even earlier). I would do 1st/2nd week of June as your start date just to be safe (but again, consult with your ISO).

2) Call the program to ask. Specify you are AMG and really interested in the program. Also, visa sponsorship may vary by specialty, e.g., FM in one hospital sponsors both H1/J1 but IM only sponsors J1. This is why you should compile the list and talk to program coordinator if you are interested.

3) 2-year home requirement can be waived with J1 waiver (look up this in detail). Only jobs in federally designated underserved areas may be eligible for J1 waiver, meaning you will be severely limited when seeking employment post residency. This is the reason to avoid J1 if at all possible. You are at a much better position as AMG as most programs are more receptive to your application despite needing visa. I would leverage this to apply to all programs in your specialty of choice that sponsor H1 and rank accordingly after interview season.

This is amazing, thank you so much. Both you and aProgDirector (and others) have been incredibly helpful. I will be referencing this thread throughout my residency match process. I hope other international AMGs can also take something away from this.

1) Good point actually, I was looking at IM programs when looking at visa status because I figured it was a hospital wide policy, but I guess that's not necessarily true. Looks like I have no choice but to email every program coordinator that I am interested in.

 

[differentiating]

I echo the concerns about OPT - I started orientation recently, and one of my co-interns (also an AMG without US citizenship) had to step out after the welcome session because he's waiting on visa approval and cannot work until that's done. At this point in time, he has no idea when that might be, or how many rotations he might miss and have to make up as a result. It seems likely he'll miss his first rotation, at the very least.

It's been a nightmare for him, even though our program has been very supportive thus far.

 

[ribbit247]

As an incoming intern, I am literally going through this process now. I'm an AMG who is a non-US citizen and I applied for OPT after Match day and still haven't recieved my OPT, it's been >90 days. My med school international office said that pretty much everyone gets approved on day 90 but so far nothing. Other people are in the same situation. I called to expedite the process twice and was rejected both times. I called USCIS and asked how much longer it will take and they said it will take a minimum of 3 months, but average of 3 months to 5 months, some take longer. I don't know why it's a rule that you can only apply up to 90 days in advance of graduation but the process can take up to 5 months, when residency starts like a month after graduation.

One thing I found out was that you can apply for an H1B visa even without taking step 3. Apparently AMGs don't technically need step 3 to apply for H1b, it's been mentioned in this forum before. If your program offers H1B you can ask they can sponsor you for it immediately using Premium Processing which is $1225 I think, but you get a guaranteed response in 15 days. However, most institutions have a policy that you need to have passed Step 3 to be eligible to apply for H1B, but it may be a case by case basis. Your program has to pay for everything which can be a few thousand dollars. But the immigration officer needs to know that american grads don't need step 3, if they don't know that then the application will be rejected.

Main thing, apply for your OPT as soon as you can in February!! You don't know to know the program you are going to, you can update that later once you match. And definitely list your start date as like mid june when orientation begins, because you won't be able to take part in it without a valid visa.

If a program only offers J1, don't even do an OPT, J1 is way easier and faster.

 

[differentiating]

I echo the concerns about OPT - I started orientation recently, and one of my co-interns (also an AMG without US citizenship) had to step out after the welcome session because he's waiting on visa approval and cannot work until that's done. At this point in time, he has no idea when that might be, or how many rotations he might miss and have to make up as a result. It seems likely he'll miss his first rotation, at the very least.

It's been a nightmare for him, even though our program has been very supportive thus far.

Update - with the help of a sympathetic congressperson, my co-resident was able to get his approval a few days ago, overturning a denial the week before. He still has to wait to get his card in the mail, but is hopeful now that he’ll only miss 1-2 weeks beyond orientation rather than multiple rotations.

 

[ribbit247]

Update - with the help of a sympathetic congressperson, my co-resident was able to get his approval a few days ago, overturning a denial the week before. He still has to wait to get his card in the mail, but is hopeful now that he’ll only miss 1-2 weeks beyond orientation rather than multiple rotations.

omg does this actually work?? What state are you guys in. Who should I call?

 

[differentiating]

omg does this actually work?? What state are you guys in. Who should I call?

I’m on the west coast. My understanding is that he appealed to our local congressperson, and that their staff helped with expediting review of their application.

 

[GoSpursGo]

omg does this actually work?? What state are you guys in. Who should I call?

It's probably state and district dependent, but worth a shot. Basically call whoever the congressperson is for the district where your hospital is located.

 

[ribbit247]

It's probably state and district dependent, but worth a shot. Basically call whoever the congressperson is for the district where your hospital is located.

Thanks, just did that.

I’m on the west coast. My understanding is that he appealed to our local congressperson, and that their staff helped with expediting review of their application.

Did he tell you how long it took from the congressmen to take action?

 

[differentiating]

Thanks, just did that.

Did he tell you how long it took from the congressmen to take action?

No. I know the congressperson had been involved for a while, prior to the recent denial, but I haven’t asked for that level of detail.

 

[ribbit247]

No. I know the congressperson had been involved for a while, prior to the recent denial, but I haven’t asked for that level of detail.

Ah I see. Well thanks for the info!

 

[Giovanotto]

What happens if your rank list is a combination of h1b offering programs and J1 and you get an email informing you that you need to have your J1 Visa by rank time by your J1 Visa offering programs?!?!?!?

It was my understanding that you can't switch from J1 to OPT.

 

[NotAProgDirector]

I think you may have read the email incorrectly. You can't get a J visa until you have a job offer -- your employer needs to help you request it. There is no way to get a J visa before the match, unless you're matching into an "R" position and are already in another program. They can request that you have everything "ready to go", essentially ECFMG certification.

 

[Giovanotto]

I think you may have read the email incorrectly. You can't get a J visa until you have a job offer -- your employer needs to help you request it. There is no way to get a J visa before the match, unless you're matching into an "R" position and are already in another program. They can request that you have everything "ready to go", essentially ECFMG certification.

So this is what they mean by: "...Applicant's responsibility to provide documentation of J1 Visa status prior to submission of rank list to the NRMP. " ???

 

[NotAProgDirector]

I have no idea. It makes no sense. If they want full ECFMG certification (which would mean you'd have to already have graduated from medical school and submitted your diploma / proof of graduation) I would think they would just say so.

Seems like you should just ask.

 

[Giovanotto]

I have no idea. It makes no sense. If they want full ECFMG certification (which would mean you'd have to already have graduated from medical school and submitted your diploma / proof of graduation) I would think they would just say so.

Seems like you should just ask.

Yeah, I'll have to do that. Thank you for the quick reply!

 

[Giovanotto]

I have no idea. It makes no sense. If they want full ECFMG certification (which would mean you'd have to already have graduated from medical school and submitted your diploma / proof of graduation) I would think they would just say so.

Seems like you should just ask.

To clarify for others who might be reading this. International AMGs do not require ECFMG certification. It would not make any sense to do so since there is nothing to certify--you did your training at an american medical school.