Matching into Residency on H1B Visa

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Blitz2006

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Quick Question,

When I apply for Residency on H1B visa (since I am a Non-US Citizen IMG from the UK), do I apply during my final year of medical school, set up the residency, and then wait for a year for my H1B to process before I start in July

(ie. Lets say I began my final year this September, would I apply this summer for July 2011, and if I matched March 15th 2010, could I then start July 2011?).

The reason why I have to wait a year is because I can only write Step 3 after I graduate (which is in June), and I need Step 3 for H1b.

Or do I apply for residency during my year off (so after I graduate). Thus in the previous example, I would apply summer of 2010 for July 2011 start.

Replies appreciated, thank you.

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I think once you have the step 3 the program will apply for a H1B visa on your behalf, you can't get one on your own. while applying for whichever speciality make sure they sponsor H visa as not all of them do it and they all prefer J visa. hope this helped.
 
I think once you have the step 3 the program will apply for a H1B visa on your behalf, you can't get one on your own. while applying for whichever speciality make sure they sponsor H visa as not all of them do it and they all prefer J visa. hope this helped.


Hey,

Appreciate the post, thanks.

So does that mean I apply for residency this summer or next summer (For July 2011 start)? Thats what I'm a bit confused about.

cause I read in some places that it is better to setup with the Program director your residency spot, and then once you pass Step 3 they can process H1B visa (assuming obviously the hospital will sponsor you).

However, I also read that you shouldn't apply for residency until you have Step 3 completed, cause only then can you get H1B sponsorship approved.

Bit confused...

And I dont' want to be criss crossing the atlantic for interviews one year too early....

Thx again, any replies is much appreciated.
 
I am not too familiar with visa issues.

But, it looks like you need help with your timelines. Even when applying with a visa, most people apply to programs through the match. The application process starts at the very beginning of your 4th year. The applications are filed on ERAS, an electronic service. The application service usually opens around July, and applications usually can be submitted Sept 1. The applications are for positions in the following year. For example, you apply Sept 1, 2009, and if you match, you will start your residency on July 1, 2010. You also need to register for the Match at the NRMP. Both the ERAS and NRMP websites have a calendar of dates of deadlines and what not.

ERAS:
http://www.aamc.org/students/eras/

NRMP:
http://www.nrmp.org/
 
You do not apply in 2009 to start in 2011. Residency programs do not give deferments. They will process your visa application for you.

Thus, if you wish to start in July 2011, then you apply September 2010, regardless of Visa issues. This is why most FMGs who need a visa apply after they have graduated from medical school.

There are some programs that start off cycle, ie, January instead of July. You can run a filter on FREIDA and see if there are any in the field you are interested in, this would allow you to take just 6 months off after graduation rather than a year.
 
You do not apply in 2009 to start in 2011. Residency programs do not give deferments. They will process your visa application for you.

Thus, if you wish to start in July 2011, then you apply September 2010, regardless of Visa issues. This is why most FMGs who need a visa apply after they have graduated from medical school.

There are some programs that start off cycle, ie, January instead of July. You can run a filter on FREIDA and see if there are any in the field you are interested in, this would allow you to take just 6 months off after graduation rather than a year.

Wow. I did not know about FREIDA. Just went to the website and found several programs that start in Jan. Thanks Winged Scapula for that, very informative.

So here's my last, follow up question:

I did some research. So lets say I graduate June 2010. I take my Step 3 in July (I can only take Step 3 after graduation). Step 3 Results come out in November 2010. Is there any chance I can start residency Jan 2011? If I wanted Jan 2011 start date, would I start to apply Sept 2010 even though my Step 3 results wouldn't be ready for a few months (since I would be requesting for H1B visa for January). Or, would I apply Sept 2009 for Jan 2011 (If I can get the July 1 2010 start date pushed 6 months to wait for my Step 3 results/H1B visa)

Also, on that FRIEDA site, many residencies say start date is "negotiable", so I'm assuming there are cases when I could start residency in months such as Feb...or am I wrong?

Thx again for all your help
 
Wow. I did not know about FREIDA. Just went to the website and found several programs that start in Jan. Thanks Winged Scapula for that, very informative.

So here's my last, follow up question:

I did some research. So lets say I graduate June 2010. I take my Step 3 in July (I can only take Step 3 after graduation). Step 3 Results come out in November 2010. Is there any chance I can start residency Jan 2011? If I wanted Jan 2011 start date, would I start to apply Sept 2010 even though my Step 3 results wouldn't be ready for a few months (since I would be requesting for H1B visa for January). Or, would I apply Sept 2009 for Jan 2011 (If I can get the July 1 2010 start date pushed 6 months to wait for my Step 3 results/H1B visa)

Also, on that FRIEDA site, many residencies say start date is "negotiable", so I'm assuming there are cases when I could start residency in months such as Feb...or am I wrong?

Thx again for all your help

OK, so if you graduate in June 2010, you need to be "ECFMG certified" before applying for step 3. First, by graduating in June 2010, do you mean you will fulfill your graduation requirements or will you physically have your diploma in hand?

You need your final medical school diploma in hand, and USMLE step 1, 2CK and 2CS to be ECFMG certified. Assuming you are done with the exams, once you get your diploma, the certification will take 2 months, then application for step 3 atleast 15 days, and then find a test centre. I dont see you being able to take step 3 before september. However you can go ahead and apply for ERAS in 2010 and go through with interviews and the mtch etc. Step 3 result is needed eventually only at the very end for the visa processing. If you match, you will be starting in June 1011. Your visa processing will start about march 2011, by which time you will need Step 3 result to be able to get an H1B. Programs may want to have it by Feb 2011 ( rank order list deadline), but thats about the earliest.

You will have a year between ending med school and starting residency this way, which most IMGs have anyway. You can do some research, or sme clinical work in the UK in the meantime, etc in the meantime.

Hope it helps a bit.
 
Wow. I did not know about FREIDA. Just went to the website and found several programs that start in Jan. Thanks Winged Scapula for that, very informative.

You're welcome...I'm glad it was helpful.

I did some research. So lets say I graduate June 2010. I take my Step 3 in July (I can only take Step 3 after graduation). Step 3 Results come out in November 2010.

Step 3 results should take less than 4 weeks to get back...others who have taken it more recently can give an update on the current timeframe from taking the exam and posting the results, but for all the computerized exams the results come back much quicker than you are anticipating (ie, 4 months).

Is there any chance I can start residency Jan 2011?

As long as you are ECFMG certified by residency start date and have a visa, you can start (providing you find a program that offers you a position).

If I wanted Jan 2011 start date, would I start to apply Sept 2010 even though my Step 3 results wouldn't be ready for a few months (since I would be requesting for H1B visa for January).

Yes, you would apply during September 2010, letting programs know that you would be available to start work in January pending getting the H1B visa. However, this may be difficult because it can take 6-9 months to get an H1B visa, and some programs don't sponsor them at all, so you would have to take Step 3, get interviewed at a program, they would have to offer you a position outside of the match and then apply for the visa - all to happen by January. Given the timelines, unlikely to happen.

Here is some excellent information on H1B visas from aProgramDirector:

aProgramDirector said:
The H Visa

An H visa is a true work visa. It allows a non-US citizen to hold a professional position which requires significant training. H visas are commonly used by physicians and by IT professionals. Because of the "Home Country" issue with the J visa, they are often preferred by non-US citizens training in the US. However, they have some other issues.

Basic facts:

They are much more difficult to get. There is an annual limit to the number of H visa's available in the US. Last year, this limit was 65,000. It's extremely complex, but last year all of the visas were given away many months before they would be valid. Current practice suggests that it may take 6-9 months to get an H visa, if one is obtainable at all.

They are much more expensive and complicated. Usually you need to hire a lawyer to make it all happen, which costs $$$. There is a $1000 premium processing fee, which really isn't optional if you want to start your training anywhere near July 1st. This site has a list of all the documents / paperwork you will need to generate.

Some residency programs refuse to sponsor H visas because of all of the work involved.

Non profits and Universities are immune to the cap, and hence can always get an H visa. However, an H obtained outside the cap is only transferrable to another institution immune to the cap.

In order to get an H, you will need to pass all THREE steps of the USMLE (unlike the J, where you only need Step 1 and 2). Realistically, you should have passed all three before even applying for a residency position if you wish to try to get an H visa.

You can transfer your H Visa anytime you want, although it usually takes 2-3 months to do so.

If you get hired in the US into a permanent job (i.e. NOT residency) on an H visa, your employer can sponsor you for permanent residency. This is one of the easiest paths to citizenship. Note I said "easiest", not "easy". This is the major advantage of the H visa. Note that if your H is obtained outside of the cap, this will only work for an employer who is University / Non profit.
Your H visa is only good for 6 years (actually it's good for 3 years, and renewable once). This can be a big problem if you decide to do a complex fellowship (like interventional cards, which is 3+3+2 = 8 years in most institutions now).

Dependents (Spouse / children) obtain H-4 visas. They cannot work in the US on these visas at all.

You can moonlight on an H1-b visa if you can obtain a full license (which depends by state).

Or, would I apply Sept 2009 for Jan 2011 (If I can get the July 1 2010 start date pushed 6 months to wait for my Step 3 results/H1B visa)

You can discuss this with programs but most are expecting that if you apply in September 2010 that you are planning on starting work in July 2011 but could be available sooner if the visa were obtained. You would not apply September 2009 with a plan to start January 2011.

Also, on that FRIEDA site, many residencies say start date is "negotiable", so I'm assuming there are cases when I could start residency in months such as Feb...or am I wrong?

Iffy. Take what is written on FREIDA with a grain of salt. It is often written by administrative personnel, not updated, etc. However, these things *may* be negotiable but most programs would likely prefer a July 1 start date, with some allowing an off cycle start, but these dates are usually fixed. You would have to contact specific programs and ask about how flexible they would be.

Clearly an H visa is better than the J, but you also have to realize that many programs will not sponsor residents for an H visa. You also need an attorney to help you with this.

Bottom line is:
- take Step 3 as soon as possible after graduation
- Apply September 2010 with a plan to start July 2011
- Tell programs that interview you that you could start January 2011 if the visa was obtained
- Ask programs that interview you if there are any alternate start dates between January 2011 and July 2011 (probably not, but it doesn't hurt to ask. Some specialties might be more flexible).
 
Bottomline,

This has been a very helpful thread. Thanks for the informative responses Winged Scapula.

I'll be lurking on the forums as usual

Cheers,
 
Most non-profit institutions are exempt from the H1B cap. ie there are unlimited H1B visas available for non-profit organisations.
 
if the H1B is renewable only once...

I did my prelim year at a separate institution so I transferred now that i am in my advance program---does this qualify as a renewal?

i'm asking because i'm in a 4year program, and i'm interested in a 2 year fellowship and then maybe a 2nd fellowship? how feasible is that? also are there any rules about the type of fellowship u need if u wanted to remain on the H1B? i.e. does it have to be ACGME-accredited?

would be great if we could hear from people who made the transition 😀 thanks
 
if the H1B is renewable only once...

I did my prelim year at a separate institution so I transferred now that i am in my advance program---does this qualify as a renewal?

No. You transfered your H1b visa from one employer to another. Perfectly legal, 3 year visa timeclock remains unchanged.

i'm asking because i'm in a 4year program, and i'm interested in a 2 year fellowship and then maybe a 2nd fellowship? how feasible is that? also are there any rules about the type of fellowship u need if u wanted to remain on the H1B? i.e. does it have to be ACGME-accredited?

As above, you still have the full 6 years available on your H1b. That should fit a 4 year program and a 2 year fellowship. It would not fit a second 2 year fellowship. You can extend an H1b beyond 6 years if you are seeking an employer based green card, but you wouldn't be able to do that as a fellow.
 
whoa...i didn't know that. sigh. so, what would be a common path for people on H1B who want to do further fellowships?
 
:laugh:
😡
:scared:

:nono:
🤣

Where to start with this one?

That has got to be THE HEIGHT of desperation.

I guess if person is decent looking, he/she can find plenty of nurses who would be very happy to marry a doctor. 😀
 
In many cultures people fell in love after marriage anyway so can't be that bad.:laugh:
 
whoa...i didn't know that. sigh. so, what would be a common path for people on H1B who want to do further fellowships?

You could:

1. return to home country for 1 year, and apply for another full H1b.
2. Get a job after the first fellowship. If you get employed on an H1b, you can apply for a green card. This is a complex process which I don't fully understand, but your H1b gets extended until the GC process is complete. Then, you do the second fellowship.
3. Switch to J1
4. Get married to a US citizen -- although this is VERY complicated and can easily get you deported. There are specific law/rules that try to catch "fake marriages" to simply obtain citizenship. Consult an immigration lawyer before getting married.
 
whoa...i didn't know that. sigh. so, what would be a common path for people on H1B who want to do further fellowships?

With H1b you just have to leave the country for a year so basically you can go any where you want to. You can do one year of peace core service if you are interested in travel and it can be good interview discussion.

As for applying for 7th year extension after 6 years is lot more complicated and my knowledge is several years old so don't count on it. Briefly,
You/an employer need to apply for GC application and your GC application has to be pending for more than 1 year at the time of 7th year H1b extension application. So basically some one has to apply for GC application for you in your 5th year on H1b.

When you apply for GC job, it has to be based on your experience at the time of job application. Lets say you are cardiology fellow but you can NOT pursue cardiologist position as you have not done your fellowship so you can only look for an internist or hospitalist position. Once you go on that route you are essentially off 3 -5 or more years as your GC can take quite a long time. Even though you would a cardiologist by the time you will start your GC job but you can only work as IM specialist. I never pursued this track so as I said earlier don't count on it and if you really need to know then you should speak with an immigration attorney.

I think it is very very long term thinking as of yet if you are interested in applying for fellowship as lot can happen between now and then. Right now job market is tight so people who applied for GC are getting it very fast. By the time you will in a position to apply for GC, hopefully economy will back in full swing so you probably have to wait many years of back log.
 
thanks!

consult a lawyer before i get married...there goes thoughts of romantic escapades and elopement. hahaha.

anyone ever heard of fellowships *willing* to sponsor GC?

i think i like the idea of just going out of the country. I've heard there are some interesting fellowships in Canada as well.

oh it is long term, as applications are due. Now I have to think which one I really, really like, and which one I can live without if need be. 😕
 
thanks!

consult a lawyer before i get married...there goes thoughts of romantic escapades and elopement. hahaha.

Feel free to elope. Just run it by your lawyer first.

anyone ever heard of fellowships *willing* to sponsor GC?

In order to sponsor you for a GC, they musy be offering you a permanent job. I doubt you want to be a fellow forever. If your visa was good for 1/2 of the fellowship, and they were willing to hire you at completion, it might be possible.

i think i like the idea of just going out of the country. I've heard there are some interesting fellowships in Canada as well.

If you are a canadian citizen, this is an option.
 
Feel free to elope. Just run it by your lawyer first.

sad...just when u want 2 throw all cares 2 the wind...of course if that were true, i should care less about fellowships and visa issues, right? ahhh...something tells me, i'm settinng myself up for spinsterhood......rage! RAGE against the machine! 😛

but thanks APD, as always, your wisdom is much appreciated !
 
Hi everybody,
my situation is pretty complex and after talking to international advisors, director programs i am deeply sadened that I have like hit the biggest obstacle so far. Okay so I somehow managed to enter a US medical school and currently hold a F1 visa status. I have taken step1 like msot med students here and I am in my third year of school planing to take step 2 in august or whatever. My question is how the heck do I go about applying matching? Most schools say they will sponsor me ( or the ECFMG will) for the J1 but we all know that visa sux. SO i was looking into med schools that give H1 ( if anyone has a list of schools especially their surgery [programs that sponsors these that'd be great) and most do not give H1. Than an advisor told me that for H1 you need all three steps? Well how the heck am i supposed to get step 3 when im like any other american graduate and about to take step 2 and apply fro residencies through eras ? I have no way of getting that step 3 before graduation? so i was wondering if anyone knew, are there any exceptions to the rule, to obtain the H1b(granted the schools sponsors you) without the step3 since i am american med graduate?
plase help me with an advise if you have.im like literaly getting depressed about this whole ****ty visa process🙁🙁
 
your medical school should have someone to help you through this. I have 3-4 international classmates (all of whom went to college in the US) who need visas and encountered no problems matching.
 
your medical school should have someone to help you through this. I have 3-4 international classmates (all of whom went to college in the US) who need visas and encountered no problems matching.

Thanks for those who have replied to my questions and especialy aProgDir. Basically we got hit pretty bad by IKE and so many people got layed off and I might really be the only international student in the class dealing with this situation so when i call they do not have much "experience" in this whole matter. YOU would be amazed how many different answers i get everytime i call a school and my bill is gona be austronomous. Basically i have hears that officially i dont need step3 to apply for H1B but an immigration advisor from a school in NYC ( i wont mention for HIPAA purposes lol) said, no we still require step3 regardless, it is our policy. Gosh, every school has their own policy its just such a mess LOL
anyways, im sure it will all work out eventually, i just wish there was less stress and more educated people about this situation. SO far the north east coast have given be the most accurate information, so if anyone has questions call new england schools, they are "educated" about this matter 🙂
thanks guys
 
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