Missing my intern orientation and nothing I can do about it!

[DrKabi]

---

Members don't see this ad.

I am an IMG who will be starting an IM residency on an H1B visa. Unfortunately there is a very strict rule which states you cannot come into the United States more than 10 days before the start of the job for which you have been given the H1B visa. In my case this means that I will miss all of the 10 days of intern orientation at my program . I am very worried about how badly this will affect me and having to play catch up for the rest of the year. Are there people who faced a late start or missed out on the orientation before the start of intern year? How did this adversely affect you and how did you deal with this. Any tips and advice will be very welcome.
PS: My program is aware of this but has made no mention of how they plan to help me catch up although I have raised this with the PD and PCs.

 

[Crayola227]

there's no way to convince the government these days of orientation are for the start of the job?

I'm guessing your employer could give you such a letter. It might help. There's usually ways around these sorts of rules if you are smart.

 

[ProfMD]

Orientations by and large are not that useful. You will probably need to take ACLS (2 class) and learn how to use the EMR, but most everything else is fluff, in my opinion.

 

[DrKabi]

there's no way to convince the government these days of orientation are for the start of the job?

I'm guessing your employer could give you such a letter. It might help. There's usually ways around these sorts of rules if you are smart.

The rule cannot be bent or so the consular official informed me. I did try to explain when I attended my visa appointment with all the relevant information from my program about the start dates of the orientation. The official was very sympathetic but let me know there was nothing she could do at her level to allow me earlier entry. HAs anyone had success coming in earlier than ten days before the start of residency on an H1B visa? If yes what did you do to circumvent this rule?

 

[Crayola227]

Orientations by and large are not that useful. You will probably need to take ACLS (2 class) and learn how to use the EMR, but most everything else is fluff, in my opinion.

true, but it's a useful time to get lots of other stuff out of the way, like navigating the city, getting your dry-cleaning, unpacking your coffee machine, etc
they often take professional profile photos, help you set up your email on your phone, get a hospital parking permit, troubleshoot your EHR login, getting healthcare established

it's easy to take that time for granted when you spend 1-2 weeks wasting 90% of your time, but the 10% of time that's useful would be a nightmare to try to add onto your first intern month. Hence the invention of orientation

that said, the program will do everything in its power to have you start and do well in the beginning. Do your best to make it, communicate lots to the govt agencies and your employer, and it will all work out one way or the other.

 

[Crayola227]

The rule cannot be bent or so the consular official informed me. I did try to explain when I attended my visa appointment with all the relevant information from my program about the start dates of the orientation. The official was very sympathetic but let me know there was nothing she could do at her level to allow me earlier entry. HAs anyone had success coming in earlier than ten days before the start of residency on an H1B visa? If yes what did you do to circumvent this rule?

There's no bending of the rule. Have your employer say that you start your job on the first day of orientation for the purposes of the visa.

 

[DrKabi]

true, but it's a useful time to get lots of other stuff out of the way, like navigating the city, getting your dry-cleaning, unpacking your coffee machine, etc
they often take professional profile photos, help you set up your email on your phone, get a hospital parking permit, troubleshoot your EHR login, getting healthcare established

it's easy to take that time for granted when you spend 1-2 weeks wasting 90% of your time, but the 10% of time that's useful would be a nightmare to try to add onto your first intern month. Hence the invention of orientation

that said, the program will do everything in its power to have you start and do well in the beginning. Do your best to make it, communicate lots to the govt agencies and your employer, and it will all work out one way or the other.

Thanks for the encouragement. Like you rightly pointed out I am also incredibly worried about having insufficient time to find my bearings in a new city and sort out living and transportation logistics while adapting to the intern schedule. I'm pretty sure I am not the first in this situation and I guess I will survive like others have before me.

 

[dozitgetchahi]

Wait, what?

There are a fair number of FMG residents that come in on H1B visas, and I've never heard of this problem happening.

For starters, the day you start orientation is the day you start the job, no? My benefit coverage and everything else that made me an 'official employee' started that day for both my residency and my fellowship. Is there some program that considers the 'first day of work' to be some day long after orientation starts?

Is this a restriction of the US government or of your home country?

I'm confused and this doesn't make much sense to me.

 

[Raryn]

I am an IMG who will be starting an IM residency on an H1B visa. Unfortunately there is a very strict rule which states you cannot come into the United States more than 10 days before the start of the job for which you have been given the H1B visa. In my case this means that I will miss all of the 10 days of intern orientation at my program . I am very worried about how badly this will affect me and having to play catch up for the rest of the year. Are there people who faced a late start or missed out on the orientation before the start of intern year? How did this adversely affect you and how did you deal with this. Any tips and advice will be very welcome.
PS: My program is aware of this but has made no mention of how they plan to help me catch up although I have raised this with the PD and PCs.

If you can come to the states 10 days before you start, and your orientation is 10 days... even if they count the start date as the first day you work, don't those 10 day periods overlap? I mean, you might miss the first day because of travel concerns, but why can't you make days 2-10?

That, and why didn't your program put on the visa application that your start date is the first day of orientation?

This sounds really weird.

 

[rokshana]

Wait, what?

There are a fair number of FMG residents that come in on H1B visas, and I've never heard of this problem happening.

For starters, the day you start orientation is the day you start the job, no? My benefit coverage and everything else that made me an 'official employee' started that day for both my residency and my fellowship. Is there some program that considers the 'first day of work' to be some day long after orientation starts?

Is this a restriction of the US government or of your home country?

I'm confused and this doesn't make much sense to me.

i agree that its odd since i'm sure there are plenty of people that come in an H1B for residency, but think its unusual for orientation to be counted as part of employment...both my residency and fellowship started on july 1st for employment even though there was a week of orientation for residency that was in june...and for fellowship my benefit coverage didn't start until a month after being employed...think this varies among programs...

 

[Raryn]

i agree that its odd since i'm sure there are plenty of people that come in an H1B for residency, but think its unusual for orientation to be counted as part of employment...both my residency and fellowship started on july 1st for employment even though there was a week of orientation for residency that was in june...and for fellowship my benefit coverage didn't start until a month after being employed...think this varies among programs...

It's variable. ACGME has a guideline I think that orientation should (but not must) be paid. My residency orientation was paid, fellowship orientation won't be.

 

[Crayola227]

i agree that its odd since i'm sure there are plenty of people that come in an H1B for residency, but think its unusual for orientation to be counted as part of employment...both my residency and fellowship started on july 1st for employment even though there was a week of orientation for residency that was in june...and for fellowship my benefit coverage didn't start until a month after being employed...think this varies among programs...

Completely agree; my experience with residency.

Still with @Raryn this still seems odd.

 

[NotAProgDirector]

As an employer, if you require orientation, it must be paid. If it is voluntary, then it doesn't need to be paid. If they required it, and you were to be paid, then your first employment date would be the first day of orientation.

To the OP: you can ask if your program could webcast the orientation -- then you could watch it on a computer.

Also to the OP: If you can't attend orientation, it's not a good idea to start with the idea that it's the program's problem to fix this for you. You will be expected to work to your full potential on day 1. Blaming anything on a lack of your ability to attend orientation could be taken the wrong way. Perhaps that's not fair, but it's life.

 

[Raryn]

As an employer, if you require orientation, it must be paid. If it is voluntary, then it doesn't need to be paid. If they required it, and you were to be paid, then your first employment date would be the first day of orientation.

To the OP: you can ask if your program could webcast the orientation -- then you could watch it on a computer.

Also to the OP: If you can't attend orientation, it's not a good idea to start with the idea that it's the program's problem to fix this for you. You will be expected to work to your full potential on day 1. Blaming anything on a lack of your ability to attend orientation could be taken the wrong way. Perhaps that's not fair, but it's life.

"Voluntary" isn't always voluntary. My fellowship orientation is optional... if I want to start work without it, I just have to personally scheduled a half dozen meetings with various departments, and won't get trained on order entry until something like September. I mean, it's doable and I'm fairly certain a motivated high school student could figure out order entry on their own... but it's still not the most reasonable of all "requests".

 

[Lee Ik-jun MD]

I am an IMG who will be starting an IM residency on an H1B visa. Unfortunately there is a very strict rule which states you cannot come into the United States more than 10 days before the start of the job for which you have been given the H1B visa. In my case this means that I will miss all of the 10 days of intern orientation at my program . I am very worried about how badly this will affect me and having to play catch up for the rest of the year. Are there people who faced a late start or missed out on the orientation before the start of intern year? How did this adversely affect you and how did you deal with this. Any tips and advice will be very welcome.
PS: My program is aware of this but has made no mention of how they plan to help me catch up although I have raised this with the PD and PCs.

Do you still have a valid tourist visa? The one you used for your clinical skills and interview?
Enter the US as a tourist. Do the orientation.
Exit the country 9 days before you start, go to Canada or Mexico
Then enter on your H1b

Problem solved. Costly? A little bit but at least you didnt break any law.

 

[dozitgetchahi]

Also to the OP: If you can't attend orientation, it's not a good idea to start with the idea that it's the program's problem to fix this for you. You will be expected to work to your full potential on day 1. Blaming anything on a lack of your ability to attend orientation could be taken the wrong way. Perhaps that's not fair, but it's life.

It may not 'be fair', but it's a bit crazy to expect people to show up for orientation, not certify the visa that way and then just wave your hands while somebody is scrambling/drowning when they show up for work the first day and don't even have a badge/computer access/anything else.

 

[DrKabi]

Thanks for all the replies. This isn't a rule I am making up. Infact I was advised just a few days ago by my program to not make travel arrangements to enter more than ten days before July 1st. Orientation starts a week earlier than the 20th at my program which is why I am missing the whole thing instead of just a few days. As for coming in on a visitor's visa to attend the orientation I no longer have a valid visitor's visa and only have the valid stamped H1b visa. It will be super weird to be requesting a visitor's visa now. Lastly my program filed my H1b visa application with the start date for the job being July first and not the start of orientation. I have no clue as to why they did this. All I know s that because of this the consular officer was not able to grant me an earlier entry.

 

[marsh20]

As an employer, if you require orientation, it must be paid. If it is voluntary, then it doesn't need to be paid. If they required it, and you were to be paid, then your first employment date would be the first day of orientation.

To the OP: you can ask if your program could webcast the orientation -- then you could watch it on a computer.

Also to the OP: If you can't attend orientation, it's not a good idea to start with the idea that it's the program's problem to fix this for you. You will be expected to work to your full potential on day 1. Blaming anything on a lack of your ability to attend orientation could be taken the wrong way. Perhaps that's not fair, but it's life.

Not true with my program. Orientation in the last two weeks of June was mandatory. It also consisted of EMR training as well. It wasn't everyday but it was definitely mandatory and there was no getting around it. We weren't paid a dime for that time. We started on the payroll on July 1st.

 

[NotAProgDirector]

Not true with my program. Orientation in the last two weeks of June was mandatory. It also consisted of EMR training as well. It wasn't everyday but it was definitely mandatory and there was no getting around it. We weren't paid a dime for that time. We started on the payroll on July 1st.

This is 100% illegal. Whether it's worth complaining about, that's the $1 million question. A whistleblower lawsuit after you graduate and have a job?

 

[RadOncDoc21]

This is 100% illegal. Whether it's worth complaining about, that's the $1 million question. A whistleblower lawsuit after you graduate and have a job?

Can I be put on that lawsuit? I need some help paying pay back my loans and an extra mil would help out a lot!

 

[rokshana]

This is 100% illegal. Whether it's worth complaining about, that's the $1 million question. A whistleblower lawsuit after you graduate and have a job?

is that new? i had the same experience in residency...orientation in june, not paid, not voluntary...

 

[CopaceticOne]

is that new? i had the same experience in residency...orientation in june, not paid, not voluntary...

No, it is basic labor law. The thing is - if the interns don't know they can't raise the issue.

So note to everyone - If work (any work) requires you to be there, they are required to pay you.

This is true for the waiter who needs to attend a staff mtg, person told they need to work over the weekend to ship more boxes, or a new intern who is required to attend orientation. Yes there are caveats regarding exempt vs non-exempt status, but everyone should still be paid for that time.

 

[Carlin]

Since you will have those 10 days before work starts, that will probably be a good time to get a lot of those things that Crayola listed done, even if it's not official orientation time. See if you can schedule appointments during that week with your PD and the medical education office so that they can get you up to speed on what you missed during orientation. You might even be able to arrange to take ACLS and get trained on the EMR.

 

[Perrotfish]

No, it is basic labor law. The thing is - if the interns don't know they can't raise the issue.

They can't raise the issue anyway. These aren't McDonalds employees fighting for a raise because they have nothing to lose, these are medial trainees who 100% need their employers to sign off on their training so that they can move on with their lucrative careers. No one is stupid enough to rock the boat over two weeks pay. Or work hour violations. Or really anything that doesn't involve unwanted physical contact

Honestly the only reason they pay residents at all is that they're not really paying them: the government reimburses residencies for every dollar of a resident's paychecks. If they want to skip the only two weeks of pay that would actually come out of their pocket... well then that's what they're going to do.

 

[Follow the Cairns]

No, it is basic labor law. The thing is - if the interns don't know they can't raise the issue.

So note to everyone - If work (any work) requires you to be there, they are required to pay you.

This is true for the waiter who needs to attend a staff mtg, person told they need to work over the weekend to ship more boxes, or a new intern who is required to attend orientation. Yes there are caveats regarding exempt vs non-exempt status, but everyone should still be paid for that time.

Copacetic is correct. If you "suffer or permit" employees to work (i.e. require it), they must be compensated.

When my husband started his residency in 2001, I took a job as an HR Manager in the same hospital. He came into my office one day complaining about why his orientation was unpaid, if it was, in fact, mandated by his employer. He knew this was BS based on his previous experience working in the business world and supervising employees. I mentioned this to the Chief Human Resources Officer of the Hospital, who shook her head, rolled her eyes, and said she would discuss with the GME Office. Starting that next year, Residents were compensated for orientation. In all those years prior, apparently nobody had brought this up before, or if they had, it hadn't made it upline to her.

My husband still wants that week of pay......

 

[Psai]

Copacetic is correct. If you "suffer or permit" employees to work (i.e. require it), they must be compensated.

When my husband started his residency in 2001, I took a job as an HR Manager in the same hospital. He came into my office one day complaining about why his orientation was unpaid, if it was, in fact, mandated by his employer. He knew this was BS based on his previous experience working in the business world and supervising employees. I mentioned this to the Chief Human Resources Officer of the Hospital, who shook her head, rolled her eyes, and said she would discuss with the GME Office. Starting that next year, Residents were compensated for orientation. In all those years prior, apparently nobody had brought this up before, or if they had, it hadn't made it upline to her.

My husband still wants that week of pay......

He earned it!

 

[Follow the Cairns]

He earned it!

And he paved the way to improve things for those who came after him. That alone should be reward enough, right? Okay, maybe not.

 

[gutonc]

This thread was basically finished after the subject line.

 

[waldenwoods]

When I had intern orientation in 2009, my program paid for our time. There were three people who had continuity clinic away from the primary hospital, which had another EMR, and we had to have training on it, so the three of us were compensated for that half day as well (the other residents didn't have any job duties scheduled at the time we had our EMR training). There are programs out there that are fair in terms of pay for orientation.

I don't know why programs and places in general have such long orientation periods. When I was starting an attending job, I was offered a 2-week orientation period and I wanted more days off so I negotiated to start a bit later than they wanted me to start. Then a non-clinical community outreach job came up on one of the days of my orientation period that was interesting, which I opted to participate in, so I ended up having only five work days of orientation (rather than 10) and I got pretty much everything done that I absolutely needed to complete before starting my clinical work, and I wasn't even very busy on those five days. As someone wrote above, most of orientation is fluff. I agree.

 

[dozitgetchahi]

When I had intern orientation in 2009, my program paid for our time. There were three people who had continuity clinic away from the primary hospital, which had another EMR, and we had to have training on it, so the three of us were compensated for that half day as well (the other residents didn't have any job duties scheduled at the time we had our EMR training). There are programs out there that are fair in terms of pay for orientation.

I don't know why programs and places in general have such long orientation periods. When I was starting an attending job, I was offered a 2-week orientation period and I wanted more days off so I negotiated to start a bit later than they wanted me to start. Then a non-clinical community outreach job came up on one of the days of my orientation period that was interesting, which I opted to participate in, so I ended up having only five work days of orientation (rather than 10) and I got pretty much everything done that I absolutely needed to complete before starting my clinical work, and I wasn't even very busy on those five days. As someone wrote above, most of orientation is fluff. I agree.

Oh yes, most of it is garbage. But's garbage that some executive or some idiot over in legal deemed 'mandatory' for all trainees to do, so they will have to do it.

For fellowship, I recently had to do a huge block of pre-employment mandatory modules *at home, on my own time* that took at least 20 hours to complete. These modules were laden with nonsense - as a nearly board-certified internist I had to sit through very elementary crap like 'how to identify MI symptoms in a floor patient' (it was clearly aimed towards nurses or even nursing assistants). If I don't know how to do that by now, well, there's a problem.

 

[Psai]

Oh yes, most of it is garbage. But's garbage that some executive or some idiot over in legal deemed 'mandatory' for all trainees to do, so they will have to do it.

For fellowship, I recently had to do a huge block of pre-employment mandatory modules *at home, on my own time* that took at least 20 hours to complete. These modules were laden with nonsense - as a nearly board-certified internist I had to sit through very elementary crap like 'how to identify MI symptoms in a floor patient' (it was clearly aimed towards nurses or even nursing assistants). If I don't know how to do that by now, well, there's a problem.

Oh my god, I had these stupid modules teaching me about strokes. I didn't spend 4 years getting this degree to have some smug, douchebag actor in a white lab coat lecture me about what a stroke patient looks like to an amateur. Let me know when you want me to teach you how to read a ct stroke study, punk

 

[marsh20]

This is 100% illegal. Whether it's worth complaining about, that's the $1 million question. A whistleblower lawsuit after you graduate and have a job?

No I am simply posting this so others know their lucky if their program pays them for orientation. Value whatever you get in residency.

 

[NERDY]

How has the program handled previous residents on visas, as they likely have similar issues every year with regards to start date?

 

[DrKabi]

How has the program handled previous residents on visas, as they likely have similar issues every year with regards to start date?

Pretty much the same. They say they one I will be coming in late after orientation week, but I am the only on coming in on an H1B visa this year in a residency with 30 intern so I guess it's not practical for them to change dates for one person. I am currently talking with the coordinators to see if I can catch up some of the mandatory aspects of the orientation at least. Will see what happens.

 

[Animalcules]

Pretty much the same. They say they one I will be coming in late after orientation week, but I am the only on coming in on an H1B visa this year in a residency with 30 intern so I guess it's not practical for them to change dates for one person. I am currently talking with the coordinators to see if I can catch up some of the mandatory aspects of the orientation at least. Will see what happens.

I think your program screwed up. For immigration purposes, first day of orientation should be your first day of work. You shouldn't suffer because your international office screwed this up. But sorry to hear this. I know it would create a lot of anxiety for pretty much everybody in your shoes. Best of luck!


Sent from my iPhone using SDN mobile app

 

[Raryn]

This is 100% illegal. Whether it's worth complaining about, that's the $1 million question. A whistleblower lawsuit after you graduate and have a job?

Just to follow this up, I burned the last of my residency vacation to be able to make it to my fellowship orientation (which was "optional" only in that there's no way I could start remotely close to on time if I didn't go it) which was spread out over the last 2 weeks of June. So I asked the GME office whether it was paid, and they said no. Later on, during the benefit orientation, I asked HR whether it was paid, and they explicitly said no, my start date is July 1. When I asked whether this may fall afoul of labor law (which when I investigated, it certainly does) they said I was welcome to bring it up with the dean.

At this point, there's no way in ---- I'm barging into the deans office and demanding my X hundred dollars for orientation, so I'm dropping it. But it certainly can happen in real life. And this was all within the last few weeks.

 

[dozitgetchahi]

They can't raise the issue anyway. These aren't McDonalds employees fighting for a raise because they have nothing to lose, these are medial trainees who 100% need their employers to sign off on their training so that they can move on with their lucrative careers. No one is stupid enough to rock the boat over two weeks pay. Or work hour violations. Or really anything that doesn't involve unwanted physical contact

Honestly the only reason they pay residents at all is that they're not really paying them: the government reimburses residencies for every dollar of a resident's paychecks. If they want to skip the only two weeks of pay that would actually come out of their pocket... well then that's what they're going to do.

Yep. And yet around SDN we repeatedly hear the bizarre nonsense that 'residents cost health systems money', which is the biggest load of poppycock I've heard since Bill Clinton told us he 'didn't have sexual relations with that woman'. They use us because we're dirt ****ing cheap compared to anyone else who could do our jobs.

 

[<L>]

i agree that its odd since i'm sure there are plenty of people that come in an H1B for residency, but think its unusual for orientation to be counted as part of employment...both my residency and fellowship started on july 1st for employment even though there was a week of orientation for residency that was in june...and for fellowship my benefit coverage didn't start until a month after being employed...think this varies among programs...

Visa issues for various reasons have happened a couple times at my hospital that I know of. You start late. It happens. Fellowship applications ended up a little screwed up for those people down the line, but nothing that couldn't be resolved.

 

[Lee Ik-jun MD]

I am an IMG who will be starting an IM residency on an H1B visa. Unfortunately there is a very strict rule which states you cannot come into the United States more than 10 days before the start of the job for which you have been given the H1B visa. In my case this means that I will miss all of the 10 days of intern orientation at my program . I am very worried about how badly this will affect me and having to play catch up for the rest of the year. Are there people who faced a late start or missed out on the orientation before the start of intern year? How did this adversely affect you and how did you deal with this. Any tips and advice will be very welcome.
PS: My program is aware of this but has made no mention of how they plan to help me catch up although I have raised this with the PD and PCs.

so are you here already?
good luck with internship!

 

[DrKabi]

so are you here already?
good luck with internship!

Yes I made it. Missed all of intern orientation but started with everyone on time July first , which I guess is more important. Sounds like I didn't miss much during orientation was able to catch up on most things this first week of internship year , so all good . Thanks to everyone for your kind and encouraging words of advice.

 

[Lee Ik-jun MD]

Yes I made it. Missed all of intern orientation but started with everyone on time July first , which I guess is more important. Sounds like I didn't miss much during orientation was able to catch up on most things this first week of internship year , so all good . Thanks to everyone for your kind and encouraging words of advice.

well that's good.
During my time, the orientation week ( before july 1st) is when the program makes you BLS,ACLS,NRP certified.
so are you doing those during after july 1st now?

 

[maxxor]

well that's good.
During my time, the orientation week ( before july 1st) is when the program makes you BLS,ACLS,NRP certified.
so are you doing those during after july 1st now?

This is program dependent. My internship required me to do my own BLS/ACLS certification on my own.

 

[DrKabi]

well that's good.
During my time, the orientation week ( before july 1st) is when the program makes you BLS,ACLS,NRP certified.
so are you doing those during after july 1st now?

I was already BLS /ACLS certified and don't need to re-certify until next year so was spared 🙂