Orientation about Visas ??

[NotAProgDirector]

1. If they won't allow an OPT visa, then you'll need another visa. They may sponsor a J instead. It's unlikely they would pass up an OPT and try to get you an H visa.
2. You definitely want to know what type of visas they sponsor. If they don't sponsor an H and you match there, you'll be stuck. Best option is to look at program websites, they likely have this info posted there.
3. I would recommend reading the rest of this thread. The H visa is covered in multiple posts.

Of note, ERAS season opened this week. You're talking about still sorting out where you're applying. You want to get your apps out ASAP. It's not too late yet.

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[SevenChen]

Thanks for your answering my questions.
1. I read this thread and some people mentioned that J1 visa is good for IMG but it is not so common used by Canadian citizen U.S medical graduate. Is that true?
2. As a Canadian citizen U.S graduate, if we don't use J1, the only option is H1B (or OPT to H1B). However, very few residency programs sponsor H1B. It seems I don't have much opportunities to get into residency programs. Could you please kindly give me some suggestions what I can do for Visa issue to improve my opportunities to get into residency. Many thanks for your helps!

 

[NotAProgDirector]

1. Canadians use J visas all the time. And the recent announcement that Health Canada is ending it's policy of limiting J visas simplifies the situation greatly. The "problem" with the J visa is that you would need to return to Canada for 2 years after training, or get a J waiver job.

2. If you match somewhere that doesn't offer H visas, then you get a J visa. If you want an H visa (which I completely understand), then you need to try to target / get interviews from programs that offer H visas. There's nothing else you can do.

 

[SevenChen]

aProgDirector, I know what I need to do now. Thank you so much for your helps!

 

[xkn123]

I'm a Chinese Citizen studying in a US medical school on F visa. I'm going to apply for US residency soon. I have several questions.
1. I've heard that recently residency programs are increasing unwilling to sponsor H visa and prefer to sponsor J visa. Are there still many programs willing to do so?
2. I'm thinking going to surgery, which is 5 year program. Suppose I finally fall into a J visa after my F/OPT period. There will be potentially problem with my J visa waive. If I didn't successfully waive J home country residence and forced to leave after my PGY-3 year. How bad the situation would be? Does it mean I'm leaving this program or I can still continue after 2 years?
Thank you very much in advance.

 

[NotAProgDirector]

I'm a Chinese Citizen studying in a US medical school on F visa. I'm going to apply for US residency soon. I have several questions.
1. I've heard that recently residency programs are increasing unwilling to sponsor H visa and prefer to sponsor J visa. Are there still many programs willing to do so?
2. I'm thinking going to surgery, which is 5 year program. Suppose I finally fall into a J visa after my F/OPT period. There will be potentially problem with my J visa waive. If I didn't successfully waive J home country residence and forced to leave after my PGY-3 year. How bad the situation would be? Does it mean I'm leaving this program or I can still continue after 2 years?
Thank you very much in advance.

1. This is something that changes frequently. The H visa program has been under some scrutiny due to the current administration's "America First" policy. However, I don't think they really cared about medical residents, most of their interest was in the IT world. The sudden canceling of "premium processing" also created havoc. All that said, the H visa program is back to "normal". Plenty of programs are still offering H visas. It's a moving target.

2. No idea what you're talking about. J visa is good for up to 7 years. If you're a GS resident on a J visa, you'll be able to complete all 5 years of training on the J visa (or 1 on OPT and 4 on J). No one forces you to leave after the PGY-3. When you complete all training, you then have to leave for 2 years and return to China, or get a J waiver position.

 

[Gunner128]

Hello aProgDirector,

I am a medical student from India with a dream of settling in the US. I have a question.

After clearing the steps, assume that I get a residency in the US with a J1 visa.

After completing my residency, I’ll have to go back to India for a period of 2 years to fulfill my 2 yr home residency requirement. India has recently stopped issuing the no- objection certificate so there is no realistic chance of getting a J1 waiver for me.

What should my plan of action be after those 2 years in India? Should I start looking for jobs in US hospitals who sponsor a H1b visa after those 2 years? Would I realistically stand a chance of securing a job in a hospital
in the US after my 2 yrs of home residency requirement?

I know, its a silly question but, a reply would be appreciated!

And by the way, I love your detailed replies! I’m a big fan from India.

 

[NotAProgDirector]

This is hard to answer. You certainly will need a visa when you return, and H1b would be the most likely although an O visa is also possible, and there could be others.

I do worry that employers will worry about your 2 year gap. and you can't start the visa process for 2 years, getting a visa often takes months more than that.

Also, I think if you get a job at a VA, they can sponsor your J waiver without a no-objection letter. Not certain about this.

 

[Gunner128]

This is hard to answer. You certainly will need a visa when you return, and H1b would be the most likely although an O visa is also possible, and there could be others.

I do worry that employers will worry about your 2 year gap. and you can't start the visa process for 2 years, getting a visa often takes months more than that.

Also, I think if you get a job at a VA, they can sponsor your J waiver without a no-objection letter. Not certain about this.

Thank you so much for the reply aProgDirector!
I guess, there is still the option of serving in an underserved area for 3 years, but as far as I know, these positions are limited to 30 per state.

 

[NotAProgDirector]

There is nothing about the program you have applied to, or the country that you have come from, that impacts your ability to get a J1 waiver. Each state gets 50 waivers a year, so a popular state like FL probably has many more people interested in a J1 waiver than spots available, so your chances of getting a J waiver in FL are probably low. But you won't be limited to FL -- you can look at any state, and VA's are (generally) immune to these limits so that might be a possibility. If prior graduates of the program have had troubles getting J waivers, that (perhaps) says something about the program itself, but perhaps says more about those folks who didn't do what it took to get a position. Your programs can't stop you from getting a J waiver, to my knowledge.

 

[JAH2022]

@aProgDirector ,thank you so much for replying. Much appreciated!

 

[Gray_ish]

Thank you @aProgDirector and many others for the useful info provided in this thread. Unfortunately, I have searched the entire thread but couldn't find information specific to my situation. I seek your kind advice on the following!

Background:
I'm currently a non-US IMG in Asia who will be doing a post-doc research fellowship in 2020. The fellowship is at a large academic institution on the east coast, and they have kindly offered to sponsor a J-1 Visa for me. I hope to do ~2 years of research to get strong letters that will help me match into a residency program in the US.

I have several questions:

1. I understand that within the J-1 visa, there are several different categories. Will this research fellowship be considered under the J-1 'Research Scholar' category (i.e. maximum length of 5 years) or J-1 'Physician' category?
2. Assuming this is a J-1 'Research Scholar' visa, will I still be subject to the two-year foreign residency requirements whereby I will have to leave the US after the visa is due (similar requirement as the J-1 Physician visa sponsored by the ECFMG)?
3. While on the J-1 'Research Scholar' visa during my research fellowship, will I be able to switch to an employment-based immigration visa such as the EB-1? I understand that applying for an immigrant visa is not permitted while on the J-1 Physician visa.
4. Assuming I am able to obtain and switch to the EB-1 visa before applying for the match while still in the research fellowship, will having an EB-1 visa boost my chances at 1) getting more interviews and 2) securing a spot at a competitive institution that may not traditionally accept IMGs?

I understand that these are very technical questions that are difficult to answer. Your help is greatly appreciated!

 

[NotAProgDirector]

Free advice is worth exactly what you paid for it. But, given that:

1. Yes. The physician category is only for GME training. This is up to the place that is hiring you and they should be able to answer it for you.

2. This is very complicated to answer. First, it depends upon what country you are coming from. You start here to see if your home country is on this list: Skill List by Country

If it's not on that list, you move on to the funding question below. If it is, then you need to look up the types of research that trigger the 2 year rule, and that's here: 2009 Revised Exchange Visitor Skills List

Medical research is type 51.12. There is also a group 26 for Biological research. If your country is listed here and Group 51 is included, then you will have a 2 year HRR. If not, then...

The last question is whether your research is funded by your home gov't, or the US gov't. If your home gov't is paying for anything, then your get a 2 year HRR. If you're being funded by a specific US funding program for international exchange students, then you get a 2 year HRR. If your PI gets funding from the US gov't via an R01 or similar grant, then you PROBABLY do not get a 2 year HRR. But here's the fun part: it's completely up to the State Dept when they review your visa app. You won't know until you actually get it -- and once you get it, you can't give it back.

3. Theoretically yes if you don't have a 2 year HRR. EB-1's are not easy to come by. If you have enough scholarly activity to qualify, you could probably just get one now. It's unlikely you'd generate the publications in 1 - 1.5 years needed to qualify for an EB-1, although anything is possible. But you'd need to qualify, apply, and get it in time for the match, or be happy with a clinical J. Timing wise, this is going to be very difficult. Applications (where you'll declare your visa plans) are due on Sept 15th, so you'd have to have a completed EB-1 by then. From my very limited experience, the application process is at least 6 months, so you'd need to qualify and apply by March of the first year of your fellowship -- since you'll have started in July, you'd only have 9 months to get enough done to qualify.

4. Places that don't take IMG's won't care if you were a US citizen and didn't need a visa at all -- they won't take you. It's possible that having an EB-1 with an EAD would put you in the same bin as US-IMG's, as you wouldn't need a visa. It's also possible that programs would be unfamiliar with the EB-1 program and not consider you at all.

 

[Gray_ish]

Free advice is worth exactly what you paid for it. But, given that:

1. Yes. The physician category is only for GME training. This is up to the place that is hiring you and they should be able to answer it for you.

2. This is very complicated to answer. First, it depends upon what country you are coming from. You start here to see if your home country is on this list: Skill List by Country

If it's not on that list, you move on to the funding question below. If it is, then you need to look up the types of research that trigger the 2 year rule, and that's here: 2009 Revised Exchange Visitor Skills List

Medical research is type 51.12. There is also a group 26 for Biological research. If your country is listed here and Group 51 is included, then you will have a 2 year HRR. If not, then...

The last question is whether your research is funded by your home gov't, or the US gov't. If your home gov't is paying for anything, then your get a 2 year HRR. If you're being funded by a specific US funding program for international exchange students, then you get a 2 year HRR. If your PI gets funding from the US gov't via an R01 or similar grant, then you PROBABLY do not get a 2 year HRR. But here's the fun part: it's completely up to the State Dept when they review your visa app. You won't know until you actually get it -- and once you get it, you can't give it back.

3. Theoretically yes if you don't have a 2 year HRR. EB-1's are not easy to come by. If you have enough scholarly activity to qualify, you could probably just get one now. It's unlikely you'd generate the publications in 1 - 1.5 years needed to qualify for an EB-1, although anything is possible. But you'd need to qualify, apply, and get it in time for the match, or be happy with a clinical J. Timing wise, this is going to be very difficult. Applications (where you'll declare your visa plans) are due on Sept 15th, so you'd have to have a completed EB-1 by then. From my very limited experience, the application process is at least 6 months, so you'd need to qualify and apply by March of the first year of your fellowship -- since you'll have started in July, you'd only have 9 months to get enough done to qualify.

4. Places that don't take IMG's won't care if you were a US citizen and didn't need a visa at all -- they won't take you. It's possible that having an EB-1 with an EAD would put you in the same bin as US-IMG's, as you wouldn't need a visa. It's also possible that programs would be unfamiliar with the EB-1 program and not consider you at all.

Hi @aProgDirector , thank you for the thought put into that detailed reply!

My country is not on the 2009 Revised Exchange Visitor Skills List, which is good. I'm hoping that my academic stats are enough to obtain a EB-1 (currently, I have >25 pubs, >250 citations, >60 peer reviews, 1 editorial board membership, MRCS).

The way I see it is I have 2 options:

1. Take the J-1 Research Scholar, hope there's no 2-year HRR (i.e. institution didn't get government funding AND/OR the State Dept is feeling kind that day), then apply for EB-1 in my 2nd year of the fellowship
--> How difficult is it to switch from a non-immigrant J1 to an immigrant EB-1? I'm aware that I'll definitely require the help of a lawyer to explain the change of intent

2. Apply for EB-1 with premium processing, hope I get it based on my stats, then leave for the fellowship.
--> If I fail to get the EB-1, will this jeopardize my chances of getting a J1 subsequently?

Thank you for the tremendous help so far!

 

[NotAProgDirector]

Plan 2 seems the most reasonable. The fellowship won't make you any more competitive for an EB-1. This assumes that the place will take you on an EB-1, which is anyone's guess.

 

[Gray_ish]

Thanks for all the advice @aProgDirector. It was extremely helpful!

 

[xkn123]

Dear aPD,
I'm about to be matched this year as US senior, on F-1 visa now. Going to radiology (mostly advanced programs), and internal medicine prelim year. I'm thinking about apply for OPT before the match day so I can get it in time before my residency. So here's my question:
1. Does most programs start at 7/1? I heard different info from different programs, while my advisor says all of them officially start on 7/1. Should I apply OPT in advance before the match day considering the slow processing of USCIS? If yes, what should be a good start of OPT time?
2. Suppose I start my OPT before 7/1, there might be a few days gap between the end of my OPT and the end of intern year. How is that usually solved if H1b cap gap is not available e.g. I fall into J1?
3. Would H1b cap gap be a problem if my PGY-1 and PGY-2 employers are different?
Thank you.

 

[NotAProgDirector]

Dear aPD,
I'm about to be matched this year as US senior, on F-1 visa now. Going to radiology (mostly advanced programs), and internal medicine prelim year. I'm thinking about apply for OPT before the match day so I can get it in time before my residency. So here's my question:
1. Does most programs start at 7/1? I heard different info from different programs, while my advisor says all of them officially start on 7/1. Should I apply OPT in advance before the match day considering the slow processing of USCIS? If yes, what should be a good start of OPT time?
2. Suppose I start my OPT before 7/1, there might be a few days gap between the end of my OPT and the end of intern year. How is that usually solved if H1b cap gap is not available e.g. I fall into J1?
3. Would H1b cap gap be a problem if my PGY-1 and PGY-2 employers are different?
Thank you.

Missed this post somehow.

1. Programs start at various times. Most start in June sometime with orientation. There usually is enough time between match day and beginning of internship to get an OPT. That said, last year at least one of our interns needed an OPT and it was delayed.

2. Usually, if you're getting an H1b your employer will apply during your OPT. Most residency programs are exempt from the cap, so getting an H1b isn't a huge problem although it is expensive for employers. So usually you'll have an H1b long before your OPT expires. You can't "fall into" a J visa, you would need to apply for it, it's a slow process also, and once you have a J you can't get an H anymore.

3. This is actually a HUGE problem. If you match into two different programs, your prelim will NOT likely apply for an H visa for you -- they are expensive and complicated, and you'd be on an OPT. Your PGY-2 employer may apply for an H visa while you're in your PGY-1, but H visas are employer specific. I believe (but could be completely wrong) that once you have an H, your OPT visa is over. And you will likely run into the problem that your OPT expires before your internship ends because of the June start. So, you def need a visa lawyer to help you navigate this situation.

 

[Ohellothere]

Thanks @NotAProgDirector and everybody else for posting comprehensive and insightful responses! They have significantly deepened my understanding of the US visa types.

My post relates to E-3 Visa. For those reading this thread, the E-3 visa is a non-immigrant, Australian nationals only visa, similar to TN visa for Canadians, except there is no clause barring physicians from clinical contact with patients. The visa is applied for by the applicant at a US embassy, renewed every 2 years (indefinitely). The processing time is usually a few weeks and can be done at any time of the year. The sponsoring program only files one piece of electronic paperwork - a LCA with the Department of Labor. E-3 visa costs nothing to the program sponsoring it and they do not need to go through PERM certification.

I'm applying for Match 2022, but a few of my Australian friends are applying for the Match this year, and they told me there was no option for ticking E-3 on ERAS (only J1 and H1b). In addition, while at least some programs seem to be aware of the existence of E-3, just about every program director on interview trails did not know what an E-3 visa is. Understandably so, seeing it is only available to Australian citizens, who I presume make up a very small minority of the IMG match.

I think this visa is quite advantageous, given the rarity of H1bs and the precarious situation J1 is in. In addition, I know of Australians commencing GME in the US under this visa, so it's been tried and done before. I humbly think the attractiveness of E-3 to programs that know about it is somewhere between a J1 and a GC/EAD, with H1b being least attractive.

However, to use E-3 visa, I conclude I must advertise it to PD's, either on ERAS on interviews.

1. I could potentially flex E-3 advantages on ERAS, but I'm worried this is out of sync with the rest of the application. It clearly does not fit into a personal statement, and it'd be breaking MSPE guidelines to be placed there. Do I even bother informing PDs about it on ERAS? I assume most are under time constraints and would detest seeing a huge paragraph relating to visas while scouring for applicants to interview
2. Instead of talking about it on ERAS, I could bring it up during interviews. However, I'm worried this unfamiliarity scares PDs away. In addition, how will they even tie me to E-3 when it comes to rank day? Perhaps a follow up email in Jan/Feb (but maybe that'd be a bit presumptive/annoying).
3. Sooo .. how do I convince a program to sponsor an E-3 ?!

 

[NotAProgDirector]

There's no simple answer to your question. An E3 visa definitely looks like it would work, but whether programs will be willing to consider it is their choice. It does require the hospital to submit an LCA -- so that will probably require some work from a lawyer (although I really don't know what this entails). You could request that ERAS update their visa questions (unlikely to be successful). Otherwise, I think your best choice is to just add a paragraph about this to your personal statement.

 

[Pier]

I think I read almost anything pertinent to visa problems on the forum, including this whole topic.
Firtsly, I want to express my gratitude to NotAProgDirector, crucially important for all of us international students/graduates.
And now, into the fray.

Q.1 My understanding is that the situation is like this:
J1 (6+1 yr) ->
J1-waiver (3 yr) ->
H1B (3+3 yr + "recapture" of time out of the US) -> PERM labor certification -> I-140 -> I-485 -> GC=PR

For the sake of completeness for posterity (including the future me coming back here) I add a quote of the best message I found (by Raryn) explaining what happens after the 3yr of J1 waiver:

[...] First you must obtain the J1 waiver.

Then either your employer needs to file for a PERM labor certification OR *you* need to file for an EB-2 green card with a National Interest Waiver. The latter is basically the only path of *you* applying for a green card rather than an employer doing it on your behalf - but getting the it is damn near impossible unless you promise to do >5 additional years working in an underserved location (or for a VA).

The more normal PERM labor certification option can only be done once you've completed the waiver process. It can take 6+ months - so most commonly you switch to a different sort of visa to keep working while that process goes on.

(Source)

My problem, though, is that even from the H1B a non-US IMG will need to get through the PERM labor certification, in any case. Which means passing through this:

The DOL must certify to the USCIS that there are not sufficient U.S. workers able, willing, qualified and available to accept the job opportunity in the area of intended employment and that employment of the foreign worker will not adversely affect the wages and working conditions of similarly employed U.S. workers.

(Source: dol.gov)

BUT, I suppose I must be wrong, otherwise non-US would never get GC=PR unless they work for the whole time after residency (and/or fellowship) in an underserved area/VA (so even more time beyond the end of the J1 waiver). This suspicion (of me being wrong) is strengthened by messages like this one by NotAProgDirector:

I think we are talking about different things here. If you train on an H visa, and then after completing training get hired in a permanent job on an H visa, your employer can sponsor you for a GC. This is the easiest way to get a GC, since it basically always works. But, you can't do it while you're a resident (at least I haven't heard of residency programs doing this), you wait until you get your first job. The "EB" pathway is when you try to get a GC for yourself -- a much more difficult path.

(Source)

How can it be easy if it has to go through the PERM LC? Am I overestimating this PERM LC complexity, maybe because employers (such as hospitals) don't really have to go through it for reasons of which I'm unaware of?

Can someone clarify?

__________________________________________________________________________

Q.2 To get an H1B you need:

1. ECFMG certification (which is gained after USMLE Steps 1&2)
2. USMLE Step 3
3. Training Licence

To my understaning, Step3 and Training Licence are given only after your residency match. This would mean that the program itself is "providing" these requisites for the H1B .
But this would be against many messages I read in which is always repeated that you should get Step 3 BEFORE applying for any residency program, to be more competitive.

What am I missing?

 

[Ohellothere]

Just an extra question: how important is having a home medical license for visa purposes? I know a lot of countries grant a medical license straight out of medical school, but Australia only hands it out after PGY1.

 

[NotAProgDirector]

Getting the PERM certification is not complicated. I have no experience in that area, but it's never been a problem. There are plenty of physician jobs (i.e. minimal unemployed trained physicians), so you won't be displacing anyone. The DOL looks at the picture at a distance -- it's not whether the position you're applying to has a US Citizen who might be interested, but whether that US Citizen can get any physician job at all.

Step 3 can be taken long before you start residency. You just need to have passed the earlier steps, and graduated from medical school. If you want an H visa for internship, then you must have taken S3 (would recommend prior to applying, but getting a score in app season would probably be OK). If a non-US citizen is in a US medical school on an F visa, then they complete their interhship on OPT and apply for H status in their PGY-1 (Step 3 might not be required).

The program will apply for the training license (which is very fast) and the H together.

Having a medical license in your home country is not needed for J or H visas, will make no difference. Might be needed for some of the EB pathways.

 

[Pier]

Well, that's definitely reassuring (about the PERM certification hurdle).

Step 3 can be taken long before you start residency. You just need to have passed the earlier steps, and graduated from medical school. If you want an H visa for internship, then you must have taken S3 (would recommend prior to applying, but getting a score in app season would probably be OK).

This means that, as an IMG, there is no way to match for a H1B-residency straight after graduation, because they cannot apply for the matching season during their last year of med school (while AMG can).
On the other hand, they could apply to the matching season during their last year if they accept a J1 (since they don't need Step3, which would require graduation).

In other words: H1B needs at least a gap year between YOG and the beginning of residency, while J1 could go without this gap year.
(Applying for a J1 would have other logistical difficulties like "how do I attend to the IVs in the matching season Oct-Jan while still managing to attend my last year of med school? Ehh").

Do I understand it correctly?

 

[NotAProgDirector]

Mostly. Although some foreign medical schools graduate in December. Then it might be possible to take S3 and still start on an H in July. But the timeline would be tight.

I expect that most IMG's coming on an H visa have a year gap. Often there's a gap because of the interview issue as you mentioned, although that's also easier if the grad date is in Dec.

 

[MaiJ]

Dear NotAprogramDirector, thank you so much for being active on this thread.

Going through this thread has given me a lot of insight.

I do have a few questions regarding US visas for IMGs (I am a non-US IMG). I would be extremely thankful if you can provide any insight. I plan to apply for radiology residency.

• Are there any visa options besides the J1 scholar to do research in the states? (My country is on the skill list which obliges me to go back after being done with the research or shift my J1 scholar status to J1 alien physician. - P.S. Getting a no objection letter from my home country is difficult-)

• If H1B is an option for a research post:
• How hard is it to obtain a post-doc research fellow on H1B?
• If the department hiring research fellows states that they would be providing J1 scholar visas for their fellows, would there be any possibility to grant an H1B in such a post instead (I.e. Are these hard set rules?) Please note that the residency program I intend to apply to provide IMG residents H1B visas.
• In case I was granted an H1B visa for research, and I spent 2-3 years doing research. How would that impact my residency considering that radiology residency is 5 years and the time limit is 6 years?
• AFAIK while on H1B I will be able to apply for EB1-A but will I be able to apply for an EB2 GC using this H1B (my country does not have a backlog)? Would a post doc research position be considered an employment position in which I would apply through the PERM certification route or will I be applying as a standard national interest waiver applicant?
• If I file for EB1-A during my H1B research position and failed to get it approved, and failed to match into H1B residency will this block my way of getting a J1 residency because of my previous immigrant intent?

• IF I start residency on H1B:
• It is my understanding that residency programs don’t sponsor Green Cards since they are training posts, is it also true that fellowship program don’t sponsor Green Cards?
• When shall I apply for a Green Card, is it by finding a general radiology job post the 5 years of residency? (I know that internists do 2 years of hospitalist jobs to get their Green Cards, will I be running into a similar situation). Would I be able to find a general radiology job for 2 years?

• Some of radiology fellowship are 1 year and some are 2, if I plan to go for:
• A one-year radiology fellowship.
• A 2-year radiology fellowship.

How should I go about approaching these 2 scenarios? (Time line wise with the final intent of obtaining a GC).

• If I entered the residency on J1 alien physician, I think I would be reluctant to obtain Green Card through waiver. At the same time, I wouldn’t want go back to my home country to meet the 2-year rule without knowing I would return to the US with a Green Card. Would I be able to file for EB1-A during residency/fellowship or would I have to wait till the 2-year home requirement is met before I can file such a petition. In other words, if I don’t marry a US citizen, is there any way I can guarantee obtaining a Green Card through EB1-A before returning to my home country. Again, would filing for an EB1-A during residency violate the non-immigrant intent of J1 alien physician? If so, when is the earliest that I can apply for EB1-A (1-140 approval) while I am on/ending J without it affecting my residency/fellowship?

• Since radiology is an advanced specialty requiring a prelim/transitional year, is it hard to find such a year supporting H1B?

• Is there any possibility of publishing research while being on B1/B2 or is it illegal?

• Do most physicians applying for EB1 that go through 2-3 years of research, residency and then fellowship (with the intent of obtaining the GC BEFORE the end of fellowship) apply to EB1-A extraordinary ability? Or can some of them do it through EB1-B outstanding researcher?

• If I want to avoid the J1 scholar due to the 2-year home requirement issue, and due to my assumptions, that getting an H1B for research is difficult, would I be able to do research while I am on F1 visa for MPH? Does MPH provide an OPT, and if so, will I be able to do research while on OPT?

Best of luck in all of your future endeavours.
Many thanks in advance.

 

[NotAProgDirector]

Most of your questions are far beyond my knowledge / abilities. You would need to consult a visa lawyer to answer many of these convoluted legal scenarios.

Although it does appear possible to be a post doc on an H1b visa, it also appears to be very rare. It's much more expensive and legally complicated for the employer, and they cannot pass the costs to the employee. Just getting a post doc spot on a visa is a challenge, as many NIH grants can only be used to fund post docs who are citizens / PR's. Whether there are other complex visa options for post docs, I have no idea -- but the more complicated you make the situation, the less likely anyone will take you.

If you actually get an H1b for research, you will start the H clock. You would be unlikely to be able to continue in residency on an H, it will expire.

I know nothing about the EB visa system. I doubt that a post doc would qualify as a permanent position, since it's expressly temporary. But that's a question for lawyers.

You can always switch from an H to a J visa. By switching to a J, you lose any ability to have dual intent except via the waiver process.

Fellowships don't sponsor green cards. They often take many years to finalize. (Nothing would stop a fellowship from doing so, but it's very unlikely).

When you're done with your training, you would find a job in the US. if on a J visa, you'll need a waiver of some sort -- and if so you would need to work for 3 years at a full time level, complete the waiver, and then you could start the process of a GC. If you're on an H visa, you could start the GC process immediately. But in all cases the GC is sponsored by your employer -- they can require any amount of time before starting the process.

If you want to do a fellowship, you would usually do it right after the residency by extending your visa, and not start with the waiver / GC process until you have a job. It would be possible to get a job after the residency, it will take years to settle out your GC, and you're just unlikely to go back to fellowship after that.

Yes, it's hard to find a prelim program that is willing to sponsor an H. They are very complicated and expensive, and the likelihood of a program offering it for a 1 year position is low. Your best chance is matching at the same institution -- then they will have you for 6 years. But perhaps there are programs that do offer them for 1 year prelims.

It's illegal to do any significant research on a B visa, even if you are unpaid. It is very illegal to be paid while on a B visa.

Again, I know nothing about EB visas. Even if this is a legal pathway of some sort, there's no guarantee that any institution will accept you on that type of visa.

If you're enrolled in a US MPH program on an F visa, then yes you can do research on an F. And any F visa can lead to an OPT extension, and that's a full working visa. So it would be possible to get into a US MPH program, be on an F visa for a year, then an OPT for up to 3 years. But, you'd need to find a way to pay for the MPH (probably $50-60K and you're unlikely to qualify for any grants or loans, they are likely to ask for all of the money up front in escrow). During the OPT you'd still be limited by the lack of ability to be paid off of most NIH grants. You can't use the OPT for an internship/residency.

Every pathway you're considering will take years. The farther you are from your medical school graduation, the less likely you are to get a residency at all. In general, those more than 5 years out from graduation find it very challenging.

 

[MaiJ]

Dear NotAProgramDirector,

Thank you for taking the time to write this very thorough response.

I just have 2 questions regarding the OPT.
1- Is there any specific reason that I will be limited by the lack of remuneration from most NIH grants had I been on OPT ? Must I be on J1 scholar for such remuneration to occur ?
2-If My MS degree can relate to the internship year one way or another (e.g. an MS in clinical research which is too generic) , will I still not be able to use a year of OPT for internship?

Kindest Regards.

 

[NotAProgDirector]

1. I am not an expert on research funding, so I don't know. All I know is that some NIH grants are limited to US citizens / PR's. Whether OPT vs J1 scholar would count, I don't know.

2. No. Your MS degree does not relate to a clinical internship in any way. What you do with your OPT needs to directly follow from the F visa degree. Since an MS in anything doesn't prepare you for a clinical spot, you won't be able to do this.

 

[xkn123]

Hello aPD. Thank you for your help with my previous questions. I have a few more this time.
Now I'm in a residency on a H1b visa (I'm amg though). I'm thinking of switching (or swap) residency to another location for family reasons. I wonder how big of a role my visa status would take into the consideration due to the fact that H1b is so expensive? Standing from PD's shoes, would it prohibit me from switching anywhere because it cost so much money and paperwork for the visa processing?

 

[Meerkat_Initiate]

Hello @NotAProgDirector and everyone else on this thread! First of all I'd like to thank you for all of your help. This thread has been very informative. I'm a non-US IMG doing my MBBS (1st year) in India (visa required). I'd appreciate it greatly if you could answer my questions.

1. My medical school curriculum ends around February. Is it possible to take step 3 soon after this and submit my result before the match so that I can qualify for H1b without a gap year?​

​

2. From what I understand EB-1 green card and marriage based green card are not employer sponsored. Assuming I'm on an H1b for residency can I apply for these green cards during residency? (I know you have mentioned that you don't have much experience regarding EB but any input will be appreciated.)​

​

3. If I have sufficient research as a medical student, can I attain an EB-1 GC even before joining residency?​

​

4. Let's say I do residency on a J1 in New York. Can I take a waiver job in some other state or do I have to do it New York only? If I have to do it only in New York are waiver jobs easily attainable?​

​

5. If I match into a competitive specialty like Ophthalmology on a J1, can I get a waiver jobs? Are these even available?​

​

6. Is statement of need required for a J1 waiver. I've heard conflicting reports about this. India has stopped issuing no objection certificate. USCIS website says this - “Obtain a “no objection” statement in writing from their home country if they are contractually obligated to return to their home country upon completion of the exchange program.” Am I contractually obligated?​

​

7. I'm interested in Radiology. Are J1 waiver jobs available in this specialty? Since many radiology programs are advanced, will this prevent me from getting an H1b? Will prelim programs sponsor an H1b? Note: I'm extremely flexible when it comes to location.​

​

8. Earlier in this thread around 2011 you had said the following - "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." Since most H1b visas for doctors are cap exempt, does this mean that I cannot take a private practice job immediately after residency?​

​

9. Earlier in this thread someone had mentioned that Canada has prelim years. If this is true can I match into a Canadian prelim and write step 3 during that time and prevent a gap year? Also, when does the visa application process begin?​

​

10. Can my home country stop me in any way while obtaining J1/H1b? To what extent is my home country involved?​

​

11. Can non-US IMGs use OPT for intern year? I know this is not usually possible. Is there any way around this?​

​

Thank you for the taking the time to read through this.

 

[NotAProgDirector]

Hello aPD. Thank you for your help with my previous questions. I have a few more this time.
Now I'm in a residency on a H1b visa (I'm amg though). I'm thinking of switching (or swap) residency to another location for family reasons. I wonder how big of a role my visa status would take into the consideration due to the fact that H1b is so expensive? Standing from PD's shoes, would it prohibit me from switching anywhere because it cost so much money and paperwork for the visa processing?

It's likely to be an issue. It's much easier to get a second H visa once you have your first, but you will need an entirely new H visa, all of the paperwork starting from the beginning. Many programs won't sponsor an H at all. Programs that are willing to sponsor an H might be willing to do this. Just trying to get a new spot isn't the easiest, and this will make it more complicated. Best of luck!

 

[NotAProgDirector]

1. My medical school curriculum ends around February. Is it possible to take step 3 soon after this and submit my result before the match so that I can qualify for H1b without a gap year?

​

Not realistically. You'd need to graduate, get your diploma, submit it to ECFMG, get ECFMG certified, then sign up for S3 (which you can't do until you're ceritifed), then take the exam, and then pass the exam -- all in time for the match. Places that consider H visas are unlikely to consider you because the timeline won't work.

2. From what I understand EB-1 green card and marriage based green card are not employer sponsored. Assuming I'm on an H1b for residency can I apply for these green cards during residency? (I know you have mentioned that you don't have much experience regarding EB but any input will be appreciated.)​

​

Yes, an H visa lets you apply for any GC you'd like.

3. If I have sufficient research as a medical student, can I attain an EB-1 GC even before joining residency?​

​

Not likely, but I'd don't have much experience with EB visas. Many programs may be unwilling to sponsor you for an EB-1. I expect most will be unwilling.

4. Let's say I do residency on a J1 in New York. Can I take a waiver job in some other state or do I have to do it New York only? If I have to do it only in New York are waiver jobs easily attainable?​

​

You can do your J waiver in any state, or at any VA hospital.

5. If I match into a competitive specialty like Ophthalmology on a J1, can I get a waiver jobs? Are these even available?​

Waiver jobs in competitive fields depend upon the job market. If you're willing to work somewhere unpopular, it's quite possible. But chances of getting these competitive positions are very low.

​

6. Is statement of need required for a J1 waiver. I've heard conflicting reports about this. India has stopped issuing no objection certificate. USCIS website says this - “Obtain a “no objection” statement in writing from their home country if they are contractually obligated to return to their home country upon completion of the exchange program.” Am I contractually obligated?​

​

You will need a letter from your home country stating that they need the type of physician you are training to be, and that they will accept you back after training. This isn't a contract -- you can still do a waiver. Some countries do have a contract to return -- if that's the case then you'd need to abide by the contract.

7. I'm interested in Radiology. Are J1 waiver jobs available in this specialty? Since many radiology programs are advanced, will this prevent me from getting an H1b? Will prelim programs sponsor an H1b? Note: I'm extremely flexible when it comes to location.​

​

I don't know anything about the rads job market. J waivers can be completed at any VA hospital (with no cap) so if you're willing to work at a VA and you're flexile, it's likely you can find a spot. There may be other J waiver options. Getting an H for just a prelim year is difficult -- your best chance would be matching prelim and rads at the same place.

8. Earlier in this thread around 2011 you had said the following - "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." Since most H1b visas for doctors are cap exempt, does this mean that I cannot take a private practice job immediately after residency?​

​

Yes, you cannot take a private practice job on an H if that H was cap exempt.

9. Earlier in this thread someone had mentioned that Canada has prelim years. If this is true can I match into a Canadian prelim and write step 3 during that time and prevent a gap year? Also, when does the visa application process begin?​

​

Canada is not a viable option for most IMG's. There are all sorts of rules about matching there. Unless you're a canadian citizen, it's unlikely.

You can't apply for a visa until you match -- you must have a position before you qualify to apply. You usually apply almost immediately after the match to avoid delays (but sometimes you must wait for your diploma).

10. Can my home country stop me in any way while obtaining J1/H1b? To what extent is my home country involved?​

​

Your home country needs to give you the letter of need for the J visa. Your country has no input into an H visa. This assumes you're not "wanted" in your home country -- in that case you've got all sorts of problems.

11. Can non-US IMGs use OPT for intern year? I know this is not usually possible. Is there any way around this?​

​

No. OPT is an extension of an F student visa. You don't have an F student visa, since you're not a student in the US. Hence, you can't get an OPT.

 

[Meerkat_Initiate]

@NotAProgDirector Thank you so much for the informative responses throughout the years. This whole thread has been a goldmine. I have one more question. Assuming I'm on a J-1 research scholar visa, can I shift to an H1B for residency once my research fellowship is over? (My country does not have an HRR for J1 research visa)

 

[NotAProgDirector]

If your J visa does not have an HRR attached, you should be able to shift to any other visa type.