Rank List Help (visa vs training)

[chospal]

Hi all,

I am a non-US, visa-requiring IMG applying this cycle with 9 interviews.

Here are the programs:

3 community hospitals that sponsor H1B visa:
Maimonides
St. Elizabeth (D.C.)
Case Western/Metrohealth

4 university hospitals that are J1 only:
SUNY downstate
Penn State
UT Houston
another mid-tier university program similar to the University of Arkansas (I wanted to remain anonymous for this one)

2 community hospitals that are J1 only which I planned to rank last.

Basically, I have difficulties deciding between H1 community programs and J1 university programs. J1 comes with a 2-year obligation to go back to home country or do waiver jobs in underserved areas. However, the quality of training for me is very important. I am not big on research, but university programs seem to have more well-rounded training and opportunities to do projects. Also, I don't know how I should rank Maimonides, St. Elizabeth (DC), and Case Western/Metrohealth. They all seem to be good community programs. Location is not a big factor for me.

Any advice is welcomed. Thank you so much!

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[psychacad]

It's a tough one. J1 is a real pain in the butt. You will need to return to your home country or go through a cumbersome process to get a J1 waiver. There are plenty of J1 waiver positions, including at top university ranked hospitals, but the process will be arduous and many of them seek to exploit IMG grads. You will also be 3 years behind schedule to convert for a green card as I think you can't/extremely rare to go J1-->green card.

H1B will make your life so much easier and are much rarer these days. Personally if I have to pick among these programs, I would prioritize H1B. Maimonides has very good training and it's in a big metro city. The one program with potentially significantly better reputation is UT Houston but I don't think J1 is worth it for that. As I said in the other thread, program name isn't the best arbiter of success.

 

[Merovinge]

It would depend to me a lot on where your country of origin is. If you are able to complete the J1 waiver in 3 years and expect a green card within a year after, that's a tenable position that would not overwhelm me. If you are from India or China and have a 15+ year wait, I would plan on marrying an American (only sort of kidding), and every extra year would be really painful. There are probably some countries in-between that will be shades of grey that would likely push me towards H1B.

 

[psychacad]

It would depend to me a lot on where your country of origin is. If you are able to complete the J1 waiver in 3 years and expect a green card within a year after, that's a tenable position that would not overwhelm me. If you are from India or Pakistan and have a 15+ year wait, I would plan on marrying an American (only sort of kidding), and every extra year would be really painful. There are probably some countries in-between that will be shades of grey that would likely push me towards H1B.

Frankly if they have to wait for 15+ years to get the green card finalized then 3 years won't make much of a difference. Even though nationals from India/China (don't think Pakistan are in that category) don't get an actual green card, they get a work permit and a travel document during the wait which pretty much functions like a green card, except they have to be renewed yearly.

Another point against J1: you have to go every year to your home country to renew it. Unless it's a top notch university program, to me it's a no-brainer.

 

[chospal]

It would depend to me a lot on where your country of origin is. If you are able to complete the J1 waiver in 3 years and expect a green card within a year after, that's a tenable position that would not overwhelm me. If you are from India or Pakistan and have a 15+ year wait, I would plan on marrying an American (only sort of kidding), and every extra year would be really painful. There are probably some countries in-between that will be shades of grey that would likely push me towards H1B.

Frankly if they have to wait for 15+ years to get the green card finalized then 3 years won't make much of a difference. Even though nationals from India/China (don't think Pakistan are in that category) don't get an actual green card, they get a work permit and a travel document during the wait which pretty much functions like a green card, except they have to be renewed yearly.

Another point against J1: you have to go every year to your home country to renew it. Unless it's a top notch university program, to me it's a no-brainer.

Thank you so much. I barely know any IMG psychiatrists to ask about the visa issue, so this information is really helpful.

Any thoughts on Metrohealth and St Elizabeth (DC)?

 

[Merovinge]

Frankly if they have to wait for 15+ years to get the green card finalized then 3 years won't make much of a difference. Even though nationals from India/China (don't think Pakistan are in that category) don't get an actual green card, they get a work permit and a travel document during the wait which pretty much functions like a green card, except they have to be renewed yearly.

Another point against J1: you have to go every year to your home country to renew it. Unless it's a top notch university program, to me it's a no-brainer.

Whoops I meant China not Pakistan, edited accordingly. I work at the same location as a couple doctor's who are still waiting after > a decade. I would feel the stress of this time frame and some restrictions on work outweigh a lot of benefits of better residency training.

 

[aksame]

Hi all,

I am a non-US, visa-requiring IMG applying this cycle with 9 interviews.

Here are the programs:

3 community hospitals that sponsor H1B visa:
Maimonides
St. Elizabeth (D.C.)
Case Western/Metrohealth

4 university hospitals that are J1 only:
SUNY downstate
Penn State
UT Houston
another mid-tier university program similar to the University of Arkansas (I wanted to remain anonymous for this one)

2 community hospitals that are J1 only which I planned to rank last.

Basically, I have difficulties deciding between H1 community programs and J1 university programs. J1 comes with a 2-year obligation to go back to home country or do waiver jobs in underserved areas. However, the quality of training for me is very important. I am not big on research, but university programs seem to have more well-rounded training and opportunities to do projects. Also, I don't know how I should rank Maimonides, St. Elizabeth (DC), and Case Western/Metrohealth. They all seem to be good community programs. Location is not a big factor for me.

Any advice is welcomed. Thank you so much!

Unless you are a real research person esp lab based research or high profile research, Maimonides is good enough for you to match to any fellowships (practically speaking, fellowship in psychiatry is really not hard to match) or find any jobs or make publications or have a life/work balance, the only thing is that it is in NYC and someone might enjoy rural life more.

 

[Marasmus1]

I am PGY3 psychiatry resident on J1. One thing you have to keep in mind is that many programs do not sponsor H1B in fellowship. There are great deal of J1 waiver positions in great locations. I have not heard anybody returning to their home country because they could not find a waiver.

H1B is definitely more direct path to green card less headache. However, keep in mind that you would need to find an employer that is willing to sponsor green card after residency with H1b as well. That process can be arduous as well. Personally the visa status would not have much impact on my rank order list as both has pros and cons.

 

[Pier]

[...] However, keep in mind that you would need to find an employer that is willing to sponsor green card after residency with H1b as well. That process can be arduous as well. [...]

Nonetheless this is equally true for J1 visas as soon as you complete the 3 yr's waiver job (after which the J1 is adjusted to H1B, if I'm not mistaken)

 

[psychacad]

There's also nothing stopping you from a doing a J1 fellowship while on H1. Just most wouldn't do this cause you lose all the advantages of being on H1. The usual issue with this is timeline, since J1 can be extended for 7 years whereas it's 6 for H1B, but this is not an issue cause you will be done by 6 years.
There are other ways of converting H1 to green card without employer sponsorship (if you have pubs and apply for a NIW, if you commit to work 5 years in an underserved area, (which would include parts of NYC)...etc). Green card is a crappy process regardless and you have to go through it one way or another.