How Doctors Can Come to the U.S. as J-1 Exchange Visitors
The U.S. welcomes foreign-born doctors who want to do their residency or an internship in the United States. The U.S. State Department grants “J-1” visas to persons who have graduated from medical schools outside the U.S. so they can pursue graduate medical education or training at U.S. medical schools or scientific institutions (“clinical programs”), or pursue programs involving observation, consultation, teaching, or research activities in the United States (“nonclinical programs”). This article explains the J-1 physician programs and how to get the visa.
Generally, to be eligible for a J-1 clinical program in which you will be working with patients, you must have the background, needs, and experiences suitable to the program. This requires adequate prior education and training. If you didn’t graduate from a school of medicine accredited by the Liaison Committee on Medical Education, you must pass the United States Medical Licensing Examination, Step I and Step II (or you must have passed one of the tests that used to be given to foreign medical graduates).
You will need to be able to speak and write English well, and be able to adapt to the educational and cultural environment in which you will be receiving your education or training.
Like all J-1 visa holders, you will need to buy insurance that provides a certain minimum level of benefits to you in case you get sick or injured in the United States.
Obtain Documentation of Your Country’s Need for Physicians
If you want to do a J-1 clinical program, the government of the country of your nationality (or the country where you are living with legal permanent residence) must provide a “statement of need” to the Educational Commission for Foreign Medical Graduates in the United States.
This is a statement assuring the U.S. government that your country needs people with the skills you’ll be acquiring with the J-1 visa and returning home with. Exact words are required by U.S. regulations. The statement of need must bear the seal of the government and be signed by a proper government official.
Obtain a Written Agreement With Medical School or Scientific Institution
To do a J-1 clinical program, you will need to be accepted into a program by a U.S. accredited medical school, an affiliated hospital, or a scientific institution. Getting a J-1 visa for a clinical program requires you to submit an employment agreement or contract, signed by both you and the official responsible for the training.
Obtain a Certificate of Eligibility (DS-2019) from a Sponsor
Before you can get a J-1 visa, you need the “sponsor” of your clinical or nonclinical program to certify on Form DS-2019 that you are eligible for participation in the program. The sponsor of all clinical programs is The Educational Commission for Foreign Medical Graduates.
If you’re coming for a nonclinical program (one that’s for the purposes of observation, consultation, teaching, or research), the sponsor will be a U.S. university or academic medical center or The Educational Commission for Foreign Medical Graduates.
The sponsor must sign and attach to the Form DS-2019 a certification that states “this certifies that the program in which (name of physician) is to be engaged is solely for the purpose of observation, consultation, teaching, or research and that no element of patient care is involved.” Alternatively, the dean of the medical school can attach a certification with similar assurances as required by U.S.regulation.
A U.S. university, academic medical center, school of public health, or other public health institution can sponsor a nonclinical program that does not include any activities involving direct patient care. For these programs, the only eligibility requirement is that the sponsor attach to the DS-2019 a statement that says: “This certifies that the program in which (name of physician) is to be engaged does not include any clinical activities involving direct patient care.”
Getting a J-1 Visa
The first part of the process is to get the DS-2019 from the sponsor. Unless you’re Canadian, you then need to get a J-1 visa so you can travel to the United States. To get one, you might want help from a lawyer who knows U.S. immigration law. You will go online and fill out a form called a “DS-160,” which is your application for the visa. Print out the receipt to take with you to your visa appointment.
After submitting the DS-160 online, you’ll have to pay a visa application fee, usually by going to a designated bank. Again, make sure you save the receipt. Then, you will need to set up an appointment for an interview at the U.S. consulate in your home country. At least three days before the interview, you need to pay a “SEVIS fee,” which helps fund the system that tracks J-1 visitors.
At the interview, you’ll present all the documents that support your application for a J-1 visa, including the DS-2019 form you got from the sponsor. Applicants from certain countries must pay another fee, called a “reciprocity fee,” on this day. See "The Day of Your Consular Interview" for more information.
A consular officer will ask you questions (in English) to make sure you’re eligible for the visa. You’ll go through some security checks, too. For one thing, the U.S. will want to make sure that you (like any other visa applicant) are not barred from entry due to health, security, or other issues, as described in "Inadmissibility: When the U.S. May Keep You Out."
The officer must be satisfied that you intend to return home after your J-1 residency or internship is finished. If everything goes well, you will get your visa and can start planning your trip to the United States.
If you’re Canadian, you don’t need to fill out the DS-160 form or go to a U.S. consulate for a visa. You can bring your DS-2019 form to a U.S. Customs and Border Protection officer at the airport or the U.S. border and ask to enter the U.S. in J-1 status. You’ll have the pay the SEVIS fee at this time. After a short interview, the officer should allow you into the country if you qualify for entry.
Your Family Members
Your spouse and unmarried, minor children (under age 21) can come with you to the United States. Your program sponsor must issue each family member a separate DS-2019 form. At the consulate they will apply for a “J-2” visa.
Your children can attend school while in the U.S. without having to get a separate student visa. Your family members can apply for permission to work, but the money they earn must be used for their support only, not yours.
Length of Stay in the U.S.
The U.S. government will tell you how long you can stay when it gives you the J-1 visa. As a general rule, you can stay in a clinical program for as long as it typically takes to complete the program, but no more than seven years. You can get an extension if your home country has an exceptional need for the additional qualification you gain by staying longer.
If you have finished your training or education and need more time in the U.S. to take an examination required for certification by a specialty board, you can ask for an extension. Also, if you need a certain period of supervised medical practice in the U.S. to be eligible for certification by a specialty board, you can get an extension. You can also ask for more time to repeat a year of clinical training.
Your Reporting Requirement
Every year you’re in the U.S. on a J-1 physician visa, you must file an affidavit that attests that you are in good standing in your J-1 program, and that you promise to return to your home country when your education or training in the U.S. is done.
Changing Your Program
If you come to the U.S. and decide you don’t like the particular clinical program you signed up for or want to switch specialties, you can ask for a change. You can change programs only once, and it has to be within the first two years of your U.S. stay.
Coming Back to the U.S. After Your J-1 Residency Is Done
If you come to the U.S. to do a clinical program, you must return to your home country for two years before you can return to the U.S. on an “immigrant” (permanent) visa or get permanent resident status or get a long-term work visa in the H or L category. You may want to consult with an immigration lawyer to see whether you can get a waiver of this two-year home residency requirement, but one of the types of waivers normally available to J-1 visitors—given when your government says it has no objection to you staying in the U.S.—is not available to J-1 clinical program physicians.
If you’re doing a nonclinical program, the two-year home residency requirement doesn’t apply unless your participation in the J-1 program is being financed by your home country’s government or you’re pursuing a field of study set forth on your home country’s Exchange Visitor Skills List.