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International Clinicians: Keys to Immigration


This presentation discusses how international clinicians can get visa train in the US. Schedule a legal consultation at The 2 most common options are: 1) J Visas - Once an IMG has passed USMLE, Parts I and II, and matches with a medical residency program, he obtains a DS-2019 form from the Educational Commission for Foreign Medical Graduates (ECFMG) and either changes his status to J-1 in the US or goes abroad to get a J-1 visa. This subjects him to the 2-year home residency requirement. 2) H-1B Visa - Physicians who have passed all 3 parts of the USMLE and have matched with an employer who agrees to sponsor them for an H-1B visa may do so to avoid having to apply for a J waiver down the road. Most residency programs are "cap-exempt" so the physician does not have to worry about the numerical caps on H-1B petitions. See our Physicians Immigration Guide at – PowerPoint PPT presentation

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Title: International Clinicians: Keys to Immigration

International Clinicians/IMGs Keys to Immigration
Presented by Immigration Attorney Carl
Shusterman to AMN Workforce Summit November 7-8,
Internationally Born Medical Graduates An
Essential Resource
  • IMGs make up 25 of the physician workforce
    (includes US IMGs)

Are most represented in Are most represented in
Nephrology 45
Internal Medicine 37
Psychiatry 32
Oncology 30
Pulmonology 30
Anesthesiology 28
Pediatrics 28
Gastroenterology 28
Source AMA Physician Master File
IMGs by Country (Top Ten)
Country Percent Total
India 20 47,581
Philippines 8.7 20,861
Mexico 5.8 19,929
Pakistan 4.8 11,330
Dominican Republic 3.3 7,892
Former USSR 2.5 6,039
Grenada 2.4 5,708
Egypt 2.2 5,202
South Korea 2.1 4,982
Italy 2.1 4,978
IMGs in U.S. come from 127 countries
Source AMA Physician Master File
IMGs Heaviest Concentration by State as a Percent
of All Active Physicians
1. New Jersey 39
2. New York 38
3. Florida 35
4. Illinois 33
15. Texas 25
All United States 25
Source AMA Physician Master File
IMGs Number of Potential Candidates Coming Out
of Residencies
  • Total graduating residents per year 25,000
  • Number of IMGs approximately 7,000

Visa Options For Residents Fellows
  • J Status (training visa)
  • H-1B Status (employment visa)
  • Permanent Residence and Other Options

Consequences of J Status for IMGs
  • 2-Year Home Residency Requirement
  • Must return to Country of Nationality or Last
    Residence for 2 years before obtaining H or L
    visa or Green Card

How to Obtain a J Waiver
  • Persecution
  • Exceptional Hardship
  • To USC/LPR Spouse
  • To USC/LPR Child (under 21 unmarried)
  • Interested Governmental Agency (IGA)

J Waivers Interested Governmental Agencies
  • Federal Agencies
  • ARC
  • VA
  • HHS
  • DRA
  • Conrad State Programs

Conrad 30
  • Primary care and/or specialists
  • All 50 states participate
  • Some have 10 flex spots the physician does
    not have to practice in an underserved area, as
    long as he/she sees patients from underserved
  • Some states run out of spots, some do not
  • Check with Mr. Shustermans office

Medical Residency/Fellowship on H-1B Status
  • Passage of USMLE, Parts I, II III
  • Acceptance to Residency Program
  • H-1B Petition

H1B Visa
  • No 2-year rule doctor does not have to practice
    in an underserved area

But there is a cap!
  • 85,000 H1Bs per year
  • April 1st is filing date
  • Physicians who receive J waivers are exempt from
  • So are doctors who work at academic institutions,
    government or non-profit research institutes

Permanent Residence Employment Options
  • PERM
  • National Interest Waiver
  • The Law (1999)
  • The Regulations (2000)
  • The Lawsuit (2005)

What about Canadian Physicians?
  • They are not considered IMGs
  • LMCC accepted in almost all states for licensure
  • Can qualify for H-1B if they have a U.S. exam
  • But dont need a U.S. exam for a green card

Immigration Reform Bill in Congress
  • Would make the Conrad 30 program permanent
  • Would make J status dual intent
  • Would exempt spouse/children from 2-year rule
  • Would make it easier for H-1B MDs to change jobs
  • Would eliminate per-country quotas
  • Would provide a faster route for green cards to
    physicians and their families


Finding IMG Resources Online http//
  • We Link to
  • Governmental Sites
  • Conrad 30 Programs
  • HPSA/MUA List
  • Job Opportunities

How to Keep Current
  • Physicians
  • Immigration Guide
  • Social Media
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