Chapter 4 J-1 Visas for Graduate Medical Training

• Jurisdiction: United States

In 2014, more than 80 percent of the physicians who entered the United States on visas in order to participate in graduate medical training programs used the J-1 visa. The J-1 is used for participants in the U.S. Department of State’s Exchange Visitor Program, which is open to individuals entering the United States for a wide variety of purposes: camp counselors, au pairs, high school exchange programs, international scholars, foreign dignitaries, and, of course, physicians participating in residency and fellowship programs. While there are hundreds of J-1 programs in the United States, only the Educational Commission on Foreign Medical Graduates (ECFMG) may sponsor physicians.

What qualifications does a physician need in order to pursue graduate medical training on an ECFMG-sponsored J-1 visa?

1. The physician must pass the U.S. Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge. ECFMG also will accept the former Visa Qualifying Examination, the National Board of Medical Examiners examination Part I and Part II, the Foreign Medical Graduate Examination in Medical Sciences, or an acceptable combination thereof. Older exams like the ECFMG Examination or the Federation Licensing Examination do not meet the J-1 requirements (though they still may suffice for licensing, as well as H-1B visa petitions).

2. The physician must have an ECFMG certificate without expired examination dates (see Chapter 1). Exceptions are made for graduates of Liaison Committee on Medical Education (LCME)–accredited U.S. and Canadian medical schools.

3. There must be a contract or official letter of offer for a position in an approved graduate medical education or training program.

4. The physician must provide a Statement of Need from the Ministry of Health of the nationality country or country of last permanent residence.

What is the Statement of Need?

The Statement of Need from the home country or country of last residence provides written assurance that the country needs physicians in the specialty in which the physician will be training, and that the physician will return to the home country or country of last residence when the program is completed. ECFMG expects the Statement of Need to come from the country of permanent residence if the physician is living permanently in a country other than the country of nationality.

Statements of Need must meet the following requirements:

- Specify the exact specialty and/or subspecialty that the doctor will pursue and that there exists a need for qualified physicians with that specialty;

- Be issued by the central office of the appropriate Ministry of Health; and

- Have a certified translation if the original is not in English.

A new Statement of Need would be needed if a physician seeks to change specialty, the letter on file with ECFMG is expiring, or the physician is seeking to change host institutions.

How does a physician apply for ECFMG J-1 sponsorship?

After a physician is accepted into a host institution’s graduate medical training program, the physician and the institution’s training program liaison (TPL) will coordinate the submission of the J-1 application with ECFMG. ECFMG will communicate with the TPL regarding the status of the application with ECFMG.

The initial online application for the J-1 is submitted by the TPL through ECFMG’s Exchange Visitor Network (EVNet). The TPL provides details on the appointment of the physician, and the J-1 applicant is then sent information by ECFMG confirming the institution’s initiation of the J-1 application on behalf of the physician. Then, the physician will complete the “J-1 Visa Sponsorship” section of ECFMG’s Online Applicant Status and Information System (OASIS). Once the TPL and physician have completed the forms and submitted all the required supporting documentation, ECFMG will proceed with reviewing the application.

ECFMG will then create an electronic record for the J-1 and each J-2 dependent in the Student and Exchange Visitor Information System (SEVIS), a database jointly administered by the U.S. Departments of State and Homeland Security. Form DS-2019, Certificate of Eligibility for Exchange Visitor (J-1) Status, is generated through SEVIS to confirm the J-1 sponsorship approval. SEVIS is the system that ECFMG must use throughout the J-1 and J-2’s time in the United States to document their maintaining of status during their stay.

Find the paper application at www.ecfmg.org/evsp and submit with a copy of the dependent’s passport biographic page.

Once ECFMG approves sponsorship for a J-1, it will mail the original Form DS-2019 to the TPL via regular first-class mail (unless the TPL requests courier service and provides ECFMG with a pre-paid/pre-addressed airbill along with the supporting documents for the J-1 application).

What documentation does ECFMG expect from a physician applying for J-1 sponsorship?

ECFMG lists the following items to be uploaded in OASIS by the physician. Required documents:

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