Visa for IMG (international medical graduate) doctors falls into three major categories – J1, H1B, or an O visa. This could be for the traditional residency where J1 is more common and the alternate entry path program where H1B is more common. These are sponsored by the employing hospital or relevant authorities or both. There may be others but they are mostly an exception.
There are two major categories of USA visas called nonimmigrant (temporary) and immigrant (permanent). There are 38 different nonimmigrant visa categories and 13 immigrant visa categories starting with an alphabet and sometimes a number. I will tell you about each of the visa for IMG types. I am neither an immigration consultant nor an attorney, but I went through this process and have seen many people living through this process. I will share my personal experience. This will give you my thoughts so you know the pros and cons of each and this will help you make a decision.
By Dr. Rajeev Iyer, MBBS, MD, FASA
Associate Professor of Anesthesiology
University of Pennsylvania, USA
Can doctors get an H1B visa for IMG?
“International Medical Graduates (IMGs) who seek entry into U.S. programs of Graduate Medical Education (GME) must obtain a visa that permits clinical training to provide medical services” according to American Medical Association.
The H-1B visa for IMG is meant for temporary workers in specialty occupations who hold professional-level degrees like Medical School, residency, and fellowship. A visa for IMG is a perfect fit for this requirement. The H-1B visa allows a foreign national to enter the USA for professional-level employment and this is given up to a maximum of six years.
Do hospitals sponsor H1B visas for IMG Doctors?
An IMG doctor visa candidate moving into the USA can be based in any country. The first step is that the IMG doctor applies for a job in the USA. Once a suitable job offer is available based on the hospital and immigration requirements, then a petition will be filed on behalf of the IMG doctor by the employer which in this case will be the hospital hiring the IMG doctor. The H1B petition will be approved when the doctor is still outside the USA. Using the approved petition, the IMG doctor visa can be stamped on his/her passport which will enable entry into the USA and start working.
There may be a situation when the IMG doctor is in the USA on a visitor visa (B1/B2) when the petition is approved. This could happen because the IMG doctor may be visiting family and friends. In this case, the IMG doctor has to leave the USA and then reenter back on the H1B to start working.
Who is eligible for H1B Cap?
Each year, there is a limit on how many H1B visas are issued. Like you, I read in the news about the lottery system used to allot the H1B Visa. The H1B visa for IMG at least to my knowledge is exempt from H1B cap which in other words means all eligible employed IMG doctors will get an H1B visa if sponsored by their employer.
What are the disadvantages of H1B visa for IMG?
As an IMG, the H1B is perhaps the best visa to have. However, there are some disadvantages of H1B visa for IMG (some general and some specific to IMG) and here they are
- Maximum limit of 6 years
- Requires renewal and a petition has to be filed
- The candidate must leave USA, have the H1B visa re stamped and renter USA with the new renewed visa. However, this is not a mandatory requirement unless you don’t want to leave the USA
- A major drawback I have seen for IMGs is that their spouses tend to be either professional people or very experienced but unfortunately the spouses or children cannot work and only the primary person can work.
- The dependent’s spouse or children are given a Visa called H4 which lets them stay in the USA and go to school but cannot work.
- Requires the passing of USMLE Step 3
What is the minimum salary for H1B visa?
Since the H1B visa for IMG is offered to professional workers with a Master’s degree the salary will typically be a six-figure number. If the candidate enters the USA as a resident then he/she will be given a resident salary. I am not aware of a minimum salary with H1B visa for IMG. It depends on the nature of the job, location, and other factors that normally decide pay.
Which is better H1B or J1 visa for IMG?
Both H1B and J1 are temporary work visas and have pros and cons. Based on two major factors (2-year waiver requirement with a J1 visa and the ease of transition of H1B to apply for a green card), H1B scores higher than J1. Here are my suggestions:
- If you are offered, I suggest choosing H1B.
- If you are offered a J1, check if you can get H1B.
Can I get a green card without H1B visa?
An H1B is not a mandatory requirement to get a green card. If you enter the USA on a visa for IMG, then H1B is certainly a better choice. However, there are many eight categories available to apply for Green Card. For an IMG doctor, the most common category is likely to be employer-based and the second most common family based. The other possibilities are rare but I have seen this happen.
How soon after H1B visa can I apply for a green card?
Green can be applied for any time after an H1B visa for IMG. There is no predefined time limit. It comes to a point when your employer wants to sponsor you for a green card or you decide to apply on your own. I have come across many green card rejections when people have applied on their own but none when the employer sponsors it. This does not mean to say it doesn’t happen but at least I have not across anyone saying my employer sponsored green card was rejected. Of course, I am saying this in relation to the visa for IMG. I have come across this among nonphysician professionals. A green card can also be applied for without a visa by staying in your home country. These are usually family-based permanent residency sponsorships.
This below video will show you the pros and cons of a H1B visa for IMG
How Can I Get a J-1 Visa?
J visa is a type of exchange visitor nonimmigrant visa meant for individuals who are approved to participate in exchange visitor programs in the United States. The J-1 visa for IMG is sponsored by Educational Commission on Foreign Medical Graduates or ECFMG. The U.S. Department of State has authorized ECFMG to sponsor J-1 visa for IMG. Most IMG doctors entering the US through residency programs get in on a J-1 visa, although this is not always the case. I do have friends and others I know who entered on an H1B.
To obtain a J-1 visa, you have to meet the below eligibility criteria:
- Complete USMLE Step 1 and Step 2
- Obtain ECFMG certification
- Have a job offer from the hospital sponsoring your position
- You will need a letter called “statement of need” from the Ministry of Health from whichever country you are in as a legal permanent resident. This is irrespective of your country of citizenship. The statement of need is a way to say your home country requires you to undergo training in the USA system.
Can I apply for a green card with a J-1 Visa for IMG?
The J-1 visa for IMG is relatively easy to obtain. The amount of paperwork required from the hospital is also relatively less compared to H1-B. The J-1 comes with a caveat. After J-1 you have two options:
- Return back to your home country for 2 years to share the knowledge you obtained in the USA
- Obtain a J-1 waiver job in the USA.
Everyone I know has taken the second option of finding a J-1 waiver job. Subsequently, they transition to an H1B visa and then apply for a green card.
I have shown the pros and cons of a J-1 Visa in the video below
Can IMG doctors get an O visa for IMG?
I have seen very few O Visa for IMG although they do exist, and they have been successful. The “O” Visa is given to an individual who possesses extraordinary skill in the field of medicine and has demonstrated extraordinary achievement in their field and they’re recognized nationally or internationally. “Extraordinary” is the key here.
There are various categories like 01, O2, and O3 under the O Visa categories, however, one of the biggest cons of this is this has a three-year limit, and the extension of O Visa involves a lot of paperwork. The hospital sponsoring you should be willing to support an “O” Visa. Irrespective of the Visa type if your ultimate plan is to settle in the U.S., a petition for a green card must be applied, it has to be approved and then you change your status to be a green card, then you satisfy the residency requirements to be a U.S. citizen.
I have shown the features of O Visa in the below video
Do doctors get green cards faster?
There is a myth saying it is very easy for doctors to get a green card. This is not true. The Department of Homeland Security has a high requirement of who qualifies to have a green card. There are doctors who have been successful in getting a green card in a few months and there are also doctors who have not received a green card in almost 10 to 15 years and this is true, especially for candidates from where there is a huge backlog of the number of people waiting for a green card. so ultimately it depends on where your country of birth is and your background and what makes you special to be eligible for a green card.
The permanent residency backlog can be checked on the U.S. Department of State website.
If given a choice between a J1, H1B, and “O” Visa, I personally would pick an H-1B visa.
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