H-1B Visas for Physicians: Advantages over the J-1 Visa

Since 1990, the H-1B nonimmigrant visa has been available to graduates of foreign medical schools who possess a “readiness to practice” in the United States, which includes: 1) passing the FLEX or equivalent exam (either the NMBE or USMLE), 2) passing an English language exam, and 3) obtaining permission to practice from the U.S. state of practice. The foreign physician visa beneficiary must also be sponsored by a petitioning institution that conducts the graduate medical program. The H-1B visa confers many advantages over a J-1 visa, the most important of which being that unlike the J-1, you will not be required to return to your home country for two-years following your H-1B visa stay, and you may adjust your status to become a permanent resident.

Contact us if you are a physician and would like to process an H-1B visa. The immigration lawyers at The Law Firm of Shihab & Associates are experienced and have represented physicians and other foreign medical graduates in a variety of immigration matters.

Will My Graduate Medical Program Sponsor My H-1B Visa Instead of a J-1 Visa?

For many years, international medical graduates entered U.S. graduate medical programs almost exclusively under J-1 Exchange Visitor visas. Graduate medical programs typically have a high level of familiarity with the J-1 visa program, and may have a negative perception of the H-1B visa program as too burdensome and too costly to prepare and file, with too much scrutiny under the Labor Condition Application requirement.

However, in recent years, many graduate medical programs have become increasingly familiar and friendly with the H-1B visa option for foreign physicians, and many have found it to be the more preferable visa option. There are a number of important advantages to the H-1B visa over the J-1 Exchange Visitor visa classification.

Am I Required to Return to My Home Country After My H-1B Visa Stay?

No. Unlike the J-1 visa, you may extend your H-1B visa for a maximum of six years, and during that time you may also adjust your status to apply to become a permanent resident. In contrast, the J-1 visa requires you to leave the country and return to your last country of permanent residence for a minimum period of two years after your graduate medical education has been completed.

What are Other Advantages of an H-1B Visa over a J-1 Visa?

Here is a non-exhaustive list that showcases the many benefits of the H-1B visa over the J-1 Exchange Visitor visa category:

• As mentioned above, unlike the J-1, H-1B visas do *not* require you to return to your home country for two years after your visa stay, and you may later adjust your status to become a permanent resident.

• J-1 visas face an increased probability of delays at the consular level compared with H-1B visas.

• H-1B visas allow for added control over processing times through USCIS processing;

• H-1B visas may be renewed when you are in the U.S. through the USCIS, which eliminates the possibility for substantial delay at the consular level for J-1 visas.

• H-1B visas also include the added feature of portability, which means that as a visa holder you will have a much greater degree of flexibility if you should decide to change programs and/or institutions. This can eliminate a very worrisome source of delay and uncertainty.

• As an H-1B visa holder, you will have much greater flexibility to engage in research activities in addition to your clinical service. The J‑1 Exchange Visitor Program has very strict provisions for you to transfer from a research program to clinical program.

• H-1B visas provide greater flexibility to participate in non-accredited, emerging training programs. In contract, the J-1 program imposes heavy burdens when you attempt to enroll in a non-ACGME accredited training program. These programs are often in highly-specialized, cutting edge fields utilizing brand new technologies and methods, in highly desirable specialty fields. Even if you start out in a board-accredited program, you may wish to change to a non-accredited specialty field later on in your training. The H-1B visa provides this flexibility.

• Many international medical graduates prefer and insist that their medical program institutions provide sponsorship of their H-1B visa as a term of enrollment. This preference is especially true for programs that are unable to consistently fill their training slots, and as an international medical graduate, you can play an invaluable role in stabilizing the growing needs of these programs for talented medical professionals.

The Changing Face of the U.S. Healthcare System

The entire conception of the healthcare profession within the U.S. is rapidly undergoing a makeover for the 21st century. Instead of the previously predicted shortage of primary care physicians, we are now facing a huge shortage of and growing demand for specialty care providers, as well as the emergence of entirely new fields of medical practice that as of yet have not been officially recognized by the American Boards. These bleeding-edge fields often are highly technical, specialized, and desirable fields to study and work in.

While foreign medical graduates have suffered for many years under the now discredited notion of an oversupply of foreign physicians within the U.S., there is an increasing public awareness of the benefits of foreign medical graduates in the physician workforce. Despite this, we have yet to see any major changes in immigration policy for the J-1 Exchange Visitor program, which creates major hurdles and barriers for foreign physicians to fully engage in their residency and clinical fellowship programs. Until the J-1 visa policy aberrations can be corrected and brought into harmony with current national healthcare needs, the H-1B visa continues to be an attractive option for foreign physicians.

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