Avoid potential complications with visas

Residency Program Insider, January 19, 2018

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Editor’s Note: The following is an excerpt from The Residency Coordinators Handbook, Third Edition. For more information about this book, click here.

Many of the residents in the United States are international medical graduates, training here on a sponsored training or exchange visa, generally an H1-b or a J-1. The H1-b visa has a limit of five years before a change in status must occur (such as employment, and sponsorship for a U.S. Permanent Residency Card, colloquially known as a “green card”). The J-1 is the traditional training or exchange visa, issued for the length of the residency program, but can be extended for up to seven years if the holder continues training in a related, accredited fellowship position.

It is important to know the visa status and the amount of time remaining on your international candidate’s visa when assembling your fellowship interview and match lists. All the years one trained in the U.S. counts, so, for example, if a resident on a J-1 visa completed a preliminary residency year in medicine and followed up that year with a five-year general surgery residency, that resident would have completed six years of training and would only have one more training year available on the J-1 visa before he or she would have to return to his or her home country for two years, or find a waiver job. This resident could qualify for a surgical subspecialty fellowship in colon-rectal surgery, if desired, after completing his or her surgery residency because it is only one year long, but could not complete a fellowship in vascular surgery because it is two years in duration.

Most international residents know the visa regulations better than we do, but some look for loopholes and ways out of their commitment in order to stay in the U.S., especially if they were unsuccessful in finding a waiver job. Some incorrectly believe that their hospital or program would certainly be willing to sponsor them and let them finish their training because they are really good and talented, or will let them return home for two years and then return to complete their remaining specialty training. Still others never truly intend to complete the fellowship they enter, simply wanting to obtain the additional year or so of training until their visa expires and they must return home. The consequences resulting from their actions to the program or the other fellows in their program are never considered by these individuals. To protect the program and its fellows, coordinators must be diligent in confirming the employment and visa status of fellowship candidates, verifying that each one will be able to complete the training program if accepted or matched.

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