Visa is the biggest and the most important issue that scares most of the IMGs and plays a major role in getting a residency position. With many programs not sponsoring visas for residency training and few sponsoring J1 visa and very few sponsoring H1B visa makes the residency application more complicated for the IMG. So it becomes a critical question to resolve whether the program would sponsor a visa for IMG or not if yes than which one a J1 or a H1B. H1B is the most desired and ideal visa for most of the International Medical Graduates. IMG friendly programs are generally immigration-conscious and will offer H1-B and attract more qualified physicians and thereby improve their programs. We have tried to give a comprehensive overview of different visas their advantages and disadvantages. The most common visas available for IMGs are B-1, B-2, F-1, H-1, J-1, O-1 and Green Card (Permanent Residence). In 1998 the most popular visa amongst international medical graduates was J-1 (33 % of IMG resident physicians), which is second to IMGs with Green Card comprising of about 35 % of the IMG resident physicians. The least common visas were F-1 and B-1/B-2 visa constituting 0.2 and 0.3 percent of IMGs.

The first issue that concerns IMG is entry to US on a visitor (B-2) or any other kind of visa for taking CSA or any of the USMLE exams. The general tip for the visa is one should establish that you have strong ties to her or his home country. This evidence can include proof of home country investments, proof of home or business ownership, and immediate family (who are not accompanying the IMG). On entry in US an IMG is issued a I-94 form at the port of entry which states the duration of stay allowed to the person entering United States. While leaving the country the alien is expected to surrender the I-94 form. After completing the basic requirements i.e. exams, interview and match the next question arises is to get the valid visa to start the residency training. Here is basic information about the visas available for IMGs.

The J-1 visa is the most common visa amongst IMGs. The Exchange Visitor Program is intended to foster international social, scientific and cultural exchange. Many if not most program sponsors are universities, where the environment for such exchange is acknowledged highly rewarding and productive. It is primarily used to bring students, trainees, teachers, professors, research scholar, and international visitors to the US. This program is administered by the US information agency (USIA), a division of the Department of State. J-1 visa issues concerning the IMGs have been discussed below.

The duration of the Visa is limited to the time normally required to complete such a program. The maximum amount for participation in a training program is ordinarily limited to seven years unless the IMG involved has demonstrated to the satisfaction of the USIA director that his or her home country has an exceptional need for further training.

The law requires that a J1 visa holder, upon completion of the training program, leave the US and reside in the home country for a period of at least two years. The visitor has to return to his home country and not any other country like Canada or United Kingdom. The 2-year rule may not always be applied to a J-1 researcher or scholar. Physicians wishing to pursue medical career in US fear that on returning to home country, they might fall seriously behind their peers in the rapidly progressing field of medicine and might find it difficult to get a job after 2 years. This requirement also extends to relatives holding J-2 dependent visas.

4-6 weeks (if change of status is requested from INS within the U.S.) Otherwise, the potential J-1 would travel to his/her home country with the form IAP-66 from the sponsoring institution, obtain the J-1 visa in the passport and re-enter the U.S. in J-1 visa status.

J-1s may transfer under the following circumstances:

J-1 visa holders can only receive stipends from their institution. No "moonlighting" allowed. All medical graduates on J-1 visa must file annual reports with their local INS office on Form -I- 644 No limitations on the number of visas issued i.e. not subjected to any “cap”.

H1B is the most ideal visa for IMGs. It is a 'specialty occupation' visa for temporary employment. Program must demonstrate that the job in question is one that requires special preparation, and that the person for whom the petition is being filed has that education or preparation.

3 years initial request and later it can be extended for another 3 additional years.

None

Dependents may not work.

It is a student visa issued by INS to foreign nationals to study in a college or universities for studies leading to a degree. Permits part-time work after first year of school or earlier under special circumstances. Few residency programs might sponsor IMG F-1 Visa with work permit.

The applicants getting the O-1 visa are of outstanding caliber. They must have received national or international endorsement in "science" (medicine). The position that is offered should require a person of extraordinary talent. The individual's curriculum vitae must demonstrate membership in associations that require outstanding talent and achievements, major awards of excellence, authorship of scholarly articles, research achievement, and previous employment in an essential position at a hospital, medical school, or clinical research center. Evidence of a high salary or other "outstanding remuneration" is also required.

Usually ECFMG certificate not required (varies from state to state). The INS requires substantiation of the claim that this individual is "distinguished". Obtain notarized and translated copies of licenses, award certificates, honors, and publications.

There are different categories under which an alien can apply for the permanent residence status.

First preference is the category given to foreign national with “extraordinary ability” which is usually demonstrated by sustained national or international acclaim and recognition in his field. A person who fits the first preference category can sponsor him or herself for the permanent residence status. By INS definition, a physician of national or international acclaim is not considered an IMG and therefore is not subjected to the rules and regulations applicable to other IMGs. Does not require a job offer or labor certification. The physician has to continue to work in his area of extraordinary ability.

"DV-1- Diversity" lottery for "Green Cards" that allows about 55,000 lucky individuals to by pass waiting time for immigration visas. Contact INS for more information. Only citizens of few countries are eligible for the lottery.