Introduction

Foreign medical graduates who seek to undertake a residency or fellowship at a hospital in the United States usually are given two choices: the J-1 exchange visitor status or H-1B status.  H-1B status is preferable because (unlike the J-1), it does not come with a requirement for the doctor to return to his/her home country for two years after their period of stay.

Qualifications

In order to qualify for H-1B status, foreign medical graduates will need to possess a medical degree, be E.C.F.M.G.-certified and have passed all three steps of the U.S.M.L.E.

Moreover, if the state where the residency or fellowship is to be conducted requires foreign medical graduates to possess a license, the doctors concerned usually must possess the requisite license before being eligible for H-1B petition approval.  Some states do not require licensure during a residency at a public hospital (such as New York), whereas some require licensure for beyond the first year of residency (such as New Jersey), while other states (such as Michigan, Ohio and Pennsylvania) require licensure for the entire residency.  Most (if not all) of the states that require medical licensure during a residency or fellowship program issue a one year "educational limited license," which is renewable on an annual basis for each year of the residency. 

This educational limited license can have an unforseen complication, as there is a U.S.C.I.S. regulation that limits the approval of the H-1B petition to the validity period of the license or one year (whichever is longer) where there is an educationally limited license.  Thus, even if the hospital is willing to request three years on the petition, the U.S.C.I.S. might limit approval to just one year because of this regulation.  Moreover, there is great inconsistency in the application of this regulation: many petitions for foreign medical graduates with educationally limited licenses are approved for more than one year regardless of this regulation, and it is impossible to predict in advance which petitions will be approved for more than one year.  For those foreign medical graduates whose petition is approved for just one year, their hospital will need to file an H-1B extension later on to provide status for the remainder of the training program.

H-1B Cap

Most medical residency or fellowship programs are exempt from the H-1B Cap.  This is because the sponsoring employer usually is either a medical school or a nonprofit hospital that is affiliated to a medical school.

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