Coordinating ECFMG J-1 Visa Sponsorship for International Medical Graduates (IMGs) in Residency

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1 Coordinating ECFMG J-1 Visa Sponsorship for International Medical Graduates (IMGs) in Residency Eleanor Fitzpatrick, MA Director - Exchange Visitor Sponsorship Program (EVSP) RPS April 4, 2016 AAFP Disclosure It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. 2

2 Learning Objectives 1. Review Requirements for IMGs/Foreign National Physicians in U.S. GME Credentials Immigration ECFMG J-1 visa sponsorship 2. Discuss the Responsibilities Associated with Monitoring J-1 Residents Regulatory compliance Administrative processing Best practices Requirements for IMGs and Foreign National Physicians 1. International Medical Graduates (IMGs) ECFMG Certificate (including U.S. citizens) Visa / visa status for Canadian citizens, other foreign nationals 2. U.S. Graduates (MDs & DOs) Diploma, USMLE and/or COMLEX Visa / visa Status for Canadians, other foreign nationals 3. Canadian Graduates Diploma, MCEE and/or USMLE Visa / visa status for Canadian citizens, other foreign nationals

3 Entry into U.S. GME General Path for Foreign National Physicians: 1. ECFMG Certification, if IMG 2. Apply for U.S. Residency Training Position Apply via ERAS Interview with programs Enroll in the NRMP Match Secure a contract/letter of offer 3. Seek Appropriate Immigration Visa / Visa Status, if foreign national ECFMG Certification IMG Credentials 1. Medical Education Credentials Completion of medical school curriculum of at least 4 yrs School and graduation year listed in World Directory of Medical Schools Primary-source verification of medical diploma and transcript(s) by ECFMG 2. USMLE Exams Step 1 Basic Science Step 2 Clinical Knowledge (CK) Step 2 Clinical Skills (CS).

4 Immigration All foreign national physicians need an appropriate visa / visa status for GME (includes both U.S. graduates and IMGs) Most Common Visas for GME J-1 Exchange Visitor Physician - ECFMG H-1B Specialty Occupation Worker Employer Less Common F-1 Student Optional Practical Training OPT J-2 Dependent - EAD ECFMG s Exchange Visitor Sponsorship Program (EVSP) Partnership Regulatory Compliance U.S. Teaching Hospital Training Program Liaison (TPL) EVSP Foreign National Physician J-1 Physician U.S. Department of State SEVIS

5 : Visa Sponsor for All J-1 Physicians in Clinical Training J-1 Physician Regulations 22CFR 62.27(b) Temporary, non-immigrant Full-time educational training / GME (not employment) Strong ties to the home country Imposes 2-year home physical presence requirement Maximum of 7 years in progressive training Government tracking in Student Exchange Visitor Information System (SEVIS) Minimum Requirements Adequate prior education ECFMG J-1 Visa Sponsorship ECFMG Certification, if IMG GME contract Statement of Need from home country Ministry of Health (country of most recent legal permanent residence) Mandatory medical and accident insurance for J-1 and J-2 dependents For a complete list of requirements, view checklists

6 ECFMG J-1 Visa Sponsorship Sponsorship Available for Participation in: ACGME-accredited residency training ACGME-accredited subspecialty training Non-Standard programs (advanced cutting edge fellowships) Extension for board examinations Sponsorship application instructions Maximum of 7 years in progressive training J-1 Sponsorship Application Process Training Program Liaison (TPL) + J-1 Physician = Complete Application Complete ON-LINE application with all required documents 4-6 weeks to review applications Regional Advisor evaluates for eligibility If approved, SEVIS Record is created ECFMG issues Form DS-2019 ECFMG notifies applicant via , provides instructions for obtaining J-1 visa status

7 SEVIS Student and Exchange Visitor Information System U.S. Government Database Managed by Departments of State (DoS) & Homeland Security (DHS) Electronic tracking of immigration activities of J, F & M visa holders Accessed by consulates, embassies, ports-of-entry, and other agencies ECFMG creates and updates SEVIS records for J-1 physicians/j-2 EVSP s On-line Application Process On-line Application Official appointment / contract details submitted by TPL Physician accepts ECFMG reviews and approves Flow * = EVNet OASIS ECFMG SEVIS/ Form DS (TPL) (Applicant) (Regional Advisor) ( DoS/DHS) * All supporting documentation scanned and uploaded.

8 SEVIS Form DS-2019 Certificate of Eligibility for Exchange Visitor (J) Status Legal document needed to apply for J visa and/or J-1 visa status Immigration tracking of J-1 physician activities Separate Form DS-2019 for J-2 dependents Visa Processing for Initial Applicants Processing Options Apply at a US Consulate Abroad or Request change of visa status through USCIS Regional Service Center in the United States Must obtain J-1 Visa status to begin GME (I-94 record) ECFMG J-1 sponsorship approval and issuance of Form DS-2019 does not grant status

9 Visa Stamp in Passport Issued by U.S. Consulate Entry Document Only* Confirms: Visa type/class Number of entries single or multiple Issue date Expiration date for entry Visa stamp may expire while in the United States in valid visa status Copyright 2016 by ECFMG. All rights reserved. U.S. Arrival/Departure Record I-94

10 Critical Issues for Initial J-1 Physicians Credentials Final medical school diploma and transcript, USMLE scores Issuance of ECFMG Certificate, medical license Immigration Approval of visa sponsorship Consular interview abroad, security clearance or Change of Status if in the United States Secure J-1 visa status document Program Start Validation of arrival Obtain Social Security # (10 day wait after U.S. entry) Eligibility for U.S. employment (I-9 Process) Confirm required medical/accident insurance Critical Issues for Continuing J-1s Maintaining J-1 Visa Status Continued full-time participation in GME Contract to progress in training Timely renewal of ECFMG J-1visa sponsorship Medical/health insurance coverage that meets federal J visa requirements Required reporting of any change in approved training plan Note: J-1s do not need to renew visa stamp annually!.

11 Monitoring J-1 physicians Required Reporting Initial Validation / Arrival to the program Timely renewal according to annual GME contract Any change in the approved training plan Visa delays Remediation Leave of absence Licensure delay Proposed off-site rotations Resignation Termination Legal concerns / emergencies, etc. Copyright 2016 by the Educational Commission for Foreign Medical Graduates (ECFMG ). All rights reserved. J-1 Physician Travel Planning Refer J-1 residents to: Be sure to discuss terms of contract with J-1 residents Risk of delayed return due to visa processing or denial Valid visa stamp and ECFMG Travel endorsed Form DS-2019 is required for U.S. re-entry Copyright 2015 by the Educational Commission for Foreign Medical Graduates (ECFMG ). All rights reserved.

12 J-1 Compliance Requires Partnership with ECFMG Copyright 2016 by ECFMG. All rights reserved. The TPL Agreement Late arrival Remediation Transfers Resignations Discussion Topics

13 During the break Discuss / think about how you might implement the information you just heard. Fill out a session evaluation. 25 QUESTIONS? ECFMG s Exchange Visitor Sponsorship Program (EVSP) Ellie Fitzpatrick General Inquiries (215) Trainings Program Liaison Inquires

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