Under §212(j) of the Immigration and Nationality Act, foreign medical graduates seeking to enter the United States for graduate medical education or training are precluded from J-1 status unless they meet the following requirements:

  1. The school offering the medical education or training must be accredited by a body or bodies approved for the purpose by the Secretary of Education and must agree in writing to assume responsibility for the alien’s education or training. Any participating hospital must join in the agreement. The only body approved by the Secretary of Education for this purpose is the Liaison Committee for Medical Education (“LCME”).
  2. The school must be satisfied that the alien is a graduate of a medical school that is accredited by a body or bodies approved for this purpose by the Secretary of Education, or that the alien has passed Parts I and II of the National Board of Medical Examiners examination (“NBMEE”) or its designated equivalent, is competent in oral and written English, is adaptable to the educational and cultural environment at the place of study or training and has adequate prior education and training. Graduates from medical programs accredited by the LCME are not required to have passed Parts I and II of the NBMEE. Since the NBMEE has now been discontinued, the alien graduate of a medical school that is not accredited by the LCME will have to show equivalency through prior passage of either the Foreign Medical Graduates Examination in Medical Sciences (or its predecessor, the Visa Qualifying Examination) administered by the ECFMG or passage of the current United States Medical Licensing Examination (“USMLE”), Parts I and II. English competency can be shown by showing graduation from a LCME accredited medical school or by passing the ECFMG English test.
  3. The alien must have made a commitment to return to his or her home country upon completion of his or her graduate medical education or training, and the country must have provided a written assurance in precise language that there is a need in that country for persons with the skill acquired by the alien through education or training in the United States.
  4. The alien must furnish the Attorney General each year with an affidavit that he or she is in good standing in the program and will return to his or her home country when it is completed.

A foreign medical graduate pursuing graduate medical education or training in J-1 status is limited to the time typically required to complete such a program, to a maximum of 7 years. Extensions of stay beyond the applicable maximum period will not be permitted unless the alien physician can show an exceptional need for the medical specialty in his or her home country which justify the granting of an extension.

A J-1 foreign medical graduate who acquired such status in order to receive graduate medical education training is ineligible to change status from J-1 to another nonimmigrant category from within the United States. However, he or she may leave the United States and apply under a different category at a U.S. consulate abroad. This restriction does not apply to other J-1 exchange visitors such as J-1 physicians engaged in observation, consultation, teaching or research.

Certain J-1 aliens are subject to a two-year home country presence requirement (the alien must return to his home country for two years before becoming eligible for H status).  The alien is subject to this requirement if:

  • The alien’s exchange program was financed, in whole or in part, by the home country government or by the U.S. government:
  • At the time of admission of acquisition of J-1 status, the alien’s skills were determined by the DOS to be in short supply in the home country; or
  • The alien has engaged in graduate medical education or training. There is an exception to permit a change of status from J-1 to H-1B, where the J-1 physician has obtained an interested government waiver from a State’s Department of Health.