For physicians abroad who wish to come the U.S to work the immigration laws present special challenges? This profession i the ‘only one which has a rule of exclusion applicable to it Certain Physicians therefore can be excluded from the U.S. simply because they wish to practice medicine here. Special credentialing requirements exist in order to avoid exclusion and in some cases there are foreign residence requirements and clinical practice restrictions. “These immigration requirements are in addition to the requirements for state licensing which must be satisfied before a doctor can practice medicine in the US.

‘Whatever the motivation behind these special requirements affecting physicians foreign physicians wishing practice here must pay particular attention to the migration process. This article will briefly describe some of the special requirements affecting foreign physicians. We will look at the credentials required for ‘permanent residence as a practicing physician clinical practice restrictions for doctors wishing to work temporarily in the U.S. in H I B status and the foreign residence requirement for exchange visitors under the J visa program

This article does not examine the state licensing of medical doctors. Even though a physician might satisfy all the requirements of immigration law and is allowed to come to the U.S. as a practicing physician this does not mean that he or she is qualified to practice medicine here. Immigration is a matter of federal law but the federal government does not license physicians. Each state government has its own rules for the licensing of physicians and readers are advise to check with the appropriate authorities in the state ‘where they wish to practice.

PERMANENT RESIDENCE

‘A foreign physician wishing to come permanently to the U.S. to practice medicine may be excluded (i.e. barred) from the country unless the physician:

  • has passed parts I and It of the National Board of Medical Examiners Examination (NBME) (or ‘an equivalent test) and is competent in written and spoken English;
  • Is a graduate of a foreign ‘medical school accredited by the enjoys to renown in the field of medicine ‘This rule applies in any case where the physician is applying for an immigrant visa at? U.S Consular Office abroad is applying at a port of entry for admission to the USS. As a permanent resident or is applying at the local INS office for adjustment of status to permanent residence. This rule does not apply in a case where a physician is coming permanently to the U.S as a relative ‘of a U.S. citizen or permanently to the U.S. as an investor under the new employment creation visa or “million dollar visa”) Nor does it apply to a physician who is coming to the U.W. through an employment-based priority worker visa as an alien of extraordinary ability or outstanding professor or researcher. Simply stated the exclusion applies to a foreign physician who is coming to the US. “to perform services as a member of the medical profession” and who is seeking permanent residence through category two or three of the employment based visa classifications. By definition the rule does not apply in a case where a physician is applying for temporary status in the US. as an H-1B temporary ‘worker or J-1 exchange visitor.

‘TEMPORARY WORKERS

A graduate of a foreign medical school who wishes to come to the US to work temporarily in the ‘medical field may be qualified for H-IB temporary worker classification. But such physicians may face special restrictions in this visa classification because for many years such physicians were not allowed to obtain H-1B visas if their H-1B employment involved patient care. The H-1B was available only to foreign physicians who came to work here temporarily in a job at a public or non-profit institution where patient care was only incidental. ‘Typical positions were in medical research and teaching in medicine. In the recent amendment to the immigration laws this limitation ‘on H-1B employment was eliminated. This might have been inadvertent however and Congress ‘now considering legislation ‘which will reinstate the limitation of H-1B employment.

It is important to note that the limitation of practice described here does not apply to an alien ‘who is a graduate of a U.S. medical school or to a graduate of a foreign medical school who is of national or international renown in his or her field. For all H-1B medical doctors regardless of the place of schooling or level of achievement new regulations of the Department of Labor must be satisfied before the H-1B application can be filed with the INS Under these regulations as currently in effect the H1B employer must pay the alien ‘and all “similarly employed workers the prevailing wage

EXCHANGE VISITORS

Foreign physicians often come to the U. S. to participate in exchange programs which provide ‘opportunities for study clinical training or research The exchange Visitor program is administered by the US. Information Agency (USIA) and its goal is to foster international relations and bring exchange visitors here to acquire training or education which will ‘be used in the home country. AS ‘such many exchange visitors are subject to the foreign residence requirement ‘This means that some but not all exchange visitors must return for two years to their home countries after conclusion of the exchange program. ‘This requirement must be fulfilled ‘or waived before the alien can reside in the US. As a permanent resident or as a temporary worker under an H-1B or L-1 visa ‘Additional restrictions are placed on J-1 visitors who receive “graduate medical education or training” (i.e. residency or fellowships in patient care services) in their exchange program. All foreign physicians who wish to participate in a program of graduate medical education or training must first be sponsored by the Educational Commission of Foreign Medical Graduates (ECFMG) must pass the Visa ‘Qualifying Examination (VQE) the Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) or parts Land Il ‘of the NBME and must commit to returning to the home country ‘upon completion of the program. Not included in the definition of “graduate medical education or training” are exchange programs involving teaching research observation consultation or incidental patient care. Physicians participation in such programs are not subject to the additional restrictions noted above and may have greater flexibility in receiving a waiver of any two-year foreign residence requirement which ‘may apply to their program.

CONCLUSION

Graduates of foreign medical schools may find opportunities in the U.S. for education training or practice. To take advantage of such opportunities the alien must comply with an apparent welt of rules and regulations. With careful attention to the details how ever the foreign medical graduate should be able to satisfy the requirements and attain his or here goal of studying training or working in the U.S. ‘This article is provided as a general introduction to immigration issues affection foreign physicians No general solution to specific problems is intended. The reader is advised to seek competent assistance and not to attempt to solve individual problems based on the information presented here.

Article extracted from this publication >> January 24, 1992