J-1 visa for physicians (ECFMG sponsorship)

The J-1 is a temporary nonimmigrant visa for participants in the US Department of State's Exchange Visitor Program. For doctors, the relevant category is the physician category for clinical training. Intealth, operating as ECFMG, says it serves as the exclusive visa sponsor for J-1 physicians in clinical training programmes at US teaching hospitals accredited by the ACGME, through its Exchange Visitor Sponsorship Program (EVSP).

ECFMG does not issue visas. It decides whether you are eligible for sponsorship and issues Form DS-2019, which you use to apply for the J-1 at a US embassy or consulate, or to change status inside the US.

International medical graduates who have matched to a US residency or fellowship that sponsors J-1s need it. ECFMG's reference guide says applicants must:

• hold a valid ECFMG certificate
• hold a signed contract or official offer for an approved clinical training programme
• provide a Statement of Need from the Ministry of Health of their country of citizenship or most recent legal permanent residence, confirming the country needs specialists in that field and that the doctor will return

Most residents reach this stage through the Match after passing USMLE Step 1 and Step 2 CK.

1. Obtain ECFMG certification and a training contract.
2. Request the Statement of Need from your Ministry of Health.
3. Apply to ECFMG for sponsorship; the hospital confirms contract details online.
4. Receive the DS-2019 and pay the SEVIS fee, which ECFMG lists as $220 for initial applicants.
5. Apply for the J-1 at a US consulate, then enter the US.

ECFMG says sponsorship lasts for the time typically required to complete the programme, as defined by the ACGME or specialty boards, and federal regulations limit it to a maximum of 7 years. A specialty change is allowed once, within the first 2 years.

All J-1 physicians sponsored for clinical training, and their J-2 dependants, are subject to the two-year home-country physical presence requirement in section 212(e) of the Immigration and Nationality Act. ECFMG says they must return to their country of most recent legal permanent residence for a total of at least 2 years before they can get certain other US statuses, such as H-1B or a green card, unless they receive a waiver such as a Conrad 30 waiver. Federal rules also set minimum health insurance cover for J-1s and dependants: ECFMG lists medical benefits of at least $100,000 per accident or illness, a deductible of no more than $500, co-insurance of no more than 25%, and cover for medical evacuation and repatriation.

• Statement of Need delays from the Ministry of Health. ECFMG says the issuing country cannot be changed once sponsored.
• Assuming you can stay after training. The two-year rule applies unless waived.
• Moonlighting. Additional work is restricted and needs approval.

See our USMLE guide and ECFMG page.