For physicians who have accepted residency/fellowship positions in the USA, the H1B is the best visa option for you. Unlike the J1 visa, the H1B visa does not have a two-year home residency requirement, and hence a J1 waiver is not needed to remain in the USA following completion of training. Moreover, H1B visa holders may utilize H1B visa transfer processing to switch from one residency/fellowship program to the other without the need to obtain ECFMG approval.

Frequently Asked Questions about the H-1B Visa Category for Medical Residents and Fellows

1. Is the H1B visa an option for all medical residents and fellows?

2. What are the requirements for H1B visa issuance?

3. What is involved in H1B sponsorship? Do all residency/fellowship programs participate?

4. What is the time frame for H-1B visa applications?

5. What is the validity period for an H-1B visa?

6. What documents are required from me to apply for H1B visa?

7. What about my spouse? Does she need to apply for H4 visa?

8. What about the H1B visa cap? Does it affect me?

9. I just obtained a residency/fellowship offer. What do I do next?

FREQUENTLY ASKED QUESTIONS:

1. Is the H1B visa an option for all medical residents and fellows?

YES. Courts and the US Immigration Service have previously determined that medical fellowship and residencies qualify as 'specialty occupations' (i.e. those occupations requiring at least a four year degree as a minimum requirement for the position'

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2. What are the requirements for H1B visa issuance?

• Fellowship or Medical Residency offer, and willingness by the sponsoring employer to sign the necessary paperwork for H1B visa application; and
• Graduation from medical school;
• ECFMG certification;
• Passage of USMLE Steps I,II,III (*) or FLEX Parts 1 and 2; and
• State Medical License or other authorization to practice medicine in the State of intended employment (if such license/authorization is required by the State) **

* Yes, it is possible to apply for H1B visa with passage of only Steps I and II. However, it is our experience that the US Immigration Service will issue a request for evidence of Step III passage about 90% of the time prior to visa approval. While, yes, we have had some clients obtain H1B approval without Step III approval, but they have been the exception to the rule.

** Most States require medical residents to have State Medical Licenses to practice medicine. However, some States such as New York do not require medical residents/fellows to hold State licenses. Other States, such as Connecticut, require that the employer obtain permits to practice for medical residents for at least the first two years of medical training.

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3. What is involved in H1B sponsorship? Do all residency/fellowship programs participate?

From the employer side, H1B sponsorship is quite straightforward. They simply sign sponsorship paperwork and post a Dept. of Labor form which verifies that the wage offered to the foreign medical resident is at least 95% of the prevailing wage for the employer.

Most residency/fellowship programs agree to H1B sponsorship. Contact our offices with questions concerning any particular program's sponsorship.

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4. What is the time frame for H-1B visa applications?

We recommend that all medical residents/fellows utilize premium processing for H1B visa applications, which guarantees a response from the US Immigration Service within 15 business days. Otherwise, an application filed under regular processing could require up to five months for approval. Moreover, we have found that US Immigration Officers at the premium processing center are much more knowledgeable about medical residencies/fellowships and are more likely to issue the H1B visa for the initial maximum validity period of three years.

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5. What is the validity period of an H-1B visa?

H-1B visas are granted initially for up to three years, and are renewable for another three-years. With some exceptions, H-1B visas are limited to six-years in duration.

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6. What documents are required from me to apply for H1B visa?

To obtain an H1B visa, the basic list of documents required from you is listed below, and organized according to your present visa situation:

(1) IF YOU INTEND ON RETURNING TO YOUR HOME COUNTRY AND OBTAINING VISA ISSUANCE AT YOUR HOME COUNTRY EMBASSY PRIOR TO YOUR RESIDENCY START DATE --

• Copy of medical school diploma and course list/transcript;
  
  
• Copy of ECFMG certificate;
  
  
• Copy of USMLE Steps I,II,III pass results letters or FLEX Parts 1 and 2 pass results letters (if you do not have USMLE Step 3, please advise us when the results will be available, and forward the results to us as soon as you can);
  
  
• Copy of valid passport (all pages);Copy of residency/fellowship offer letter or contract;
  
  
• Evidence of State Medical License/permit (when required) - if you do not yet have a State Medical License/permit, be sure to take the necessary steps to apply for the necessary license/permit, and advise us once such permit will be ready;

(2) F1 VISA HOLDERS - IF YOU ARE PRESENTLY ON F1 VISA STATUS (OR F1 PRACTICAL TRAINING STATUS) AND YOU WISH TO CHANGE YOUR STATUS FROM F TO H1B VISA IN THE USA:

• Copy of medical school diploma and course list/transcript;
  
  
• Copy of ECFMG certificate;
  
  
• Copy of USMLE Steps I,II,III pass results letters or FLEX Parts 1 and 2 pass results letters (if you do not have USMLE Step 3, please advise us when the results will be available, and forward the results to us as soon as you can);
  
  
• Copy of valid passport (all pages), I-94 card, Forms I-20, and employment authorization card (if on F1 Practical Training Status);
  
  
• Copy of residency/fellowship offer letter or contract;
  
  
• Evidence of State Medical License/permit (when required) - if you do not yet have a State Medical License/permit, be sure to take the necessary steps to apply for the necessary license/permit, and advise us once such permit will be ready;
  
  
• Evidence that you are maintaining your F1 visa status (i.e. a letter from the institution confirming your enrollment; course schedule) - for individuals on F1 practical training status, a copy of your latest pay stub will often suffice

(3) B VISA HOLDERS -- IF YOU ARE PRESENTLY ON B1/B2 VISITOR VISA STATUS AND YOU WISH TO CHANGE YOUR STATUS FROM F TO H1B VISA IN THE USA:

• Copy of medical school diploma and course list/transcript;
  
  
• Copy of ECFMG certificate;
  
  
• Copy of USMLE Steps I,II,III pass results letters or FLEX Parts 1 and 2 pass results letters (if you do not have USMLE Step 3, please advise us when the results will be available, and forward the results to us as soon as you can);
  
  
• Copy of valid passport (all pages), I-94 card, I-797 B visa approval notice (only if granted extension or change of status to B visa)
• Copy of residency/fellowship offer letter or contract;
  
  
• Evidence of State Medical License/permit (when required) - if you do not yet have a State Medical License/permit, be sure to take the necessary steps to apply for the necessary license/permit, and advise us once such permit will be ready;

(4) H1B VISA HOLDERS -- IF YOU ARE PRESENTLY ON H1B VISA STATUS AND YOU WISH TO CHANGE YOUR EMPLOYER AND EXTEND YOUR STAY ON H1B VISA STATUS:

• Copy of medical school diploma and course list/transcript;
  
  
• Copy of ECFMG certificate;
  
  
• Copy of USMLE Steps I,II,III pass results letters or FLEX Parts 1 and 2 pass results letters (if you do not have USMLE Step 3, please advise us when the results will be available, and forward the results to us as soon as you can);
  
  
• Copy of valid passport (all pages), I-94 card, I-797 H visa approval notice(s);
  
  
• Copy of residency/fellowship offer letter or contract;
  
  
• Evidence of State Medical License/permit (when required) - if you do not yet have a State Medical License/permit, be sure to take the necessary steps to apply for the necessary license/permit, and advise us once such permit will be ready;
  
  
• Copy of recent pay stub as evidence that you are presently employed (i.e. maintaining your H visa status)

(5) H4 VISA HOLDERS -- IF YOU ARE PRESENTLY ON H4 VISA STATUS AND YOU WISH TO CHANGE YOUR STATUS TO H1B VISA:

• Copy of medical school diploma and course list/transcript;
  
  
• Copy of ECFMG certificate;
  
  
• Copy of USMLE Steps I,II,III pass results letters or FLEX Parts 1 and 2 pass results letters (if you do not have USMLE Step 3, please advise us when the results will be available, and forward the results to us as soon as you can);
  
  
• Copy of valid passport (all pages), I-94 card, I-797 H4 visa approval notice (if any);
  
  
• Copy of spouse's passport, I-94 card, I-797 H1B visa approval notice, and recent pay stub as evidence of your spouse's maintenance of status;
  
  
• Copy of Marriage Certificate;
  
  
• Copy of residency/fellowship offer letter or contract;
  
  
• Evidence of State Medical License/permit (when required) - if you do not yet have a State Medical License/permit, be sure to take the necessary steps to apply for the necessary license/permit, and advise us once such permit will be ready;

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7. What about my spouse? Does she need to apply for H4 visa?

If you are married, and your spouse desires to obtain a dependent visa, she will need to apply for H4 visa.

H4 visa can be obtained via two methods:

(a) through application at a US EMBASSY/CONSULATE abroad - this application is usually submitted along with the H1B visa issuance application of the medical resident/fellow; or

(b) through application to the US Immigration Service, along with the application for H1B visa for the medical resident/fellow.

Be sure to advise us if you are married, and if your spouse requires H4 visa. If so, we would ask that you also send us the following documents:

• Copy of your spouse's passport and I-94 card;
• Copy of your marriage certificate;
• Form I-539 signed/dated; and
• Form G-28 signed/dated.

Please contact us with respect to the Forms, and we will forward them to you promptly.

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8. What about the H1B visa cap? Does it apply to me?

Under current law, the great majority of medical training programs are QUALIFYING INSTITUTIONS and thus you would be EXEMPT from the cap. QUALIFYING institutions include those which are non-profit institutions affiliated with institutions of higher educations, institutions of higher education, and nonprofit governmental research organizations (please refer to our section on H visas for further information about cap issues).

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9. I just obtained a residency/fellowship offer. What do I do next?

Gather the documents noted above, and call us to discuss how our law firm can assist you with the application process.

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