http://www.shusterman.com This presentation discusses how international clinicians can get visa train in the US. Schedule a legal consultation (by Skype, telephone or in person) at http://shusterman.com/schedule-immigration-consultation.html He discusses the visa options for foreign-trained doctors who wish to practice medicine in the US. The 2 most common options are: 1) J Visas - Once an IMG has passed USMLE, Parts I and II, and matches with a medical residency program, he obtains a DS-2019 form from the Educational Commission for Foreign Medical Graduates (ECFMG) and either changes his status to J-1 in the US or goes abroad to get a J-1 visa. This subjects him to the 2-year home residency requirement. 2) H-1B Visa - Physicians who have passed all 3 parts of the USMLE and have matched with an employer who agrees to sponsor them for an H-1B visa may do so to avoid having to apply for a J waiver down the road. Most residency programs are "cap-exempt" so the physician does not have to worry about the numerical caps on H-1B petitions. These days, over 80% of IMGs and Canadian physicians use J visas to do their medical residencies and fellowships. This is because many training programs do not sponsor physicians for H-1B visas. Also, since H-1B residents/fellows are limited to 6 years of training, getting a J visa is often a more practical alternative. Our law firm has helped thousands of International Medical Graduates (IMGs) obtain J and H-1B visas as well as J waivers and permanent residence in the US over the past 30 years. See our Physicians Immigration Guide at http://shusterman.com/physiciansusimmigration.html

1. International Clinicians/IMGs
Keys to Immigration
Presented by: Immigration Attorney Carl Shusterman to
AMN Workforce Summit November 7-8, 2013

2. Courtesy of the
Law Offices of Carl
Shusterman
Internationally Born Medical Graduates
An Essential Resource:
IMGs make up 25% of the physician workforce
(includes US IMGs)
Are most represented in
Nephrology 45%
Internal Medicine 37%
Psychiatry 32%
Oncology 30%
Pulmonology 30%
Anesthesiology 28%
Pediatrics 28%
Gastroenterology 28%
Source: AMA Physician Master File

3. Courtesy of the
Law Offices of Carl
Shusterman
IMGs by Country (Top Ten)
Country Percent Total
India 20% 47,581
Philippines 8.7% 20,861
Mexico 5.8% 19,929
Pakistan 4.8% 11,330
Dominican Republic 3.3% 7,892
Former USSR 2.5% 6,039
Grenada 2.4% 5,708
Egypt 2.2% 5,202
South Korea 2.1% 4,982
Italy 2.1% 4,978
Source: AMA Physician Master File
IMGs in U.S. come from 127 countries

4. Courtesy of the
Law Offices of Carl
Shusterman
IMGs Heaviest Concentration by State as a
Percent of All Active Physicians
1. New Jersey 39%
2. New York 38%
3. Florida 35%
4. Illinois 33%
15. Texas 25%
All United States 25%
Source: AMA Physician Master File

5. Courtesy of the
Law Offices of Carl
Shusterman
IMGs: Number of Potential Candidates
Coming Out of Residencies
 Total graduating residents per year: 25,000
 Number of IMGs: approximately 7,000

6. Courtesy of the
Law Offices of Carl
Shusterman
Visa Options For Residents & Fellows
 J Status (training visa)
 H-1B Status (employment visa)
 Permanent Residence and
Other Options

7. Courtesy of the
Law Offices of Carl
Shusterman
Consequences of J Status for IMGs
 2-Year Home Residency
Requirement
 Must return to Country of
Nationality or Last
Residence for 2 years before
obtaining H or L visa or
Green Card

8. Courtesy of the
Law Offices of Carl
Shusterman
How to Obtain a J Waiver
 Persecution
 Exceptional Hardship
To USC/LPR Spouse
To USC/LPR Child (under
21 & unmarried)
 Interested
Governmental Agency
(IGA)

9. Courtesy of the
Law Offices of Carl
Shusterman
J Waivers: Interested
Governmental Agencies
 Federal Agencies
ARC
VA
HHS
DRA
 Conrad State
Programs

10. Courtesy of the
Law Offices of Carl
Shusterman
Conrad 30
 Primary care and/or specialists
 All 50 states participate
 Some have 10 “flex” spots – the physician does
not have to practice in an underserved area, as
long as he/she sees patients from underserved
areas
 Some states run out of spots, some do not
 Check with Mr. Shusterman’s office

11. Courtesy of the
Law Offices of Carl
Shusterman
Medical Residency/Fellowship
on H-1B Status
 Passage of USMLE, Parts I, II & III
 Acceptance to Residency Program
 H-1B Petition

12. Courtesy of the
Law Offices of Carl
Shusterman
H+1B Visa
 No 2-year rule; doctor
does not have to
practice in an
underserved area

13. Courtesy of the
Law Offices of Carl
Shusterman
But there is a cap!
 85,000 H+1Bs per year
 April 1st is filing date
 Physicians who receive J waivers are exempt
from cap
 So are doctors who work at academic
institutions, government or non-profit research
institutes

14. Courtesy of the
Law Offices of Carl
Shusterman
Permanent Residence
Employment Options
 PERM
 National Interest
Waiver
 The Law (1999)
 The Regulations (2000)
 The Lawsuit (2005)

15. Courtesy of the
Law Offices of Carl
Shusterman
What about Canadian Physicians?
 They are not considered IMGs
 LMCC accepted in almost all states for licensure
 Can qualify for H-1B if they have a U.S. exam
(USMLE, FLEX, NBME)
 But don’t need a U.S. exam for a green card

16. Courtesy of the
Law Offices of Carl
Shusterman
Immigration Reform Bill in Congress
 Would make the Conrad 30 program permanent
 Would make J status “dual intent”
 Would exempt spouse/children from 2-year rule
 Would make it easier for H-1B MDs to change jobs
 Would eliminate per-country quotas
 Would provide a faster route for green cards to
physicians and their families

17. Courtesy of the
Law Offices of Carl
Shusterman
 We Link to
 Governmental Sites
 Conrad 30 Programs
 HPSA/MUA List
 ECFMG/USMLE
 Job Opportunities
Finding IMG Resources Online
http://shusterman.com

18. Courtesy of the
Law Offices of Carl
Shusterman
How to Keep Current
 Physicians
 Immigration Guide
 Social Media
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