Healthcare Immigration 101 – The Physician Rx
Doctors are in short supply and one one to help supply demand would be to better utilize and understand the ways that international physicians can play in solving this growing disparity. Foreign physicians often come to the United States to obtain premier education and training. At the end of this training (whether for medical school or a Residency or Fellowship program), many physicians would like to find a way to stay in the United States and practice medicine. Still, others received their medical education abroad but would now like to enter the United States to expand their career experiences. All of these follow different paths to obtaining work authorization.
This is often the first experience that a foreign physician or medical student will have with the U.S. immigration system. Technically, the J-1 visa is intended to be an educational exchange program, at the end of which the visa holder is expected to return home to their country of citizenship for at least 2 years before returning to the U.S., if they desire. By definition, this is a non-immigrant visa type, meaning that it is not intended to directly result in a permanent residence process of other immigrant-based visa. However, it is possible that physicians can submit an application to waive this 2 year requirement, something we will discuss at greater length in a future post.
While there are many programs and grounds for eligibility to waive the 2 year home residence requirement, most physicians will utilize the benefit requiring an interested government agency to recommend that the physician’s 2 year required be waived. Although technically inaccurate, many physicians understand that this process is only accomplished through the popular Conrad 30 program. In fact, there are many agencies that could meet this required sponsorship. In any event, the process can be lengthy and expensive and should be discussed as early as possible, with the best results available if this is discussed 9-12 months before the physician will complete his or her Residency or Fellowship program.
Some physicians mistake the J-1 and H-1B programs and being synonymous, but they are, in fact, quite different. While we will discuss some of the knitty gritty details in a future article, suffice it to say for now that an H-1B is a non-immigrant work authorization that must be approved before a physician can start a new job. Depending on the location and structure of the future employer, there are also some limitations regarding when a physician is even eligible to apply for an H-1B. Also, if a physician already has an H-1B, it may be possible to transfer to a new employer with a very simple process called portability. Again, this depends on where the physician is currently working, how long they have already been on H-1B status and how they originally received their approved H-1B. Finally, as a general rule, a physician is eligible for 6 years of H-1B, unless they are far enough down the green card process to allow them to extend their H-1B until the green card process is completed.
The Green Card, more specifically called Legal Permanent Residence, is also a process that many physicians are interested to pursue, but there are certain timing considerations. This is a change to an immigrant process, from the non-immigrant process of H-1B and so must be planned carefully. Some physicians may be eligible to “self-petition” or file their own green card petition, while many are not eligible and must instead work with their employer to sponsor their petition. While this is the final destination of many physicians, it is an expensive path and requires serious timing and planning.
Although we will discuss contract issues in greater detail in a future article, just keep in the back of your mind that when immigration issues are involved in hiring physicians, there are usually certain requirements that the federal and state agencies will want to include or exclude. Let me know if this is something you’re trying to better understand and we can address some of the specific issues that impact your specific contract offer.
Costs and Consults
One thing I am dedicated to providing is transparency and access. To make this a reality, our group is happy to look at your unique immigration situation and potential job placement to map out the steps you need in order to make that happen. We do this as a complimentary consult, free of charge. Once we understand the steps we need to take, we will outline those costs for you. Also, regarding costs, there are some that the employer is required to pay and others that an employee may be asked to pay. We outline these costs and help both the physician and employer make the most informed decision regarding future steps to a successful recruitment and job placement.
o: 385.333.7966 | c: 801.652.2142 | f: 385.200.5454 | i: +91(0)79-6134-4539