What Are the Biggest US Immigration Mistakes Made by Physicians?

The United States is a popular destination for physicians, thanks to its advanced healthcare system as well as an extremely high demand for medical professionals. Despite the shortage of trained and qualified physicians in the country, however, it isn’t easy for foreign medical school graduates to make it through the United States immigration system.

Here are 10 common mistakes made by physicians while immigrating to the U.S., and some tips on avoiding them:

1. Choosing the Wrong Visa – Before you can get a license to practice in the United States, you need to complete training in the country. If you don’t have a license, you will not be approved for a work visa. So, you first need an H-1B or J-1 non-immigrant visa that allows you to train in a residency or fellowship training program.
2. Skipping the USMLE Step 3 – You need to complete all three steps of the United States Medical Licensing Examination before you can qualify for an H-1B visa and work in the country. While you can enter a training program after passing Step 2 of the USMLE, your H-1B visa may be denied because of incomplete credentials.
3. Visitor Visa Overconfidence – To take the Step 2 CS exam, which is only conducted a few times every year, you need to visit the country on a visitor visa before entering with a J-1/H-1B visa. Don’t assume that you will get a visitor visa easily, apply at least 6 months in advance, and take the application process seriously.
4. Delaying Your Job Search – You can qualify for a J-1 waiver if you find employment in a state with a federal program or waiver program with open slots, in an underserved area, and with an employer who has recruited for an opening extensively. If you want to qualify for a J-1 waiver and H-1B visa, start your job search early.
5. Choosing the Wrong Job – If you have been granted a J-1 waiver and H-1B visa, changing employers is difficult and needs to be approved by the U.S. Citizenship and Immigration Services. This can only be done in exceptional circumstances, so be careful while picking an employer and signing a contract for your three-year commitment.
6. Overestimating H-1B Quotas – If you’re training on a J-1 or H-1B visa, you need a J-1 waiver and H-1B visa, or an H-1B change-of-status to work in the U.S., but there is a cap to H-1B visas available. To avoid running out of available slots, look for cap-exempt employers and file your application well in advance.
7. Skipping an Immigration Lawyer – With over 50 federal and Conrad 30 physician waiver programs, going over the rules for each can be difficult. Hire an immigration lawyer to review contracts and positions, to avoid finding that a position doesn’t qualify for a J-1 waiver after going through the interview process and filing for the waiver!
8. Ignoring Alternative Visas – A J-1 home residency requirement bars you from changing to another visa category, getting an H-1B visa, or getting permanent residency. It does not, however, keep you from receiving a nonimmigrant visa without a waiver. You can seek other visa options such as O-1, TN and E-2 by visiting a U.S. Consulate abroad.
9. Wrong Green Card Strategy – Don’t rely on a single green card strategy. Explore the “Physician National Interest Waiver,” available to those agreeing to provide primary care for 5 years in an underserved area, or labor certification for employers unable to hire a qualified U.S. or permanent resident physician to fill a job immediately.
10. Accepting Terrible Jobs – Taking a bad job may seem better than going home for 2 years to complete your home residency requirement. However, the latter will allow you to apply for an unrestricted H-1B visa to work in any position and area. Instead of being restricted to physician shortage areas, you could find a great job just by waiting.