Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
ECFMG 101:Managing IMG Recruitment
Eleanor Fitzpatrick, ECFMG 2011 APPD Fall Meeting
Arlington, Virginia
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Learning Objectives
Review what you need to know when recruiting IMGs and foreign national physicians:
I. The Non-negotiables: ECFMG Certification Legal immigration status to train J-1 regulations and ECFMG process
II. Other Challenges, Benefits, and Global Opportunities
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Applicant Pool for Pediatrics
U.S. Grads (MDs & DOs) = Diploma + USMLE and/or COMLEX U.S. Citizens, Canadians*, Other Foreign Nationals*
Canadian Grads = Diploma + MCEE and/or USMLE Canadian Citizens*, U.S. Citizens, Other Foreign Nationals*
International Medical Graduates (IMGs) = ECFMG Certificate U.S. Citizens, Canadian Citizens*, Other Foreign Nationals*
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Typical Pathway into U.S. GME
1. Medical School Graduation Complete ECFMG Certification, if IMG
2. Apply for U.S. Residency Training Position Apply via ERAS Interview with programs Enroll in the NRMP Match Secure a contract / letter of offer Obtain the appropriate visa / visa status, if foreign national
physician
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
ECFMG Certification
All international medical graduates (IMGs) who receive a basic medical degree from a medical school outside of the United States or Canada must be ECFMG certified to enter U.S. GME.
IMGs can apply and “Match” to a GME program with passing scores on USMLE Step 1, Step 2CK, Step 2CS
To begin GME, the final diploma & transcripts must be primary source verified and the ECFMG certificate must be issued
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
ECFMG Certification Requirementshttp://www.ecfmg.org/cert/index.html
Medical Education Credentials Complete 4-year medical school curriculum School & graduation year listed in “IMED” http://IMED.ecfmg.org
*By 2023 medical school must be accredited ECFMG primary source verifies final diploma & transcripts
USMLE Exams Step 1 Basic Science Step 2 Clinical Knowledge (CK) Step 2 Clinical Skills (CS)
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Legal Immigration Status
All foreign national physicians must obtain an appropriate U.S. training visa / visa status before they are permitted to begin GME training
“Visa” – entry document stamped in passport
“Visa Status” – reflects the approved activity associated with each visa type and the length of authorized stay in the United States
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Visa - Permit to Enter United States
Issued by U.S. Consulate abroad and stamped in passport
Expiration date applies to use for U.S. entry only
Can expire once in the United States
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Visa Status - Approved Activity
• Issued by Customs & Border Patrol at U.S. port-of-entry (I-94 card), or
• Regional Service Center of U. S. Citizen and Immigration Services (USCIS) as Change of Status (I-539)
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Most Common Visas for U.S. GME
J-1 “Alien Physician” ECFMG sponsored USMLE Steps 1, 2CK, 2CS, 2 yr home physical presence requirement,
SEVIS tracking, 7 yr max
H-1B “Specialty Worker” Employer sponsored USMLE Steps 1, 2CK, 2CS, 3, fees, no service obligation, 6 yr max
J-2 “Dependent” Employment Authorization Document (EAD) Spouse of J-1 visa holder, tied to timeline of J-1 principle
F-1 “Student” Optional Practical Training (OPT) One year extension only sponsored by U.S. Medical School
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
J-1 Requires Home Country Support
J-1 Statement of Need - Central Ministry of HealthThere currently exists in (country) a need for qualified medical practitioners in the specialty and/or subspecialty of Pediatrics.
Dr. (Applicant) has filed a written assurance with the government of this country that he will return to his/her country upon completion of training in the U.S. and intends to enter the practice of medicine in the specialty/subspecialty being sought.
MUST FOLLOW REGULATORY LANGUAGE
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
J-1 Imposes Two-Year Home Residency Requirement INA §212(e)
All J-1 physicians (and J-2 dependents) are obligated to reside in the home country for at least two years before being eligible for certain changes or adjustments in U.S. visa status (H, L, K, or green card)
J-1 /J-2 physician couples hold one obligation which must be fulfilled by the J-1 principle
Marriage to a U.S. Citizen does not waive the obligation
J-1 waivers are available through state and federal programs; most common are Conrad 30 employment in MUAs/HPSAs or VA
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved. 13
J-1 Researchers & GME Positions
Foreign national physicians often enter the United States initially as J-1 “research scholars” to gain experience and take the USMLEs
If a clinical GME position is secured, they have to work with ECFMG to request a Change of Category from J-1 research to J-1 clinical through the U.S. Department of State
In some cases they may be H-1B eligible
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
J-1 Change of Specialty / Repeat Years
J-1 physicians are permitted to change medical specialties only once within their first two years in J-1 status
J-1 may repeat up to twelve months of GME training for remedial purposed
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
J-1 Sponsorship Applications
J-1 physician + GME program (Training Program Liaison / TPL)
4 - 6 weeks to review applications ECFMG Regional Advisor evaluates for eligibility If approved, SEVIS Record is created and updated ECFMG issues Form DS-2019
ECFMG notifies applicant via e-mail, providesinstructions for obtaining J-1 visa status
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
J-1s Tracked in SEVISStudent and Exchange Visitor Information System
Data exchange between DHS / DOS Immigration tracking of the activities of non-immigrant (J, F & M)
visa holders and dependents
Accessed by consulates, embassies, ports-of-entry, and other DHS agencies
ECFMG creates and updates SEVIS records for all J-1 physicians and J-2 dependents
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Form DS-2019
• ECFMG-issued “Certificate of Eligibility for Exchange Visitor (J-1) Status”
• Legal document needed to apply for J visa/visa status
• Reflects electronic record
• SEVID ID (N000######) assigned to all J-1s and J-2s
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Applying for Initial Visa Status
Option 1: Apply at US Embassy or Consulate abroad
Option 2: Apply for Change of Visa Statuswithin the U.S. (I-539 process USCIS Regional Service Center)https://egov.uscis.gov/cris/processTimesDisplayInit.do
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Initial Arrival in J-1 Visa Status
J-1 Physicians May enter United States 30 days prior to training start
date listed on contract and SEVIS DS-2019
Program must confirm physician’s arrival in J-1 status to ECFMG within 30 days of SEVIS start date or record will deactivate
ECFMG in turn validates the SEVIS record
Application for Social Security Number requires SEVIS validation plus 10 days from date of U.S. entry
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Maintaining J-1 Visa Status
Continued full-time participation in GME Contract to progress in training Timely renewal of ECFMG J-1visa sponsorship
Required reporting of any change in approved training plan Remediation, leave of absence, off-site rotations, transfer
request, change in contract dates, resignation or termination, etc.
J-1s do not need to renew visa stamp annually
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
EVNetOn-Line J-1 Sponsorship Application
Will replace sponsorship application forms TPLs will use on-line application to submit:
Contract details Requests & notifications re: leaves of absence, travel validations,
request to add non-standard & research programs, etc. View reports on currently sponsored J-1 physicians by program,
sponsorship expiration dates, etc. Applicant physicians will be able to submit on-line information
Biographic information & provide supporting documents
Stay Tuned for Dates & Details on System Roll-out
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Issues & Opportunities
IMGs & Foreign National Physicians in GME
Communication: language, accents, idioms, ideas Behavior: learning styles, supervisory roles, gender issues Professionalism: interpersonal skills, patient care, team Personal needs: support, family, religion etc. Diverse / Global Perspective: opportunities, leadership
Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.
Questions?
[email protected] (215) 823-2127