Applicants must have an appropriate visa to begin Graduate Medical Education with the Medical College of Wisconsin Affiliated Hospitals. If a candidate does not obtain an appropriate visa that permits MCWAH to employ him/her on the designated start date, the training position will not be held and may be offered to another candidate. We currently accept the visas listed below. (Revised 2/26/14)
To be appropriate for GME, this visa must be sponsored by Educational Commission for Foreign Medical Graduates (ECFMG). A J-1 visa sponsored by a medical school is very easy to obtain, but it cannot be used for GME. It is appropriate only for research. IMGs who have participated in the Exchange Visitor Program as a researcher during the twelve-month period preceding the proposed commencement of a program of graduate medical education are ineligible for sponsorship. It is very difficult to convert J-1 sponsorship from a school to ECFMG. ECFMG states explicitly that:
“Exchange Visitors who are designated as Research Scholars when they enter the United States may not as a matter of course transfer to programs of graduate medical education. Requests for such transfers shall be denied by the Department of State unless very unusual or extenuating circumstances exist.”
To obtain ECFMG sponsorship, foreign nationals must:
- have passed Part I and Part II of the National Boards or Step 1 and Step 2 of USMLE, and pass the Clinical Skills Assessment (CSA)
- hold a valid ECFMG Certificate; and
- have written assurance from the home country Ministry of Health or equivalent agency stating that there is a need for persons with the skills the physician will acquire and that the physician will return home upon completion of the training.
ECFMG will not sponsor an individual for longer than seven years. J visa holders are not permitted to moonlight (internal or external). They cannot participate in any activities outside the approved training program nor are they eligible to receive any monies that are not part of the approved training program stipend. While ECFMG has no way of monitoring a J-1’s earnings, ECFMG has in the past been questioned by the U.S. Government on Exchange Visitors whose W-2s confirm earnings that are not consistent with trends seen for training stipends across the U.S.
Applicants seeking H-1B status for GME must have (1) a state medical license, or be exempt from a license under state law; (2) have passed FLEX Parts I and II, NBME Parts, I, II, and III or USMLE Parts I, II and III; (3) graduated from a U.S. or foreign medical school or hold a foreign medical license; and (4) demonstrate proficiency in written and oral English. Typically, this is shown by holding an ECFMG Certificate. Proof of English proficiency is not required if the individual graduated from a U.S. medical school or LCME accredited school from any location. Passage of the Canadian MCCQE/LMCC exams does not prevent the individual from having to have passed all steps of either FLEX, NBME or USMLE. Accumulating passing scores of various components of the three exams is not allowed for H-1B obtainment purposes. In addition to being exempt from the English proficiency proof requirement, individuals who have graduated from an accredited U.S. medical school are also exempt from having to prove passage of all steps of either FLEX, NBME, or USMLE in order to apply for an H-1B. The total amount of continuous time permitted in H-1B classification is 6 years, but only up to 3 years can be requested at a time. Extensions beyond the regular 6 year limit are only available in limited circumstances which will not apply to most MCWAH employees.
MCWAH will not pursue an H-1B visa for an applicant unless he/she has already passed USMLE Step 3 and the Clinical Skills Assessment.
The Department of Labor requires employers to pay all the legal and filing fees for H-1B applicants. The MCWAH Program is responsible for the expense of the H-1B visa.
It is often difficult to estimate the time that the H-1B processing will take. Premium Processing is available, for an additional $1,225. For that fee, the Immigration Service will make a first determination, which may not necessarily be an approval, on an H-1B filing within 15 calendar days. Because Premium Processing is outside the normal cost of obtaining H status for an IMG, the cost must be borne by the IMG or the department; MCWAH will not pay any part of this cost.
Housestaff on an H-1B visa are permitted to do internal and external moonlighting. If they choose to do external moonlighting, they need to pursue an H-1B through that particular sponsor. They may not receive any form of income except directly from MCWAH or from another employer that has obtained H-1B status on their behalf.