International Student Guide to Matching

by Jin Soon Yeoh, MSIV

If you are reading this, congratulations on making it this far! It is stressful enough applying for residency without having to think about visa requirements. This guide is written specifically to steer you in the correct direction and in doing so hopefully secure you the residency of your choice.

Before we begin, here are 3 important rules you should know:

1. Being an international student should not prevent you from matching into a residency program
2. You are an American Medical Graduate (AMG), not an International Medical Graduate (IMG)
3. A J-1 visa is not that much easier to obtain than an H-1B visa

Step 1: Choose your visa

You need to decide whether you plan to remain in this country or plan to return to your home country once residency is completed. This decision will determine your visa of choice. Many institutions are amenable to the more restrictive J-1 visa (sponsored by ECFMG not your program) which requires you to return to your home country after residency versus the more flexible H1-B visa. This is mainly because of the difficulties posed by administrative issues encountered in obtaining an H1-B workers visa due to immigration policies outlined by the United States Customs and Immigration Services (USCIS).The more obvious reason is that many departments simply do not have much experience in dealing with the USCIS and due to many important time-sensitive issues regarding visas, they find the process an unjustified strain on their resources.

Step 2: Select your program

If you decide on the H1-B visa, it is your job as an international student to find out which programs sponsor it. Make sure you emphasize that you are an American Medical Graduate on F-1 status and not an International Medical Graduate. Also, remind them that you will have a year of Optional Practical Training (OPT – more on this later) before they have to apply for your visa. This may pacify some programs and help them rethink their strict policies.
One common issue I recognized during my application process was that many schools would not provide me with a straight answer regarding their sponsorship of a particular visa. Do not fret! You should still apply to that program if you are determined to match there. However, it is vital that you continue to bring the subject up with the Program Director either through email or during your interview.

Step 3: Follow-up with your application

Another issue I encountered during my application process was that many schools would not even review your application if they think that you are an IMG. This problem stems from your ERAS application in which you are required to declare your citizenship and your visa of choice. Many schools make the clerical error of lumping you with IMGs without further consulting your application. If this happens, they would simply set your application aside without ever informing you. By following-up, you not only reconfirm your status as an AMG, you would also be showing significant interest toward that program.

Step 4: Interviewing

The interview process is where you can truly shine. Your immigration status more often than not serves as a good conversation point. Most programs recognize your unique background (if you have one) and will quiz you about it. Another important question you should be prepared for regarding your immigration status is whether your training will be interrupted by all the bureaucracy. As most programs are clueless when it comes to immigration, make sure you articulate clearly your plan in securing your status. Below is my standard answer to this question:
“I believe your program sponsors the H1-B and/or the J-1 visa. As I am an F-1 student, I will not require either visa immediately as I will have my Optional Practical Training visa which is valid for a year. This will give your program time to apply for my H1-B or J-1 visa later and therefore, will not jeopardize my internship start date. I will need to apply for my H1-B or J-1 visa in November of (the same year you start residency as it takes up to six months to obtain your H1-B visa). I will make the necessary provisions for obtaining that visa when the time arrives.”

Step 5: Changing their minds

During your interviews, if you find yourself face-to-face with a program which is resistant to sponsoring the H1-B visa, you may still persuade them into changing their tune with some compelling arguments. Here are the 3 reasons (for the program director not for you) for getting an H1-B visa over a J-1 visa:

1. They get to keep you on staff if they like you at the end of residency
2. It's easier to place you in a fellowship on an H1 than a J1 visa
3. Now with no cap for academic institutions, there is a low likelihood of your application getting rejected.

Additionally, you can also inform them that you are wiling to pay for all the legal fees necessary in obtaining the H-1B visa.

Step 6: Now what?

You need to get your OPT before you match as it can take up to 120 days for your OPT to be approved. The Office of International Exchange Services (OIES) will generally have contacted you by the end of January regarding the OPT. If not, all you have to do is contact the OIES and ask to speak with Eugenia Kim who will provide you with all the details on the application process. You can also visit www.uscis.gov for the most up-to-date requirements for your application. The OIES is your greatest resource and they will have everything lined up for you prior to sending out your paperwork.

After you match, you will need to apply for either your H1-B workers visa or your J-1 exchange workers visa sometime in November of your internship. This is necessary as it can take up to six months for your application to be processed. Contact the Graduate Medical Education office where you matched to get more information.

 

Relevant Information

What is an OPT?

The OPT is a form which enables you to obtain an Employment Authorization Document (EAD). Essentially, it is an extension of your existing I-20 (expires when you graduate), which together with your F-1 visa (which usually expires one year after graduation – for OPT purposes) and the EAD card (issued after you apply to USCIS), allows you to remain legally in this country for one calendar year beyond graduation. The OPT is a necessary devil as without it you cannot start your intern year.

What is the difference between the J-1 and the H1-B visa?

This is a tough question that I will try to answer to the best of my knowledge.

The J-1 visa is sponsored by the ECFMG and is designed for visiting professors, scholars, and professionals. The length of the visa is 5-years with a possible 2-year extension. Upon completion of your program, you must leave the United States and return to your home country for a period of 2 years before you can apply for readmission. This is an extremely strict requirement of the J-1 visa and most people are forced to comply. There is, however, one way around this rule; by applying for a J-1 waiver. This usually requires that you spend the next few years working in an underserved community in the United States. The waiver programs are rare and difficult to obtain so think carefully before you decide on the J-1 visa. Also, there is no cap on the J-1 visa. In other words, unlimited J-1 visas can be issued.

The H1-B visa is a more flexible workers visa. Unlike the J-1 visa, you are not required to return to your home country after you complete your residency. This leaves room for you to apply for a green card if you so choose. The H1-B visa is also subject to greater scrutiny than the J-1 visa. Your application must be approved by both USCIS and the Department of Labor before you are issued the visa. It can take up to 6 months for this process to happen. In addition, the H1-B visa has a 65,000 limit each year. You are exempt from this cap if you are hired by either an institution of higher education or a non-profit organization.
My advice: Apply for the H1-B visa.

How do I apply for an H1-B visa?  

The process of applying for an H1-B visa can be an expensive and time-consuming process. The consensus is that the application fees can cost you from $2000 to $8000.

The visa alone costs $1,130 and legal fees will make up the rest. It is highly recommended that you get an immigration lawyer who is familiar with the complicated application process. Once you match, I suggest you seek out a lawyer immediately in the state you will be practicing in order to initiate your application process. For a better understanding, check out the following website: http://www.visalaw.com/02dec1/H1B.pdf.

Remember these numbers and steps as you may be questioned about it during your interview. Knowledge of the process indicates your preparedness and keenness to go the extra mile.

This is a list of programs that sponsor the H1-B visa from personal experience and from others in your shoes: (this list is not comprehensive and is subject to change depending on the program to which you apply. Make sure you inquire before passing judgment)

Brigham's Boston University Brown Cleveland Clinic Columbia Jefferson Johns Hopkins MGH

SUNY Buffalo SUNY Downstate SUNY Upstate Temple University of Miami University of Pennsylvania Wayne State University

This is a list of programs that sponsor the J-1 visa:

Cornell Dartmouth Duke Loma Linda Mayo Mt Sinai NYU Stanford UCLA

UCSD UCSF University of Florida University of Michigan University of Pittsburgh University of Washington Vanderbilt Washington University in Saint Louis Yale

Important Websites and Numbers

Jefferson Office of International Exchange Services (OIES)
(215)503-4335
http://jefferson.edu/oies

United States Customs and Immigration Services
http://uscis.gov

Bureau of Consular Affairs
http://travel.state.gov/visa/temp/types/types_1267.html

Final Thoughts

It is important to realize that being an F-1 student will not reduce your matching chances nor will it make you a less desirable candidate. Although the residency matching process becomes slightly more complicated, with careful planning, there is no reason for you to not match successfully. There should be no surprises come match day as long as you keep good contact with the programs in which you are interested. I cannot stress this point enough. It is also important to realize that most programs will judge you based on your achievements and not your immigration status. The few that will not are probably not worth your time anyway. Finally, get all your proper documentation together and in a timely manner to avoid any unwarranted delays. Once again, congratulations on getting this far and good luck on matching!

I am also an avid DVD collector. Any contributions will only improve your karma come match day. If you need additional information, do not hesitate to contact me at jinsoon.yeoh@gmail.com.

Revised: 2/07