Orientation about Visas ??

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Hi,

I'm a British med student and was hoping to avoid visa issues by marrying my (American) boyfriend before applying for residency.

Does anyone have any rough idea (ie months, a year or several years) how far in advance of applying for the match we would need to marry in order for me to be on a green card?? (we'd be living in the UK and I would basically only be entering the US in order to do the residency and then presumably stay afterwards - do you have to have lived in the US for a certain period in order to be green card eligible?).

Also am i correct that if i was able to get the green card this would go some way to reducing the difficulty of matching as a foreign grad (as well as coming from a top UK university)?

Thanks!

Having a green card will certainly help. It takes years to get a GC -- however if you are in the process of applying for a GC you can usually get something called an EAD (Emplyment authorization document) which lets you work wihile the GC is processed.

However: you absolutely, positively, without fail must speak to an immigration lawyer prior to getting married. I cannot stress this enough. The US has a very aggressive process looking for "marriages of convenience". If you get married and trip a warning in this system, you can be deported. This happened to a classmate of mine -- long term BF wasn't a citizen, his parent became severely ill overseas, they got married to "make it easy for him to come back to the US", he left and was prevented from returning for years.

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Thanks for the very helpful advice!

I see we'll need to tread carefully with immigration both in the US and the UK so we'll make sure to find good lawyers sufficiently far in advance (to try and avoid a disastrous situation like that of your classmate). Inter-continental relationships are a huge pain!

It ought not to be a problem as we've been together for many years and will clearly be marrying for love.
 
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aProgDirector
I have two specific queries:
1. As an IMG pursuing Residency training in the US, if I apply for J1 visa, you say that the maximum duration is 7 years. If I want to train in Cardio thoracic surgery, the requirement is 6 years of general surgery and 2 years of cardio thoracic surgery which comes to 8 years. Can I get an extension of just 1 more year to complete the residency?
2. If I apply for Prelim surgery for a year, I presume I will be granted J1 visa for that period. So, once I get a residency training position, then do I apply for only an extension which would mean that I will then have only 6 years to complete my residency or can I freshly apply for a J1 visa which would mean that I still have 7 years to complete my residency?

1. You will need to apply for a J extension. Doing so is very complicated and may fail despite your best efforts. I am not sure on the process or whom gets to make the call.

2. The prelim counts as 1 year on the J. If you continue training after the prelim program, you simply will extend your J visa. The J is attached to you, not the program. So, yes, you will only have 6 years left.
 
So the statistics shown in National Residency Matching report for US gradutes, the applicants include ALL medical gradutes from a US medical school regardless of where you hold citizenship? This means that, in terms of competition for competitive specialty, there's no difference between a Canadian USMG and an US USMG if the Canadian USMG holds a greencard? So the only problem that might lead to a decreased success in residency matching for Canadian USMG is because of the H1B issue?
 
So the statistics shown in National Residency Matching report for US gradutes, the applicants include ALL medical gradutes from a US medical school regardless of where you hold citizenship? This means that, in terms of competition for competitive specialty, there's no difference between a Canadian USMG and an US USMG if the Canadian USMG holds a greencard? So the only problem that might lead to a decreased success in residency matching for Canadian USMG is because of the H1B issue?

Yes to all questions.

NRMP stats are by medical school, no matter what your citizenship is.

I expect that canadian USMG's would do equally well as US USMG's, especially if there was no visa issue.

Could some program out there simply skip over a Canadian USMG? Sure, but I expect that would be rare.
 
aPD, can you please give us some insight about cases where residents want to change their visa from one institution to another? For example, starting a PGY1 on J visa then moving to another institute for an advanced position on H1 visa and vice versa. The same goes for advancing from residency to fellowship.
 
Ive seen a couple people go from H1B -> J1, but not the other way around. I think that when you start a J1 youre stuck to it unless you get a waiver.
 
aPD, can you please give us some insight about cases where residents want to change their visa from one institution to another? For example, starting a PGY1 on J visa then moving to another institute for an advanced position on H1 visa and vice versa. The same goes for advancing from residency to fellowship.

Ive seen a couple people go from H1B -> J1, but not the other way around. I think that when you start a J1 youre stuck to it unless you get a waiver.

You can very easily move from one program to another on a J. You are only allowed to change specialties once, however.

H visas are more complicated. You can ask to have your H visa transferred to a different employer, but it'm more complex than the J.

Switching from a J to an H is "impossible". once on a J, the two year home rule attaches and there is only one way out --> a J waiver job (which actually turns your J into an H). As mentioned, an H->J change is no problem.
 
Thanks. I have another scenario that I would like to ask about. Say someone finished IM residency on J1 or H1 and s/he matched into a fellowship during PGY3 rather than PGY2. What s/he will be doing during the one-year gap between residency and fellowship? Can they work on H1/J1? Will that year be reduced from the total number of years allowed by ECFMG?
 
Another questions: some programs state at their websites that they don't sponsor visas. I was wondering if that technically means the applicant has to be either a citizen or EAD/GC holder and they don't accept any applicant who needs visa?
 
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Thanks. I have another scenario that I would like to ask about. Say someone finished IM residency on J1 or H1 and s/he matched into a fellowship during PGY3 rather than PGY2. What s/he will be doing during the one-year gap between residency and fellowship? Can they work on H1/J1? Will that year be reduced from the total number of years allowed by ECFMG?

If you finish a residency and match into a fellowship with a "gap" year:

J1 Visa -- you cannot work on a J1 visa. Your visa is dependent on you being enrolled as a resident. You MIGHT be able to be hired as a "research fellow" on your J1, but that's about it. You would need to leave the US, and then return one year later. The same 2 year rule attaches, so after you finish your fellowship you would need to return home for a full two years -- the one year in between would not count.

H visa -- it might be possible to transfer your H visa to an employer. For certain it could be transferred to your new program, if they were willing to hire you. Of course, H visas are only good for a total of 6 years, so you might run out of H visa time during your fellowship, and would not have any H visa time left afterwards to get a job (although sometimes the H can be extended further, especiually if you have a permanent job).

Another questions: some programs state at their websites that they don't sponsor visas. I was wondering if that technically means the applicant has to be either a citizen or EAD/GC holder and they don't accept any applicant who needs visa?

If they state they do not accept visas, then yes you would need to be a citizen or GC holder. No visas = No visas. This is not discrimination -- employers are under no requirement to sponsor visas of any kind.
 
If they state they do not accept visas, then yes you would need to be a citizen or GC holder. No visas = No visas. This is not discrimination -- employers are under no requirement to sponsor visas of any kind.

I was under the impression that if a program doesn't sponsor visas, I can still have ECFMG sponsor my J1 visa.

I just want to double check because I will have to avoid such prorograms if that was the case.
 
I was under the impression that if a program doesn't sponsor visas, I can still have ECFMG sponsor my J1 visa.

I just want to double check because I will have to avoid such prorograms if that was the case.

Interesting. I guess you could see it that way. The only way to know is to ask. My guess is that programs with a "no visa" policy do so because they have had too many late starts / no starts because of visa problems, and they simply want to avoid that in the future. So, they may not be interested in anyone needing an H or J. But you could be right. I expect that many programs have a clear statement on their websites about this.
 
The only way to know is to ask.

I think this is the best option I have. While searching different programs, I have noticed that what they state on their websites might not be a rigid rule or even so accurate. For example, one program says they require the certification at time of application. Upon calling the program, it turns out they mean by time of interview rather than application. That's just one example. So I believe calling programs gives the quickest answer. Thanks.
 
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So I called one of the programs that state they don't sponsor visas. They also don't accept ECFMG-sponsored visas.

aPD, I would like to take your opinion on my strategy for the match. I am applying to a competitive specialty and a non-competitive specialty as a back up plan. Even if I match into the non-competitive specialty, I'll try to change to the competitive one later on. Therefore, I am only selecting those programs that sponsor H-1 visa for the competitive specialty so that I can still change my specialty even after PGY2. Is that a good plan? Thanks.
 
I'm not sure I understand your question. I think what you're saying is that you're selecting programs in the non-competitive field that offer H-1 visas, so that you can switch later on. J visas only allow one change of fields, and that must be done in the first two years of training. So, yes, it would be best to focus on an H visa if you're likely to want to change specialties later than the PGY-2. However, remember that H visas are usually limited to 6 years.
 
I'm not sure I understand your question. I think what you're saying is that you're selecting programs in the non-competitive field that offer H-1 visas, so that you can switch later on. J visas only allow one change of fields, and that must be done in the first two years of training. So, yes, it would be best to focus on an H visa if you're likely to want to change specialties later than the PGY-2. However, remember that H visas are usually limited to 6 years.

You got my questions 100% right. It's quite possible that I won't be able to change specialty before PGY2. So if I change my speicalty after PGY2, can I also change my visa to J-1 and, therefore, be able to complete my new specialty?
 
You got my questions 100% right. It's quite possible that I won't be able to change specialty before PGY2. So if I change my speicalty after PGY2, can I also change my visa to J-1 and, therefore, be able to complete my new specialty?

Yes. You can try to complete a second residency on an H visa (sometimes possible), or switch at any time to a J.
 
Generally speaking, do institutions that sponsor H-1 visa have anything against sponsoring it for a prelim?
 
You'll have to ask. There is no simple answer. It's a bunch of paperwork and pain for a single year, but I'm sure some programs will do so.

Thank you aPD for the so helpful input.
 
I was wondering if it is possible for a resident on H1B to take a year off after residency and convert into GC then start fellowship? is that practical?
 
I believe it takes much longer than that to convert an H1b to a GC. To do so, you need to be sponsored by your employer. I doubt they would be very happy if you bailed in such a short time. It probably can be done if you take a 2-3 year break, but then getting some fellowships can be more difficult after a break.
 
Thank You aPD for the detailed explanation here.

I have a question which seems not anwered in this thread. Say I grabbed a prelim surgery spot on a J1 visa (the worst scenario on this planet) , and, at the end of 1-year prelim, I had bad luck, and could not land a PGY-2 position either in surgery or whatever speciaties. In this case, I have to repeat my first year. To my understanding, the J1 visa will not allow us to repeat it in surgery. But how about other speciaties? I mean " Does J1 visa allow us to redo PGY-1 in other subspecities like Internal Medicine, anaesthesiology etc.
 
Just wondering if I could get some thoughts on my current, somewhat unique situation...

I'm a 3rd year DO student originally from Canada studying on an F1 student visa. I plan on entering an ACGME PM&R program for residency and then hope to do a 1 year fellowship after that. I know that I can use my OPT for my first year of residency and definitely plan on using that. Where my situation becomes somewhat unique I think is that my fiancee transferred to the US with work and is currently on an L1 intracompany visa. From what I understand, this visa can be renewed every 3 years for a maximum of 7. Also, I believe it can make a transition to permanent resident status a little easier. Finally on to my questions. Assuming we get married between the end of medical school and the beginning of residency, would either of the following options be feasible for me?

1) Use OPT for PGY-1. Spouse gains permanent resident status in US and I, in turn, also gain permanent resident status and never have to worry about an H1B or J1 visa ever again.

2) Use OPT for PGY-1. Spouse renews L1 visa and I gain L2 visa status as a dependent.

Thank you very much in adavance for your help!
 
Thank You aPD for the detailed explanation here.

I have a question which seems not anwered in this thread. Say I grabbed a prelim surgery spot on a J1 visa (the worst scenario on this planet) , and, at the end of 1-year prelim, I had bad luck, and could not land a PGY-2 position either in surgery or whatever speciaties. In this case, I have to repeat my first year. To my understanding, the J1 visa will not allow us to repeat it in surgery. But how about other speciaties? I mean " Does J1 visa allow us to redo PGY-1 in other subspecities like Internal Medicine, anaesthesiology etc.

You can definitely switch to another field on a J-1, but you are only allowed to switch once.

I don't see any reason why you can't do a second surgical PGY-1 on a J, other than that's perhaps a worse scenario than your above "worst scenario on this planet".

EDIT: This answer is incorrect. The ECFMG does not allow repeat of any PGY year in the same specialty unless done for remediation. So anyone completes a prelim GS position on a J1, you cannot apply for another surgical PGY-1, including a categorical PGY-1 position. You can only apply for a surgical PGY-2 position
 
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Just wondering if I could get some thoughts on my current, somewhat unique situation...

I'm a 3rd year DO student originally from Canada studying on an F1 student visa. I plan on entering an ACGME PM&R program for residency and then hope to do a 1 year fellowship after that. I know that I can use my OPT for my first year of residency and definitely plan on using that. Where my situation becomes somewhat unique I think is that my fiancee transferred to the US with work and is currently on an L1 intracompany visa. From what I understand, this visa can be renewed every 3 years for a maximum of 7. Also, I believe it can make a transition to permanent resident status a little easier. Finally on to my questions. Assuming we get married between the end of medical school and the beginning of residency, would either of the following options be feasible for me?

1) Use OPT for PGY-1. Spouse gains permanent resident status in US and I, in turn, also gain permanent resident status and never have to worry about an H1B or J1 visa ever again.

2) Use OPT for PGY-1. Spouse renews L1 visa and I gain L2 visa status as a dependent.

Thank you very much in adavance for your help!

Your post can be answered in 5 words:

You need a visa lawyer.

You've got dual intent problems trying to convert an OPT/F visa to an immigrant status. I don't know any more about it than that. See a lawyer before you commit to anything.
 
Hey aPD,

Thank you for your response! Forgive my ignorance, but what is meant by "dual intent problems trying to convert an OPT/F visa to an immigrant status." Thanks!

cbest
 
Thank you very much for the advice, aPD! I now understand how this may become a bit complicated!
 
would it be possible to complete a residency on a j1, then go back for two years then apply for a fellowship on a h1. would that be a good plan? i wouldnt mind taking a 2 year break, ie going back, but id rather do it inbetween. thanks for your answer.
 
would it be possible to complete a residency on a j1, then go back for two years then apply for a fellowship on a h1. would that be a good plan? i wouldnt mind taking a 2 year break, ie going back, but id rather do it inbetween. thanks for your answer.
This is completely legal. However, depending on the specialty, you might find getting a fellowship spot difficult after a 2 year break. For competitive fellowships (GI, Cards, H/O) it's unlikely to work. For less competitive ones (Renal, Endo, ID) it would probably be fine, although it's hard to predict how competitive these fields will be in the future.
 
I have been looking at different programs' requirements for H1B visa, and some of them seem to ask for the scores before January 1 or mid February, and some don't specify. I'm wondering why they need the score before the match results are out? What difference will it make?
 
They might want the scores to make decisions about whom to interview -- higher score = more chance to interview.

They might simply want to make sure you passed. They could match you, have you fail step 3, and be unable to get a visa.

They might have so many applications that it's an easy way to weed some out.
 
I already have interview invites from programs that offer H1B visa. So I guess there's no need to rush for step 3 now as it will probably ok to take it in February.
 
Aprogramdirector,

Thanks for all the responses on this thread, very helpful.

One question I have is,

I'm presently a medical student (3rd year) in the UK. I'm a Dual citizen, British-Canadian, and want to do Internal Meds residency on H1b visa.

Lets say I match into IM on H1B (3 year residency). After 3 years, if I want to become an Internist and not do fellowship, how do I go about getting a GC? Does the hospital that I am an attending sponsor me for Green Card? How long is this process? 1 year? 2 ? So what do I do in hte meantime. Can I not work while waiting for GC, or can I continue to work on H1 until it is converted?

The other scenario is what if I want to do 3 year fellowship in something like Gastro or Heme-Onc, how realistic is it to match into a fellowship on H1b? I hear its quite tough. And if I do match, lets say something easy, like Endo, when do I start applying for Green Card?

My knowledge of H1b -> Green Card is a bit fuzzy, and I want to know how I go about it chronologically during my IM residency and/or fellowship.

Thx,
 
I understand that passing step 3 is required in order to get H1B visa and that I can register for and take step 3 in a state like Connecticut which has no postgraduate requirements.

I've also read that in order to get the H1B visa you need to be licensed in the state you will practice. Most states, if not all, have a requirement of 1-3 years of post graduate experience in order to grant the license.

So the question is, how do IMGs get a state license in order to get the H1B?

I've read this entire post but I havent found the answer. (I'm interested in Florida or New York, by the way)
 
I understand that passing step 3 is required in order to get H1B visa and that I can register for and take step 3 in a state like Connecticut which has no postgraduate requirements.

I've also read that in order to get the H1B visa you need to be licensed in the state you will practice. Most states, if not all, have a requirement of 1-3 years of post graduate experience in order to grant the license.

So the question is, how do IMGs get a state license in order to get the H1B?

I've read this entire post but I havent found the answer. (I'm interested in Florida or New York, by the way)

The requirement is that you have a license to do the job you were hired for. Residents commonly have a "training license" or permit. Rules vary by state, but in no state are you required (or in fact able to get) a full license without several years of residency training. Training licenses are obtained by the program, not by the applicant (although you'll likely have to sign some application).

Hence, before your program files a petition for an H visa they will obtain a training license for you, and that will suffice for the H visa. A few states do not require a training license at all, and in that case they simply can file for the visa.
 
I believe you can not moon light on either one (based on a residency contract). On H1 you can moon light only if you have a separate H1 that is sponsored on a contract based on the moonlight job. (basically a new H1)

J1 waivers are not hard to get - it is more paperwork and time consuming but a motivated empolyer can definitely work it out.
 
I already have interview invites from programs that offer H1B visa. So I guess there's no need to rush for step 3 now as it will probably ok to take it in February.

You should have it definitely by the match result. The Human resources will not be comfortable to hear that some paperwork is missing to be able to hire you. Once program directors hear from them - you are on a short leash. Most of the PDs have either had experience in their program or have heard from others about residents unable to start due to 'visa problems'.

Sorry buddy - dont make yourself too comfortable.

http://www.usmleblog.blogspot.com
 
Your post can be answered in 5 words:

You need a visa lawyer.

You've got dual intent problems trying to convert an OPT/F visa to an immigrant status. I don't know any more about it than that. See a lawyer before you commit to anything.

Obviously getting professional help is ideal. It depends to some extent on your accepting program also - some of them do not understand what OPT is. If your spouse can come in independently - it does not hurt. OPT dependents can work ? - not sure - F2/ J2 can though (unlike H1).
 
Slight correction. If you are a foreign citizen but graduate from an U.S. medical school, you are eligible for H1B immediately upon graduation. You are exempt from step 3. H1B requires you to be a "professional" and as a physician, you are considered "professional" if you either hold an American M.D. degree (as simple as that) or hold a foreign M.D. degree AND have to had passed USMLE step III.

However, realistically, if you have graduated from an U.S. medical school, you still want to use OPT anyway for your intern year because 1) use OPT for one year means you have 6 more years of H1B to use (1+6) and 2) by the time you found out where you matched, it is difficult for you to get an H1B visa approved in time to start your internship. By contrast, you can get an OPT approved without knowing where you will be because you are technically still on your student visa.

But the implication is that by Jan of the following year, you can get your residency program to apply your H1B already without having passed Step III yet. Don't wait. You are eligible to apply for your H1B up to 6 months in advance. Start planning that a month in advance (i.e. seven months before because most residency program sits on your paperwork forever before talking to the lawyer) so your lawyer get the application out on that first day eligibility. You will save yourself $1000 in premier processing fee doing so.

Yes, you can moonlight on H1B. But most places you want to moonlight at won't want to bother to get you a concurrent H1B work visa. Realistically, that's just not possible.

A few years ago, Harvard-affiliated programs, UCSF and University of Washington were H1B friendly. UCSD is a J1 visa only place. Not sure about it now.

For Canadians coming down to the U.S. for medical school, you should consider going back to Canada for residency. Doing residency in the U.S. and go through this work visa hassle is not worth your time.

A few of my attendings did J1 waivers and they made lots of money (but were really bored). I guess they were lucky. It could have been worse for them!

For all intents and purposes, Canadians are treated as like all other foreign citizens in the U.S. There are no benefits for Canadians. In fact, physicians are excluded from TN visa's. So H1B and J1 are the only options for them. The only thing that distinguishes Canadians is that they don't need a formal visa stamp in their passports (unlike other foreigners who need to get their consulates to add visa stamps in their passport which take extra few weeks of time).

I believe that if you are on J1, even if you marry an American, you cannot convert to green card or citizenship. You either go to underserved area in the U.S. for 3 years or be ready to take your American wife with you back to your home country for 2 years afterwards. Don't take the J1 visa lightly.

I will add more if I think of something.

Hi,
so first of all this is a very good threat it helped me clear lots of questions i had, like I had no idea US medical graduates on F1 can do this OPT ; ok so question time
1. DO ALL programs offer you position if you have EAD/OPT and is it your home medical school the school to give you the OPT but of course you pay?
2. I read on multiple occasions that you do not need to ahve step 3 ( yeah impossible up until u finish internship) to apply H1B and that technically you could apply for H1B as soon as you get the MD diploma from ACGME schoo, here in the states but it is best to do OPT since it is faster before residecny starts; well if that is true, does that mean that although you call all these schools and they say they only give J1 visas that they will offer you H1B after you finish internship at their school on OPT? this is wehre i was confused..or should i still only apply and go to schools that give H1b ( almost none this year as far as i know, especially if you are applying for competitive fields such as neurosurgery, ortho, plastics etcetera); thus i can get in these programs with OPT but how do I know if they will sponsor me with H1 down the road?
these are the questions. Seems people here know what they are talking about. Ive called programs and they seem to only know how to asnwer FMG related questions but not to US graduates and non us citizens:(
thank you to all
 
Hi,
so first of all this is a very good threat it helped me clear lots of questions i had, like I had no idea US medical graduates on F1 can do this OPT ; ok so question time
1. DO ALL programs offer you position if you have EAD/OPT and is it your home medical school the school to give you the OPT but of course you pay?
2. I read on multiple occasions that you do not need to ahve step 3 ( yeah impossible up until u finish internship) to apply H1B and that technically you could apply for H1B as soon as you get the MD diploma from ACGME schoo, here in the states but it is best to do OPT since it is faster before residecny starts; well if that is true, does that mean that although you call all these schools and they say they only give J1 visas that they will offer you H1B after you finish internship at their school on OPT? this is wehre i was confused..or should i still only apply and go to schools that give H1b ( almost none this year as far as i know, especially if you are applying for competitive fields such as neurosurgery, ortho, plastics etcetera); thus i can get in these programs with OPT but how do I know if they will sponsor me with H1 down the road?
these are the questions. Seems people here know what they are talking about. Ive called programs and they seem to only know how to asnwer FMG related questions but not to US graduates and non us citizens:(
thank you to all

1. Huh? Each program can decide to interview / rank you based on whatever criteria they want. Just because you have an OPT doesn't mean that some program is going to take you.

The second half of your question is correct. Whomever sponsors your F visa (i.e. your medical school) will sponsor your OPT which is techically part of your F visa.

2. This has been explained in detail in this thread, I would suggest you reread it. Yes, most people use the OPT visa for the first year to give themselves more time to deal with Step 3 and get an H1b. No, you do not need to finish internship to take Step 3 -- in fact, you just have to graduate from medical school and pass Steps 1 and 2. Technically, you can get an H1b without Step 3 if you are an international student at a US medical school (but that remains purely USCIS's choice). Many programs that are J only will make an exception in your case, but you'll have to ask.
 
Non-US citizen graduates of US Medical schools do equally well in the match. Perhaps for the most competitive slots there might be programs that don't want to bother with a visa, but this will be very rare. Again, as mentioned above, as a non-US citizen in a US school on an F visa, you'll be able to do most of your internship on an OPT visa and then likely transition to an H1b.
Hi aPD,

I just wanted to clarify a few things. I am interviewing and will potentially be entering medical school next year in the US. I am a Canadian citizen but want to practice in the US and eventually become a US citizen. My understanding (from reading this thread a few times) is that the best possible route to do this is to finish medical school on an F-visa, do PGY-1 with OPT, then transition into an H1 and then apply for a GC while I am in residency with an H1 - is this correct?

You mentioned that Non-US citizen grads match equally well except possibly in the most competitive spots. If I am most interested in orthopedic surgery do you think I will have trouble landing a residency? I'm incredibly uneasy about this whole H1 visa business because I seem to be reading mixed reviews about the difficultly in acquiring an H1 visa. I read somewhere that in more competitive residency programs that have no problems filling their spots, they may have no interest in filling in extra paperwork required to sponsor an H1 student. I don't want to come to the US planning to work my butt off but then be stuck competing for only a limited number of possible orthopedic residency spots available to non-US citizens :scared:.

James
 
James, you are basically correct. I am in med school right now and hope that I can do OPT-->H1-->GC for residency. You are pretty much correct in regards to your other statements as well: as a Canadian from a US med school, you should match comparatively to your US counterparts. However, the visa may hold you back a little, and I'll leave the rest to aProgDirector, but I do think you may be at a slight disadvantage when applying to ortho, since it is one of the most competitive residencies out there. But I don't think the bias would be significant enough for you to not come to the US.

Again, I'll leave aProgDirector to comment on competitiveness/visa bias.
 
If you do your residency on a J1 and return for two years to your home country after residency, how hard is it to obtain a working visa or PR in the US after the two years?
 
Hi aPD,

I just wanted to clarify a few things. I am interviewing and will potentially be entering medical school next year in the US. I am a Canadian citizen but want to practice in the US and eventually become a US citizen. My understanding (from reading this thread a few times) is that the best possible route to do this is to finish medical school on an F-visa, do PGY-1 with OPT, then transition into an H1 and then apply for a GC while I am in residency with an H1 - is this correct?

You mentioned that Non-US citizen grads match equally well except possibly in the most competitive spots. If I am most interested in orthopedic surgery do you think I will have trouble landing a residency? I'm incredibly uneasy about this whole H1 visa business because I seem to be reading mixed reviews about the difficultly in acquiring an H1 visa. I read somewhere that in more competitive residency programs that have no problems filling their spots, they may have no interest in filling in extra paperwork required to sponsor an H1 student. I don't want to come to the US planning to work my butt off but then be stuck competing for only a limited number of possible orthopedic residency spots available to non-US citizens :scared:.

James

Mostly correct.

Yes, the easiest path to US Citizenship is F -> OPT -> H -> GC. However, theoretically you can only be sponsored for an employer based GC by someone hiring you for a permanent job. Hence, you usually finish your residency on an H, transition to your first job on an H, and then get the GC.

As for ortho, you might find some difficulties. As you mention, it's really competitive. Some PD's will simply pass over you, taking someone else who has no visa issues. Getting an H in an academic setting is not dificult, but it does cost money and take some time and some PD's may simply want to avoid that.
 
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