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The area of physicians is a sub niche within the niche area of immigration. There are special rules that apply to physicians that don’t apply to noncitizens in other professions who hold the same status. There are different rules for clinical and non-clinical programs, with clinical programs having more restrictions.

Noncitizen medical students also need to navigate life and work in a foreign country, meet their licensing requirements, and ensure compliance with arcane immigration laws.

From our team of experienced immigration attorneys at Pelton + Balducci in New Orleans, here is some information about immigration options for “nonimmigrant” medical students who wish to continue their training in the United States.

Comparing H-1B vs. J-1

When comparing the H-1B and J-1 statuses for training physicians, several key differences emerge that impact employment opportunities, training periods, family considerations, employment flexibility during training, and intent to stay in Louisiana, or anywhere in the U.S.

Employment Opportunities after Training

For employment opportunities after training, the H-1B visa generally has certain advantages.

  1. It does not come with a two-year home residency requirement that J-1 holders face, eliminating the need for waivers and allowing for more streamlined career progression.
  2. Contracts for physicians under H-1B status are not subject to the terms of the waiver requirements (required service in MUAs and HPSAs), which means there’s more flexibility in their terms of employment.
  3. Additionally, the absence of the two-year home residency requirement also means that H-1B status also allows physicians to pursue permanent residency more quickly.

Training Periods

When it comes to the duration of training periods, the J-1 may have an edge.

  1. It potentially allows for a longer training period—up to seven years, and possibly an eighth year if the home country demonstrates an exceptional need for additional specialty training.
  2. J-1 holders can also transition to H-1B status (provided a waiver is granted) and then use the six years of H-1B for employment.

Family Members

The benefits of either status for spouses and children is a mixed bag.

For immediate employment authorization, the J-1 visa is advantageous as J-2 dependents can qualify for employment authorization right away.

H-4 dependents (spouses and children of H-1B holders), on the other hand, qualify for employment authorization only if the H-1B holder has an approved I-140 petition or has obtained an extension of status beyond the six-year limit.

Restrictions and Employment

On the other hand, when it comes to restrictions after the program, H-1B visa has the advantage. Under J-1 status, derivative spouses and children are independently subject to the home residency rule, meaning they each need to satisfy their own home residency requirements. In other words, if a J-1 were to satisfy their home residency requirement without their dependent J-2, their dependent J-2 would still be subject to the two year home residency requirement. However, a waiver for J-1 visa holders will apply to their J-2 derivative spouses and children.

In terms of employment flexibility during training, H-1B has an advantage. The Educational Commission for Foreign Medical Graduates and Department of State have made deviations from the original plan more restrictive for J-1 physicians, who cannot moonlight or have any funding source outside the approved training program. In contrast, H-1B holders can moonlight by obtaining another concurrent H-1B.

Lastly, with regard to the “dual intent” (the intention to remain permanently in the U.S.), H-1B status is again advantageous as it allows for dual intent. The J-1 visitor, in turn, is supposed to intend to remain in the United States temporarily and to leave the U.S. after the end of their program. This has obvious implications for physicians who intend to make a long-term commitment to living and working in the United States.

Contact Pelton + Balducci New Orleans Immigration Attorneys

In addition to the already rigorous demands of medical school and medical training, non-citizen physicians must also navigate the demands of maintaining their immigration status, of understanding the implications of their statuses for their professional opportunities and for their family members’ opportunities in the U.S., and they must plan their careers bearing these parameters in mind.

Consulting with an experienced Louisiana immigration lawyer can help you understand the pluses and minuses of various options and help you make the best options so that you and your family can make the most of your medical career in the U.S. Pelton + Balducci is here to help. Contact us today.

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