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DHS Proposes Visa Changes Affecting GME Programs

In a Sept. 25 proposed rule, the Department of Homeland Security (DHS) proposed to set a fixed admission period for three nonimmigrant visa classifications– J, F, and I visas.

These visas are granted to exchange visitors, academic students, and representatives of foreign media, respectively. Most relevant to the provision of health care, J-1 exchange visitor visas are granted to 15 categories of individuals, including physicians who seek to enter the United States to pursue medical residency or fellowship in an accredited program.

Under current DHS policy, individuals entering the U.S. on one of these three types of visas are admitted for the duration of status, rather than a fixed period. Duration of status is the time during which the visa holder complies with the terms and conditions of their visa category. In the case of J-1 physicians, duration of status coincides with the time that a physician is participating in an accredited program to complete their graduate medical education. DHS proposes instead to grant admission to I visa holders for an initial period of 240 days and a period not to exceed four years for J and F visa holders. This would require visa holders still completing education or training to proactively apply for an extension of status toward the end of their authorized period of stay. DHS also proposes adding a 30-day period following the program end date to allow the visa holder to prepare to return to their country or seek lawful status in the United States.

In certain cases, DHS would limit the period of admission for J and F visa applicants to two years instead of four years if:

  • the visa applicant is from a country on the state sponsor of terrorism list;
  • the visa applicant is from a country with a high overstay rate, defined as greater than 10 percent;
  • limiting the admission period to two years would serve the national interest; or
  • the program sponsor is not participating in the E-Verify system, through which employers verify workers’ employment eligibility.

The timing of applying, and being approved for, extension of status likely will pose difficulties for international medical graduates in residency or fellowship programs that last more than two or four years. The Educational Commission for Foreign Medical Graduates (ECFMG) is responsible for sponsoring J-1 physicians. ECFMG reviews and extends its sponsorship of physicians annually, which also extends the duration of status for these physicians. Under the proposed change, applicants would be required to proactively apply for an extension of status, which can take up to 19 months to process. This would conflict with residency programs’ timelines for determining whether to renew a physician’s contract for an additional year. These determinations usually are made three to five months before the start of the new program year.

America’s Essential Hospitals is analyzing the proposed rule and plans to comment. Comments on the proposed rule are due Oct. 26.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Shahid Zaman is a senior policy analyst at America's Essential Hospitals.

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