When searching for job opportunities, physicians have tons of considerations—location, compensation, paid time off, work schedule, quality of life and more.
But most IMG physicians have an additional consideration looming over their heads: immigration.
If you’re a physician with a work visa, you are well aware that your prospective employer must support or “sponsor” your work visa for you to be able to practice medicine in the U.S.
As a matter of fact, without an employer’s agreement to sponsor, there’s really no need to discuss any other aspect of a potential offer.
Knowing this, many physicians ask how and when to bring up the need for sponsorship. They also want to know which sponsorship details should be discussed, negotiated and included in the employment contract.
As with all things legal, there’s no one-size-fits-all approach, but here are some tips to make your search to find that willing sponsor a little smoother.
Start your visa sponsor search early
For the best chance of getting your preferred location and employer, you must start the job search early enough to meet immigration deadlines.
In order to do this, J-1 physicians must know the dates when their states of choice accept J-1 waiver applications. You also need to start the search a year before your residency or fellowship ends.
For example, a second-year internal medicine resident looking to work in Texas needs to know that J-1 waiver applications are accepted beginning September 1, 2016, for the 2017 year cycle. He or she must have an employer lined up by July 1, 2016, for a fighting chance of winning one of the 30 waiver slots in that state.
Similarly, H-1B residents or fellows should start their searches a year before graduation. Ideally, you should look for H-1B cap-exempt employers.
If you’re unable to secure a cap-exempt job offer, however, starting your search a year ahead lets you apply for an H-1B cap visa on April 1 of your last training year.
Communicate your immigration status
Some employers are very familiar with work visas, but many are not.
Those who have little or no experience in this area may shy away from considering visa candidates. Because you have limited time to search for a job while completing your training, it’s usually best to screen out employers who are not open to sponsorship.
Because of anti-discrimination laws, employers cannot ask you about your citizenship or immigration status before offering you a job. They’re not, however, required to sponsor a work visa once they learn you need one.
To avoid wasting time interviewing for a job that won’t meet your immigration needs, include your immigration status in your CV and mention the necessity of sponsorship at the earliest opportunity.
Doing so will eliminate employers whose policies do not allow sponsorship and will open the door for you to discuss sponsorship with the employers who are willing to consider it.
Get an immigration attorney
Immigration is a complicated legal process that can be confusing and discouraging to employers. Because its complexity may be off-putting to many employers, it’s important to reassure them that the work visa application will not be burdensome or interrupt their operations.
To ensure this is the case, you should meet with an experienced immigration attorney before or shortly after starting your search.
This attorney can evaluate your specific immigration background, explain the visa process requirements to you, and prescribe a plan to get you practicing medicine in the U.S. as quickly as possible.
Most importantly, the attorney has the credentials and expertise necessary to speak with potential employers and address their questions or concerns about the legal process.
Your employer will feel more comfortable knowing you’ve already lined up help to meet the legal challenges of your work visa.
Disclose and negotiate visa expenses
Like any legal process, a work visa application involves expenses, including both attorney fees and government application fees.
As previously mentioned, immigration laws are not straightforward, but employers and physicians must be careful to understand and follow all requirements of a work visa and green card before and after an application is approved. The immigration attorney will help both you and the employer navigate the complexities to avoid violations, however unintended.
Employers are required by law to pay some of the attorney fees and costs involved with the work visa and green card applications.
For example, at a minimum, employers must pay the ACWIA (American Competitiveness and Workforce Improvement Act) fee charged by the government for the H-1B petition, and in some cases, the employer is required to pay all fees, including attorney fees, for the H-1B visa. The immigration attorney can advise you on how the fees and costs should be shared.
Also, if you want the employer to pay more than the required minimum, you should be sure the employer’s agreement to do so is stated in your employment contract.
It’s important to know that you and the employer cannot agree that you will pay (or reimburse them for) any fees the employer is required to cover.
Put visa sponsorship in the contract
Without a doubt, work visa sponsorship is critical to your ability to work. Yet many physician contracts don’t include the language necessary to commit the employer to sponsorship for either the work visa, green card or both.
Physicians should work with their employment or health law attorney and immigration attorney to add such language if it’s not already included in the contract.
Additionally, they should ensure that the contract does not contain any language requiring the physician to reimburse mandated employer immigration costs upon termination of employment.