The search for post-training employment is often fraught with anxiety. For an international medical graduate, or IMG, there are extra levels of complexity to consider and negotiate when engaged in the job hunt and interview process.
Though many prospective employers are comfortable with the visa issues for an IMG, others are not. IMGs need to be advocates for themselves, but also recognize that there may be more limited professional opportunities for IMGs than for non-IMG colleagues.
An IMG and a prospective employer must each understand their respective rights and responsibilities and how they can—and should—effectively work together to ensure an IMG can start employment in the most timely way.
There are two common temporary visas for IMGs: the J-1 and the H-1B. In general, the J-1 is specifically for training and the H-1B is for any form of professional-level employment (including as a resident).
Physicians already in J-1 status at the commencement of their residency will remain in J-1 status if they wish to participate in any fellowship training. The J-1 has an important benefit in that its duration is directly tied to the length of the training—thus a resident seeking to become a sub-specialist through a program of four or more years of post-residency training will be able to do so while on a J-1.
J-1 IMGs also have limitations. A J-1 cannot moonlight as a means to supplement income. The other principal limit is potentially more restrictive. Under the “two-year rule,” a physician who receives graduate medical education or training in J-1 status must reside in his or her home country for two years before obtaining H-1B status or a “green card,” unless the physician can find employment in the United States that qualifies for a waiver of that requirement.
Another J-1 limitation is that relatively few fellowship programs will accept IMGs as fellows until the individual has permanent residence (i.e., a green card).