NEW ECFMG RULES MAKE OBTAINING J VISAS MORE DIFFICULT

Foreign physicians have been in the news a good deal lately, because of the termination of the US Department of Agriculture J-1 visa waiver program.  While this decision has received substantial publicity, it is not the only one to have a negative impact on international medical graduates.

The Educational Commission on Foreign Medical Graduates (ECFMG), which is the only organization that can sponsor a foreign medical graduate seeking clinical training the US on a J-1 visa, has, over the past few months, made a number of changes that seem to be resulting in a decrease in the number of international medical residents.  International medical graduates make up about 25 percent of medical residents in US training programs because there are not enough graduates of US medical schools to fill all the available residency slots.  For years, foreign students were recruited to fill these slots, but recent changes seem to indicate that many would rather the slots go unfilled. 

In 1998, the ECFMG began requiring international medical graduates to pass an English language test and a clinical skills assessment before being eligible for a J-1 visa.  Because the clinical skills assessment is offered only in Philadelphia, Pennsylvania, it is difficult for many to take it.  Not only is there the trouble and expense of coming to the US for it, many people have reported having their application for a visa so they can come to the US for the test denied.  Also, the fee to take the test is ,200, which means many are simply not able to afford it.  The implementation of this requirement led to a drop of about 20 percent in the number of J-1 visas issued to foreign medical graduates.

Now another change may make J-1 visas even less attractive.  At the end of February, the ECFMG announced that it would no longer sponsor visas for people seeking clinical training in programs that are not accredited by the Accreditation Council for Graduate Medical Education.  These programs, often referred to as “non-standard” programs, are directly associated with accredited programs, but because they involve cutting edge techniques and treatments, have not yet themselves been accredited.

According to the ECFMG, it has been told by the State Department that the Department of Health and Human Services maintains that the J-1 program is for use only for training in an accredited program.  However, there are two factors that make this decision not as negative as it could be.  First, ECFMG will be allowed to continue sponsoring international medical graduates for nonaccredited programs until June 30, 2003.  Second, ECFMG maintains that it can sponsor a student for a J-1 visa for study in a nonaccredited program so long as the program is in a subspecialty recognized by the appropriate Specialty Board of the American Board of Medical Specialties. 

ECFMG is also in the process of convening a meeting with a number of medical organizations for further discussion of this topic so that it can present recommendations on the issue to the Department of Health and Human Services.

Many observers and advocates are concerned that the Department of Health and Human Services will not change its mind on this issue, and that opportunities for international medical graduates to obtain training in cutting edge medicine will be severely limited.