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USIA ISSUES POLICY STATEMENT ON FOREIGN MEDICAL GRADUATES
The USIA has issued a policy statement addressing five problems that have come up in the administration of physician residency programs in the US.
The first issue concerns statements of need. Foreign physicians seeking to come to the US in a J-1 residency program must secure a statement of need from his or her country of nationality or last legal permanent residence. The purpose of the statement is to provide assurance to the US government that the training the physician will receive in the US will be of use to the applicant’s country of nationality or last legal permanent residence. According to the USIA, the doctor does not have a choice regarding which country will submit the statement of need. Such determination is based on the facts and is self-executing. Does the foreign medical graduate reside in his or her county of nationality. If so, then that country must submit the statement of need. If not, the statement of need should come from the country of last legal permanent residence. If a statement of need cannot be supplied, the doctor is barred from participating in the program.
A second problem addressed in the memo involves the requirement that physicians who receive waivers of the home residency requirement based on going to work in a medically underserved area must go to work on an H-1B visa after the J visa. The problem comes when the H-1B visa cap is hit and it is impossible for the doctor to start on an H-1B visa. The USIA has crafted a solution that will work for many. Participants who have received such a waiver and are sitting for specialty board examinations may continue in J-visa status. These participants may not work during this extension period and the extension period is limited to the end of the month in which the Board examination is given. It cannot, however, exceed six months.
The next question involves residents asked by their program to take on the additional responsibility of being the "chief" resident or take work outside of the residency program. According to the USIA, the number of years of eligibility for program participation is totally dependent on the period of time established by the American Council for Graduate Medical Education in the AMA’s Graduate Medical Education Directory. If the length of the program is not consistent with the GME Directory, then it will not be allowed. 
Many doctors have also enquired about "moonlighting." According to the USIA, a J-1 doctor is not authorized to work outside of the J-1 program. The doctor is not authorized to work at other medical facilities or emergency rooms at night or on weekends. 
Finally, the USIA addressed the question of whether doctors here to pursue research can switch to a residency program. The USIA believes this would be inconsistent with the policies of the program and has informed the ECFMG that individuals who have participated in the Exchange Visitor Program as a research scholar or professor participant during the twelve month period preceding their proposed commencement of a residency program are ineligible for ECFMG sponsorship.