Today, approximately one in four physicians practicing in the United States obtained his or her medical education outside the U.S. Despite this fact, some hospitals and health systems are reluctant to recruit and hire international medical graduates (IMGs) following the completion of their residency training for fear of being bogged down in the complex world of immigration sponsorship. While hiring IMGs may require more planning and attention to detail than hiring U.S.-born physicians, with a basic understanding of the issues and challenges involved with recruiting J-1 and H-1B physicians, employers can identify talented, employable physicians.
The first step in recruiting an IMG for post-medical-training employment is to identify his or her U.S. immigration status. IMGs who are training in the United States generally hold either J-1 or H-1B status. J-1 visa holders are required to return to their home country for two years following completion of their medical training unless they can obtain a waiver from the U.S. Department of State. Often, J-1 waivers for IMGs are based on requests by government agencies or state health departments for physicians who agree to work in a health professional shortage area or a medically underserved area/population for a minimum of three years.
Physicians who work or train on H-1B visas, rather than J-1 visas, do not face geographical restrictions on where they can work. The H-1B visa, however, presents its own set of issues for employers. Each year, U.S. Citizenship and Immigration Services caps the number of H-1Bs available for foreign workers. Fortunately, nonprofit entities related to or affiliated with institutions of higher education, such as academic medical centers, are exempt from the cap.
It is important to recognize that immigration sponsorship involves additional regulatory details that should be addressed either by experienced outside counsel or in-house counsel with a detailed understanding of the process. A more in-depth overview of the process is available at this link. By planning ahead and thinking strategically, hospitals and health systems can find that immigration sponsorship does not need to deter the recruitment and hiring of talented international physicians following the completion of medical training.