ecfmg 101: managing img recruitment - appd · pdf fileecfmg 101: managing img recruitment....

Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.

ECFMG 101:Managing IMG Recruitment

Eleanor Fitzpatrick, ECFMG 2011 APPD Fall Meeting

Arlington, Virginia


Learning Objectives

Review what you need to know when recruiting IMGs and foreign national physicians:

I. The Non-negotiables: ECFMG Certification Legal immigration status to train J-1 regulations and ECFMG process

II. Other Challenges, Benefits, and Global Opportunities


Applicant Pool for Pediatrics

U.S. Grads (MDs & DOs) = Diploma + USMLE and/or COMLEX U.S. Citizens, Canadians*, Other Foreign Nationals*

Canadian Grads = Diploma + MCEE and/or USMLE Canadian Citizens*, U.S. Citizens, Other Foreign Nationals*

International Medical Graduates (IMGs) = ECFMG Certificate U.S. Citizens, Canadian Citizens*, Other Foreign Nationals*


Typical Pathway into U.S. GME

1. Medical School Graduation Complete ECFMG Certification, if IMG

2. Apply for U.S. Residency Training Position Apply via ERAS Interview with programs Enroll in the NRMP Match Secure a contract / letter of offer Obtain the appropriate visa / visa status, if foreign national

physician


ECFMG Certification

All international medical graduates (IMGs) who receive a basic medical degree from a medical school outside of the United States or Canada must be ECFMG certified to enter U.S. GME.

IMGs can apply and “Match” to a GME program with passing scores on USMLE Step 1, Step 2CK, Step 2CS

To begin GME, the final diploma & transcripts must be primary source verified and the ECFMG certificate must be issued


ECFMG Certification Requirementshttp://www.ecfmg.org/cert/index.html

Medical Education Credentials Complete 4-year medical school curriculum School & graduation year listed in “IMED” http://IMED.ecfmg.org

*By 2023 medical school must be accredited ECFMG primary source verifies final diploma & transcripts

USMLE Exams Step 1 Basic Science Step 2 Clinical Knowledge (CK) Step 2 Clinical Skills (CS)


Legal Immigration Status

All foreign national physicians must obtain an appropriate U.S. training visa / visa status before they are permitted to begin GME training

“Visa” – entry document stamped in passport

“Visa Status” – reflects the approved activity associated with each visa type and the length of authorized stay in the United States


Visa - Permit to Enter United States

Issued by U.S. Consulate abroad and stamped in passport

Expiration date applies to use for U.S. entry only

Can expire once in the United States


Visa Status - Approved Activity

• Issued by Customs & Border Patrol at U.S. port-of-entry (I-94 card), or

• Regional Service Center of U. S. Citizen and Immigration Services (USCIS) as Change of Status (I-539)


Most Common Visas for U.S. GME

J-1 “Alien Physician” ECFMG sponsored USMLE Steps 1, 2CK, 2CS, 2 yr home physical presence requirement,

SEVIS tracking, 7 yr max

H-1B “Specialty Worker” Employer sponsored USMLE Steps 1, 2CK, 2CS, 3, fees, no service obligation, 6 yr max

J-2 “Dependent” Employment Authorization Document (EAD) Spouse of J-1 visa holder, tied to timeline of J-1 principle

F-1 “Student” Optional Practical Training (OPT) One year extension only sponsored by U.S. Medical School


J-1 Requires Home Country Support

J-1 Statement of Need - Central Ministry of HealthThere currently exists in (country) a need for qualified medical practitioners in the specialty and/or subspecialty of Pediatrics.

Dr. (Applicant) has filed a written assurance with the government of this country that he will return to his/her country upon completion of training in the U.S. and intends to enter the practice of medicine in the specialty/subspecialty being sought.

MUST FOLLOW REGULATORY LANGUAGE


J-1 Imposes Two-Year Home Residency Requirement INA §212(e)

All J-1 physicians (and J-2 dependents) are obligated to reside in the home country for at least two years before being eligible for certain changes or adjustments in U.S. visa status (H, L, K, or green card)

J-1 /J-2 physician couples hold one obligation which must be fulfilled by the J-1 principle

Marriage to a U.S. Citizen does not waive the obligation

J-1 waivers are available through state and federal programs; most common are Conrad 30 employment in MUAs/HPSAs or VA

Copyright©2011 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved. 13

J-1 Researchers & GME Positions

Foreign national physicians often enter the United States initially as J-1 “research scholars” to gain experience and take the USMLEs

If a clinical GME position is secured, they have to work with ECFMG to request a Change of Category from J-1 research to J-1 clinical through the U.S. Department of State

In some cases they may be H-1B eligible


J-1 Change of Specialty / Repeat Years

J-1 physicians are permitted to change medical specialties only once within their first two years in J-1 status

J-1 may repeat up to twelve months of GME training for remedial purposed


J-1 Sponsorship Applications

J-1 physician + GME program (Training Program Liaison / TPL)

4 - 6 weeks to review applications ECFMG Regional Advisor evaluates for eligibility If approved, SEVIS Record is created and updated ECFMG issues Form DS-2019

ECFMG notifies applicant via e-mail, providesinstructions for obtaining J-1 visa status


J-1s Tracked in SEVISStudent and Exchange Visitor Information System

Data exchange between DHS / DOS Immigration tracking of the activities of non-immigrant (J, F & M)

visa holders and dependents

Accessed by consulates, embassies, ports-of-entry, and other DHS agencies

ECFMG creates and updates SEVIS records for all J-1 physicians and J-2 dependents


Form DS-2019

• ECFMG-issued “Certificate of Eligibility for Exchange Visitor (J-1) Status”

• Legal document needed to apply for J visa/visa status

• Reflects electronic record

• SEVID ID (N000######) assigned to all J-1s and J-2s


Applying for Initial Visa Status

Option 1: Apply at US Embassy or Consulate abroad

Option 2: Apply for Change of Visa Statuswithin the U.S. (I-539 process USCIS Regional Service Center)https://egov.uscis.gov/cris/processTimesDisplayInit.do


Initial Arrival in J-1 Visa Status

J-1 Physicians May enter United States 30 days prior to training start

date listed on contract and SEVIS DS-2019

Program must confirm physician’s arrival in J-1 status to ECFMG within 30 days of SEVIS start date or record will deactivate

ECFMG in turn validates the SEVIS record

Application for Social Security Number requires SEVIS validation plus 10 days from date of U.S. entry


Maintaining J-1 Visa Status

Continued full-time participation in GME Contract to progress in training Timely renewal of ECFMG J-1visa sponsorship

Required reporting of any change in approved training plan Remediation, leave of absence, off-site rotations, transfer

request, change in contract dates, resignation or termination, etc.

J-1s do not need to renew visa stamp annually


EVNetOn-Line J-1 Sponsorship Application

Will replace sponsorship application forms TPLs will use on-line application to submit:

Contract details Requests & notifications re: leaves of absence, travel validations,

request to add non-standard & research programs, etc. View reports on currently sponsored J-1 physicians by program,

sponsorship expiration dates, etc. Applicant physicians will be able to submit on-line information

Biographic information & provide supporting documents

Stay Tuned for Dates & Details on System Roll-out


Issues & Opportunities

IMGs & Foreign National Physicians in GME

Communication: language, accents, idioms, ideas Behavior: learning styles, supervisory roles, gender issues Professionalism: interpersonal skills, patient care, team Personal needs: support, family, religion etc. Diverse / Global Perspective: opportunities, leadership


Questions?

[email protected] (215) 823-2127

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