New Logo for ecfmg

Educational Commission for Foreign Medical Graduates: An Overview

New Logo for ECFMG

• ECFMG is introducing a redesigned logo in conjunction with the 50th Anniversary.

• ECFMG’s Standard ECFMG Certificate and other ECFMG documents will be redesigned to reflect ECFMG’s new logo.

• Individuals who review documents related to ECFMG Certification can access more information on these changes on the ECFMG website:

• http://www.ecfmg.org/anniversary.html#look

ECFMG Private, Non-profit Organization

• Organizational Members

• American Board of Medical Specialties (ABMS)
• American Medical Association (AMA)
• Association of American Medical Colleges (AAMC)
• Association for Hospital Medical Education (AHME)
• Federation of State Medical Boards of the United States, Inc (FSMB)
• National Medical Association (NMA)

ECFMG Services

• ECFMG Certification - Credentials

• Certification Verification Service (CVS)

• Electronic Residency Application Service (ERAS)

• Exchange Visitor Sponsorship Program (EVSP)

“IMG” Definition

• An International Medical Graduate (IMG) is any physician who received his/her basic medical degree or qualification from a medical school outside of the U.S. or Canada, regardless of citizenship

• This includes any U.S. citizen who received a medical degree from a school outside of the U.S. or Canada

ECFMG Certification

• ECFMG Certification assures residency program directors and the U.S. public that the international medical graduate (IMG) has met minimum standards to enter U.S. residency programs

• ECFMG Certification is required for:

• IMG entry into ACGME-accredited GME
• Taking USMLE Step 3
• State licensure
• J-1 visa sponsorship / ECFMG

Medical Education Credential Requirements for ECFMG Certification

• Completion of a medical school curriculum of at least four academic years

• Medical school and graduation year listed in the International Medical Education Directory (IMED) See http://IMED.ecfmg.org

• Documented completion of all requirements for and receipt of final medical diploma

• Primary source verification of medical diploma and transcript by ECFMG

Examination Requirements for ECFMG Certification

ECFMG Certification Resources

• General Certification Information @ http://www.ecfmg.org/cert/index.html

• ECFMG Certification Fact Sheet @ http://www.ecfmg.org/cert/certfact.html

• Permanent Validation Sticker

• Form 246: http://www.ecfmg.org/cert/permvald.pdf
• Form 295:http://www.ecfmg.org/forms/form295.pdf

• E-Newsletter: The ECFMG Reporter

Certification Verification Service (CVS)

• ECFMG's Certification Verification Service (CVS) provides prompt, primary source confirmation of an IMG’s ECFMG certification status. This information is provided to residency programs, state medical boards and other organizations, such as hospitals and HMOs.

• Satisfies JCAHO requirement for primary-source verification of IMG’s medical school completion
• No charge for GME programs

CVS Online

• Web-based requests for confirmation of ECFMG Certification status

• Confirmations sent via postal mail

• Establish an account for your program by sending e-mail to [e-mail]

• http://www.ecfmg.org/cvs

Electronic Residency Application Service (ERAS)

• Most residency/fellowship programs require application through ERAS

• Developed by the AAMC and administered by ECFMG for IMGs, ERAS transmits the following to program directors through the Internet:

• residency applications
• letters of recommendation
• deans’ letters/ MSPEs
• transcripts
• other support documentation

Exchange Visitor Sponsorship Program (EVSP)

• Administers J-1 programs -“alien physician” per Federal Regulations 22CFR§62.27(b)

• Interfaces with DOS/DHS in tracking of J-1 physicians in SEVIS database

• Collaborates with HHS, Academic Medicine and the Legal Community on broad IMG issues

Immigration Options for Foreign National Physicians

Who Needs a Visa?

• All foreign national* physicians need appropriate visas to participate in U.S. graduate medical education (GME).

• Foreign national physicians may be U.S. medical school graduates or IMGs; all foreign national physicians need visas to train in U.S. GME
• All IMGs, regardless of citizenship, need ECFMG Certification for U.S. GME, not all IMGs need visas
• *Foreign national = non-U.S. citizen or permanent resident

Immigration Terms

• “Visa” - A permit stamped or affixed in a passport to request entry to the U.S. Only needed at time of entry into the U.S.

• “Visa Status” -Legal classification reflecting physician’s authorized activity while in the U.S., i.e. B-1, J-1, H-1B

• U.S.C.I.S. - U.S. Citizenship and Immigration Services, formerly the “I.N.S.”

• U.S. Consulate – Branch of U.S. Embassy that issues visas. Part of the U.S. Department of State. Only located outside U.S.

Complete ECFMG Certification (if IMG)

• Complete ECFMG Certification (if IMG)

• Meet examination and credentialing requirements

• Apply for U.S. Residency Training Position

• Apply to ERAS
• Interview with programs
• Enroll in the NRMP Match
• Secure a contract/letter of offer

• Seek Appropriate U.S. Training Visa/Status

• (if foreign national physician)

Most Common Visas Types for Foreign National Physicians in U.S. GME

• J-1 “Alien Physician”

• ECFMG is the only sponsor for clinical training in the “alien physician” category

• H1-B “Specialty Occupation Worker”

• J-2 “Dependent”

• J-2 is defined as the spouse or minor child of J-1 visa holder

• F-1 “Student”

• Optional practical training – one year of training

• O-1 of “Extraordinary Merit”

Visa Considerations

• Hospital policies

• Does the hospital require a specific visa classification for GME, or is it decided by the physician or by the program?

• Physician’s long term goals and plans

• Physician’s immigration history in U.S.

• Physician’s personal/family ties in the U.S.

• Assess the facts, ask questions

Considerations Specific to IMGs in General Surgery

J-1 Visa Status

• Educational & cultural exchange

• “Non-immigrant intent”

• ECFMG sole sponsor

• USMLE Steps 1, 2CK, 2CS

• Valid ECFMG certification

• Funding – hospital, home government or personal

• 7 year maximum

• Two-year home residency requirement (*waiver)

• J-2 dependents eligible for work authorization

• 4 - 6 weeks processing

• Fee = $200

H-1B Visa Status

Immigration Steps

• Determine most appropriate visa classification for physician and program

• Program applies for visa documentation from either ECFMG or USCIS/DOL

• Physician applies for a “visa” at a U.S. Consulate abroad and enters US

• If already in US in alternate “visa status,” physician applies for a change of status through government service center

• Training can not begin until physician has obtained appropriate visa status

Visa Application Process

• Physician must schedule visa appointment at U.S. Consulate in the home country via web or phone

• Possible delays due to security clearances

• Arrival in U.S. in appropriate visa status authorizing medical training

ECFMG J-1 Sponsorship

• J-1 Physician + TPL = Complete Application

• Sponsorship Available for Participation in:

• ACGME Accredited Residency Training
• ACGME Accredited Subspecialty Training
• Non-Standard Programs (advanced cutting edge fellowships)
• Extension for Board Examinations
• Sponsorship Application Materials Available @

• http://www.ecfmg.org/evsp/index.html

• Online Application Payment and Status updates through OASIS

• http://www.ecfmg.org

6 Steps of the J-1 Visa Sponsorship Process

6 Steps of the J-1 Visa Sponsorship Process (continued)

6 Steps of the J-1 Visa Sponsorship Process (continued)

• 5. J-1 Physician Reports for Training

• The foreign national physician must present the TPL with evidence of approved J-1 visa status in order to begin the GME program. Documentation includes:
• J-1 Visa Stamp in Passport
• J-1 D/S (Duration of Status) on I-94 Arrival/Departure Record
• 6. TPL Must Report Arrival / Delay to ECFMG within Thirty Days of the Training Start Date
• Failure to report inactivates the SEVIS record

Required J-1 Reporting by Host Institutions & TPLs

• Arrival / Delays – within 30 days of contract start date

• Any Change in the Approved Training Plan

• Remediation
• Leave of absence/maternity leave
• Licensure delay
• Proposed off-site rotations
• Proposed early advancements
• Resignation
• Contract termination

• Legal Concerns /Allegations, Internal Hearings, etc.

• * H-1B Reporting also required

INTERNATIONAL TRAVEL IS DISCOURAGED DURING TRAINING PROGRAMS

• Why?

• If the J-1 physician departs the U.S. with an expired visa stamp in the passport, visa renewal will be required to

• re-enter. The visa application process may involve lengthy security clearances, etc. and J-1 renewal cannot be guaranteed.

• If the J-1 Physician MUST Travel:

• Discuss contract conditions - delay, failure to return, etc.
• Refer to www.state.gov/travel
• Request travel documents from ECFMG
• Endorsed SEVIS Form DS-2019
• “Letter of Good Standing”

Maintaining Visa Status

• Strict Adherence to J-1 Regulations (22CFR§62)

• http://www.exchanges.state.gov/education/jexchanges

• Compliance With All U.S Immigration Laws

• http://www.uscis.gov

• Reporting of U.S. Address

• http://www.uscis.gov/graphics/howdoi/address.htm

• Valid Documentation for J-1

• Uninterrupted ECFMG Sponsorship / Valid SEVIS Form DS-2019
• Valid Form I-94
• http://www.ecfmg.org/evsp/index.html

Continuation of J-1 Visa Sponsorship

• Available when progressing in a full-time

• GME training program

• Requires approved contract - usually annual

• Continuation Applications Available @

• http://www.ecfmg.org/evsp/index.html

• Online Application Payment and Status updates through OASIS http://www.ecfmg.org

Special Appeals to the U.S. Department of State

• Changes in J-1 Visa Category

• Exceptional Extensions of Stay Beyond Seven Years

• Advisory Opinions in Special or Unusual Circumstances

• Reviewed on case-by-case basis;

• contact EVSP for further information.

Considerations Specific to IMGs in General Surgery

EVSP Resources Review

• EVSP Homepage @ http://www.ecfmg.org/evsp/index.html for access to:

• EVSP Reference Guide
• EVSP Fact Sheet
• Application Materials
• Updates and Memoranda

• U.S. Department of State Exchange Visitor Program @ http://exchanges.state.gov/education/jexchanges

• U.S. Citizenship and Immigration Services @

• www.uscis.gov

• U.S. Department of Homeland Security @

• www.dhs.gov/dhspublic

Questions?

• Exchange Visitor Sponsorship Program

• Tel: [phone]

• Fax: [phone]