Immigration and Federal Government Updates How Do These Changes

							              Immigration and Federal
              Government Updates: How Do
              These Changes Impact
              International Medical Graduates
              and Graduate Medical Programs


Presented by Rose Mary Valencia
Director, Visa and Immigration Services Administration
 The University of Texas M.D. Anderson Cancer Center
ryvalenc@mdanderson.org
713/794-5107
Immigration Status for U.S. Graduate
Medical Training
   A with valid EAD             O-1
   Asylum with EAD              Pending Permanent
   E-1 or 2 with valid EAD       Resident with EAD
   E-3                          Permanent Resident
   E3D with valid EAD           Refugee with EAD
   F-1 OPT with valid EAD       S with EAD
   H-1B Clinical
                                 T with EAD
   J-1 Alien Physician
                                 TPS with EAD
   J-2 with valid EAD
   K-1, 2, 3, & 4 with EAD      V-1, 2, & 3 with EAD
   L-2 with valid EAD
Visas Which Must Be Sponsored by Graduate
Medical Education Programs

   E-3 for Certain Australian Nationals Who Will
    be Employed in a Specialty Occupation
   H-1B Clinical
   J-1 Alien Physician sponsored by ECFMG
   O-1Extraordinary Ability in the Sciences

   F-1 OPT is not sponsored by GME but must be sponsored by
    academic institution where student received U.S. MD
F-1 Optional Practical Training

     Restricted to 12 months max unless employed with E-Verify
      employer and meets new F-1 OPT regulations which could
      permit an additional 17 months of OPT benefit
     Physician was sponsored on an F-1 student visa for U.S.
      Medical Degree education;
     Physician must present a valid EAD granted by US CIS;
     Change of status to another visa category will be required if
      program cannot be completed within the period of the
      authorized EAD.
     J-1 ECFMG; H-1B Clinical; E-3; and, O-1 possible visa
      options
     Change of status must be approved & received before F-1
      OPT expires.
Employer Obligations and Concerns When
Sponsoring E-3 Visa

   Willingness to sponsor & pay W-2 Wages
   Secure approved Labor Condition Attestation
   Comply with all Department of Labor regulations
   Restrict employment to job title, duties, %, &
    location(s) as defined on petition
   Processing time
   Application fees if physician seeks change of
    status in the U.S.
   E-3 numerical limitation of 10,500 per fiscal year
Physician’s Obligations and Concerns When
Seeking E-3 Visa Sponsorship

   Physician must meet all criterions to be granted E-3 visa
   Employment restricted to employer &employment as defined
    on LCA and appointment letter
   E-3 does not permit Dual Intent
   E-3 does not carry a two-year home residency obligation;
      If physician is already subject to the two-year home
       residency obligation, physician will not be eligible to change
       status in the U.S.
      Does not prohibit E-3 to be granted by U.S. Embassy or
       Consul abroad and US Customs and Border Protection
      E-3 visa does not remove two-year home residency
       obligation but rather places obligation on HOLD
   E-3 dependent(s) are eligible for EAD
E-3 Document Required
    Original Labor Condition Form signed by employer;
    Department of State Visa application;
    Proof of Australian Citizenship;
    Job Offer Letter which contains job title, salary, begin date,
     description of job duties, and, professional credential
     requirements;
    License or permit to practice medicine in the State;
    Medical degree and evidence of equivalency;
    Evidence of strong ties to home country (E-3 does not
     permit dual intent)
    Evidence of any previous immigration status being lawful.
J-1 Alien Physician
   Traditional visa sponsored for GME Training
   Sponsored by ECFMG for
      Qualified International Medical Graduates requiring visa
       sponsorship for GME training
      Qualified U.S. Graduates who are Internationals requiring
       visa sponsorship for GME training
   Permits full-time educational training not employment
   Limited to the time typically required to complete specialty or
    subspecialty training requirements as determined by the
    American Board of Medical Specialties (ABMS) not to exceed
    maximum stay granted is seven (7) years
   Carries two-year home residency requirement
J-1 ECFMG General Sponsorship Requirements


   Passage of acceptable medical exams;
   Standard ECFMG Certificate as defined by ECFMG;
   Contract or an official letter of offer for a position in
    an approved GME or training program;
   Statement of Need;
   Evidence of sufficient financial funds;
   Required insurance;
   ECFMG fee(s); and,
   General visa sponsorship eligibility
Fees
 Initial or Continuation Sponsorship
   $200.00 Administrative Fee
 Change of Category; Exceptional
  Extension of Stay; and Advisory Opinion
   $606.00 per request
Physician Documentation to Qualify for H-1B
Clinical Visa Sponsorship

   Evidence of successful passage of the Federation Licensing
    Examination (or an equivalent examination as determined by
    the Secretary of Health & Human Services or is a graduate of a
    United States medical school;
   Evidence of competency in oral and written English;
           Which shall be demonstrated by the passage of the English language
            proficiency test given by ECFMG or USLME I, II, & III or equivalency
            exams; or,
           Is a graduate of a school of medicine accredited by a body or bodies
            approved for that purpose by the Secretary of Education
   Evidence of license to practice in the state (institutional permit
    is acceptable); and,
   Evidence of foreign medical degree being equivalent to a U.S.
    medical degree (e.g. credential evaluation)
Employer Obligation to Sponsor H-1B
Clinical Visa
   Pay 100% prevailing wage or actual wage whichever,
    is the higher of the two with no discrimination to
    others in the same job title;
   Secure approved Labor Condition Form & comply
    with all DOL regulations;
   Pay all H-1B application fees;
   Prepared to pay reasonable transportation cost
    home should need arise;
   Maintain Public Record File; and,
   Prepared to comply with audits
Department of Labor Regulations
   The earliest an LCA can be filed with DOL is 6
    months prior to the program begin date;
   LCA & I-129 should include all sites physician will
    rotate;
      LCA should be posted at all sites
   DOL plans to implement a new portal system called
    iCERT for LCA & PERM;
      Employers or attorneys will be required to create
       new user accounts;
      iCERT timeline is scheduled between April 15 –
       May 15, 2009
O-1 Extraordinary Ability Update

Level of expertise indicating    O-1 Considerations:
the person is one of the small    Initial petition can be done
percentage who have arisen to      for 3 years with one year
the very top of the field          extensions – No finite
                                   period
endeavor
                                  Denial rate
              Or
                                  Processing time of O-1
                                   petition with USCIS and at
Must demonstrate sustained         U.S. Embassy/Consul
national or international         Application fees (including
acclaim and recognition for        Attorney fees) can be paid
achievements in the field of       by employer or international
expertise by providing such       Premium Process is
evidence.                          possible
Travel Alert Updates
   Visa applicants must schedule appointments on-line at www.travel.state.gov
   All visa applications at U.S. Embassy or Consul are subject to:
        Personal interviews;
        Security Clearances; and,
        10 print biometrics.

   F, J, H, and O interviews appointments are given priority; however,
    appointment does not guarantee
        Visa will be granted; nor that
        Visa will be granted on same day as interview

   Rise in visa application delays due to Security
        Large number of Security delays currently being experience appear to be Technology
         Alert List (TAL) related
        Internationals who have been subject to the TAL delay have been delayed by 20 days
         to four months.
        IMG’s and GME Programs should be prepared for potential delays in return to the U.S.

        NO EXPEDITE FOR SECURITY CLEARANCES
Reporting Change of Address

   All non-U.S. Citizens must comply with the filing the
    appropriate AR-11 Change of Address Form to DHS
    within 10 business days of such address change for
    each non-U.S. citizen in the household who has a
    change of address
   AR-11 can now be done on-line at www.uscis.gov
   ECFMG encourages IMG’s on the J-1 Clinical Visa to
    report Change of Address in OASIS so they can
    report to SEVIS timely
          IMG is also encouraged to file AR-11
New I-9 Delayed Until 4/3/09
   A federal register notice published on February 3, 2009 delays
    the effective date of use of the new I-9 until April 3, 2009

   Rule amends
        Types of documents acceptable in the I-9
         identity and employment authorization
         verification process, and
        Requires all documents to be unexpired in
         order to be acceptable for I-9 purposes.
   Employers must ensure use of correct version of Form I-9 to
    verify the employment eligibility of new hires.
No Match Letters/Social Security
   Rule will require employers to take timely steps after
    receiving a “no-match” letter from the Social
    Security Administration (SSA) or the Department of
    Homeland Security (DHS).
   Steps to be taken will be identified in letter received
    from either SSA or DHS
   Currently, this rule is in the courts and the latest
    update is that the courts will not act on this matter
    until March, 2009 or later.
Department of Public Safety and/or
Motor Vehicle Regulations
   In preparation & compliance with Real ID Act,
    States have begun to enforce changes in
    eligibility of initial, renewal , or replacement
    Driver Licenses and/or State IDs
     Valid immigration status;
     Immigration status valid at least six months in the
      future at the time of application
E-Verify

   Federal Contractor E-Verify Rule
    Delayed Until May 21, 2009
     Rule would require federal contractors to
      enroll in E-Verify
   State E-Verify Rule
     CertainStates have already implemented
      the E-Verify System and others have
      proposed such legislation at State level
Resources
   ECFMG – www.ecfmg.org
   Department of Labor – www.dol.gov
   Department of State – www.travel.state.gov
   Citizenship & Immigration Services – www.uscis.gov
   Customs & Border Protection – www.cbp.gov
   Immigration & Customs Enforcement – www.ice.gov
   I-9 – www.uscis.gov
   Real ID Act – www.dhs.gov
   No Match Letters – www.dhs.gov
   Social Security Administration – www.ssa.gov