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International Student Guide to Matching

by Jin Soon Yeoh, MSIV 2007

updated by OIA 2012

If you are reading this, congratulations on making it this far! It is stressful enough applying for residency without having to think about visa requirements. This guide is written specifically to steer you in the correct direction and in doing so hopefully secure you the residency of your choice.

Before we begin, here are 3 important rules you should know:

  1. Being an international student should not prevent you from matching into a residency program
  2. You are an American Medical Graduate (AMG), not an International Medical Graduate (IMG)
  3. J-1 immigration status is not that much easier to obtain than H-1B status

Step 1: Choose your visa

You need to decide whether you plan to remain in this country or plan to return to your home country once residency is completed. This decision will determine your visa of choice. Many institutions are amenable to the more restrictive J-1 visa (sponsored by ECFMG not your program) which requires you to return to your home country for 2 years after residency versus the more flexible H1-B. This is mainly because of the difficulties posed by administrative issues encountered in obtaining H1-B employment status from immigration policies outlined by the United States Customs and Immigration Services (USCIS).The more obvious reasons are that many departments simply do not have much experience in dealing with the USCIS and time-sensitive issues regarding immigration issues, they may find the process a strain on their resources.

Step 2: Select your program

If you decide on the H1-B status, it is your job as an international student to find out which programs sponsor it. Make sure you emphasize that you are an American Medical Graduate on F-1 status and not an International Medical Graduate. Also, remind them that you will have a year of Optional Practical Training (OPT - more on this later) before they have to apply for your status change. This may pacify some programs and help them rethink strict policies.

One common issue I recognized during my application process was that many schools would not provide me with a straight answer regarding their sponsorship of a particular immigration status. Do not fret! You should still apply to that program if you are determined to match there. However, it is vital that you continue to bring the subject up with the Program Director either through email or during your interview.

Step 3: Follow-up with your application

Another issue I encountered during my application process was that many schools would not even review your application if they think that you are an IMG. This problem stems from your ERAS application in which you are required to declare your citizenship and your status of choice. Many schools make the clerical error of lumping you with IMGs without further consulting your application. If this happens, they would simply set your application aside without ever informing you. By following-up, you not only reconfirm your status as an AMG, you would also be showing significant interest toward that program.

Step 4: Interviewing

The interview process is where you can truly shine. Your immigration status more often than not serves as a good conversation point. Most programs recognize your unique background (if you have one) and will quiz you about it. Another important question you should be prepared for regarding your immigration status is whether your training will be interrupted by all the bureaucracy. As many programs are clueless when it comes to immigration, make sure you articulate clearly your plan in securing your status. Below is my standard answer to this question:
“I believe your program sponsors the H1-B and/or J-1 immigration status. As I am an F-1 student, I will not require change in status immediately as I will have my Optional Practical Training visa which is valid for a year. This will give your program time to apply for my change to H1-B or J-1 status later and therefore, will not jeopardize my internship start date. I will need to apply for the change to H1-B or J-1 status in November of (the same year you start residency as it takes up to six months to obtain your H1-B status). I will make the necessary provisions for obtaining that status when the time arrives.”

Step 5: Changing their minds

During your interviews, if you find yourself face-to-face with a program which is resistant to sponsoring H1-B status, you may still persuade them into changing their tune with some compelling arguments. Here are the 3 reasons (for the program director not for you) for getting into H1-B status over a J-1 status:

  1. They get to keep you on staff if they like you at the end of residency
  2. It's easier to place you in a fellowship in H1 rather than J1 status
  3. Now with no cap for academic institutions, there is a low likelihood of your application getting rejected.

Step 6: Now what?

You need to get your Optional Practical Training (OPT) before you match as it can take up to 120 days for your OPT to be approved. The Office of International Affairs (OIA) will generally have contacted you by the end of January regarding the application process for OPT. If not, all you have to do is contact OIA and ask to speak with Eugenia Kim who will provide you with all the details on the process. You can also visit for the most up-to-date requirements for your application. The OIA is your greatest resource and they will have everything lined up for you prior to sending out your paperwork

After you match, you will need to apply for either your H1-B employees status or your J-1 medical trainees status sometime in November of your internship. This is necessary as it can take up to six months for your application to be processed. Contact the Graduate Medical Education office where you matched to get more information.


Relevant Information

What is an OPT?

The OPT is a status which enables you to obtain an Employment Authorization Document (EAD). Essentially, it is an extension of your existing I-20 (expires when you graduate), which together with your F-1 visa (which usually expires one year after graduation - for OPT purposes) and the EAD card (issued after you apply to USCIS), allows you to remain legally in this country for one calendar year beyond graduation to work in a field related to your degree. The OPT is a necessary devil as without it you cannot start your intern year.

What are the differences between J-1 and H1-B statuses?

This is a tough question that I will try to answer to the best of my knowledge.

The J-1 is sponsored by the ECFMG and is designed for visiting professors, scholars, and professionals. The length of the status for medical trainees is 5-years with a possible 2-year extension, depending on your program. Upon completion of your program, you must leave the United States and return to your home country for a period of 2 years before you can apply for readmission. This is an extremely strict requirement of J-1 regulations and most people are forced to comply. There is, however, one way around this rule; by applying for a J-1 waiver. This usually requires that you spend the next few years working in an underserved community in the United States. The waiver programs are rare and difficult to obtain so think carefully before you decide on the J-1. Also, there is no cap on the number of Exchange Visitors in J-1 status. In other words, unlimited J-1 visas can be issued.

The H1-B, in many ways, allows more flexibility. Unlike for the J-1, there is no requirement to return to your home country after you complete your residency. This leaves room for you to apply for a green card if you so choose. The H1-B application is also subject to greater scrutiny than the J-1. Your application must be approved by both USCIS and the Department of Labor before you are issued the status. It can take up to 6 months for this process to happen. There is a cap on the number of H1-B employees per year, but there are exemptions that may apply to an academic institution.
My advice: Choose H1-B status.

How do I apply for H1-B status?  

The process of applying for H1-B status can be an expensive and time-consuming process. The consensus is that the application fees can cost the employer from $2000 to $8000.

The application alone costs more than $1,320 and legal fees may make up the rest. Your employer will take charge of the process and is required to pay associated fees. Your employer may use in-house personnel to complete the application, or may hire outside immigration attorneys who are familiar with the complicated application process. Once you match, I suggest you immediately seek out the designated person at your new place of employment in order to initiate your application process. For a better understanding, check out the following website:

Remember these numbers and steps as you may be questioned about it during your interview. Knowledge of the process indicates your preparedness and keenness to go the extra mile. This is a list of programs that may sponsor H1-B status from personal experience and from others in your shoes: (this list is not comprehensive and is subject to change depending on the program to which you apply. Make sure you inquire before passing judgment)

Boston University
Cleveland Clinic
Johns Hopkins
SUNY Buffalo
SUNY Downstate
SUNY Upstate
University of Miami
University of Pennsylvania
Wayne State University

This is a list of programs that sponsor the J-1 visa:

Loma Linda
Mt Sinai
University of Florida
University of Michigan
University of Pittsburgh
University of Washington
Washington University in Saint Louis

Important Websites and Numbers

Jefferson Office of International Affairs (OIA)

United States Customs and Immigration Services

Bureau of Consular Affairs

Final Thoughts

It is important to realize that being an F-1 student will not reduce your matching chances nor will it make you a less desirable candidate. Although the residency matching process becomes slightly more complicated, with careful planning, there is no reason for you not to match successfully. There should be no surprises come Match Day as long as you keep good contact with the programs in which you are interested. I cannot stress this point enough. It is also important to realize that most programs will judge you based on your achievements and not your immigration status. The few that do not are probably not worth your time anyway. Finally, get all your proper documentation together and in a timely manner to avoid any unwarranted delays. Once again, congratulations on getting this far and good luck on matching!

Revised: 8/20

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