1 Educational Commission for Foreign Medical Graduates: An Overview.

11

Educational Commission Educational Commission for Foreign Medical for Foreign Medical

Graduates: An OverviewGraduates: An Overview

Copyright©2005 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights Copyright©2005 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved.reserved. 22

New Logo for ECFMGNew 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

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


ECFMGECFMGPrivate, Non-profit Private, Non-profit

OrganizationOrganizationOrganizational 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 ServicesECFMG Services

ECFMG Certification - Credentials

Certification Verification Service (CVS)

Electronic Residency Application Service (ERAS)

Exchange Visitor Sponsorship Program (EVSP)


““IMG” DefinitionIMG” 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 CertificationECFMG 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 programsECFMG Certification is required for:

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


Medical Education CredentialMedical Education Credential Requirements for ECFMG CertificationRequirements 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 Examination Requirements for ECFMG Certificationfor ECFMG Certification

Spoken English Proficiency (SEP) is part of the USMLE Step 2 CS

English language proficiency test (TOEFL)

USMLE Step 2 CSClinical Skills

ECFMG Clinical Skills Assessment (CSA)

USMLE Step 2 CK Clinical Knowledge

USMLE Step 2 Clinical Science

USMLE Step 1 Basic Science

USMLE Step 1 Basic Science

Current RequirementsPrior Requirements*

*A valid ECFMG Certificate may be based on previously-administered examinations.


ECFMG Certification ECFMG Certification ResourcesResources

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

http://www.ecfmg.org/cert/permvald.pdf

http://www.ecfmg.org/forms/form295.pdf


Certification Verification Certification Verification ServiceService(CVS)(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 OnlineCVS 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 [email protected]

http://www.ecfmg.org/cvs


Electronic Residency Electronic Residency Application ServiceApplication Service

(ERAS)(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 VisitorExchange Visitor Sponsorship Program Sponsorship Program

(EVSP)(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

1414

Immigration Options Immigration Options for Foreign National for Foreign National

PhysiciansPhysicians


Who Needs a Visa?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 TermsImmigration 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.


Entry into U.S. GMEForeign National Physicians and

IMGS 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 TypesMost Common Visas Typesfor for Foreign National Physicians in U.S. in U.S.

GMEGME 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 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 Considerations Specific to IMGs in General SurgeryIMGs in General Surgery

Preliminary Years

Research Before/Durin

g Training

Subspecialty Training

Give IMGs competitive edge

Requires advance to categorical

Extends overall duration

Prior to residency requires change of category

During residency extends overall duration; visa timeframe considerations

Requires careful planning

Must change visa status or petition for an exceptional extension if not completed within allowed visa status maximum


J-1 Exchange Visitor VisaJ-1 Exchange Visitor Visa

vs.vs.

H-1B Temporary WorkerH-1B Temporary Worker


J-1J-1 Visa StatusVisa 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 StatusH-1B Visa Status

Temporary Worker in a Specialty Occupation “Dual Intent” Employer sponsored USMLE Steps 1, 2CK, 2CS, 3 Funding – hospital salary 6 year maximum No home residency requirement H-4 dependents not eligible to work 6 - 16 weeks Fees - DHS, DOL & Attorney


Immigration StepsImmigration 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 ProcessVisa 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 SponsorshipECFMG 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 6 Steps of the J-1 Visa Sponsorship ProcessJ-1 Visa Sponsorship Process

1. TPL and Physician Complete Application, Submit to ECFMG

2. ECFMG Regional Advisor Evaluates Application TPL is notified of application deficiencies If all requirements are met, application is approved

Electronic SEVIS record is created SEVIS Form DS-2019 is issued

3. SEVIS Form DS-2019 is mailed to TPL TPL makes copy for hospital records TPL forwards SEVIS Form DS-2019 to the physician



(continued)(continued)

4. Physician Applies for J-1 Visa Status U.S. Embassy or Consulate abroad, or USCIS

Regional Service Center in the US Requires electronic SEVIS Record and Form DS-

2019

For detailed instructions see:Option 1: Apply at U.S. Embassy or Consulate Abroad

http://www.unitedstatesvisas.gov/obtainingvisa/index.html

Option 2: Apply for Change of Visa Status in the UShttp://www.uscis.gov



http://www.uscis.gov/



(continued)(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 ReportingRequired J-1 Reportingby by Host Institutions & TPLsHost 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 TRAVELINTERNATIONAL TRAVELIS DISCOURAGED

DURING TRAINING PROGRAMSDURING 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 StatusMaintaining 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 Continuation of J-1 Visa Sponsorship 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 theSpecial Appeals to theU.S. Department of StateU.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 Considerations Specific to IMGs in General SurgeryIMGs in General Surgery

Preliminary Years

Research Before/Durin

g Training

Subspecialty Training

Give IMGs competitive edge

Requires advance to categorical

Extends overall duration

Prior to residency requires change of category

During residency extends overall duration; visa timeframe considerations

Requires careful planning

Must change visa status or petition for an exceptional extension if not completed within allowed visa status maximum


EVSP Resources ReviewEVSP 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?Questions?

Exchange Visitor Sponsorship ProgramTel: (215) 823-2121Fax: (215) 386-9766

1 Educational Commission for Foreign Medical Graduates: An Overview.

Documents

Transcript of 1 Educational Commission for Foreign Medical Graduates: An Overview.