1 educational commission for foreign medical graduates: an overview
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Educational Commission Educational Commission for Foreign Medical for Foreign Medical
Graduates: An OverviewGraduates: An Overview
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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
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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)
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ECFMG ServicesECFMG Services
ECFMG Certification - Credentials
Certification Verification Service (CVS)
Electronic Residency Application Service (ERAS)
Exchange Visitor Sponsorship Program (EVSP)
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““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
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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
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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
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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.
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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
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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
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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
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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
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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
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Immigration Options Immigration Options for Foreign National for Foreign National
PhysiciansPhysicians
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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
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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.
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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)
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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”
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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
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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
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J-1 Exchange Visitor VisaJ-1 Exchange Visitor Visa
vs.vs.
H-1B Temporary WorkerH-1B Temporary Worker
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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
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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
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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
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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
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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
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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
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6 Steps of the 6 Steps of the J-1 Visa Sponsorship ProcessJ-1 Visa Sponsorship Process
(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
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6 Steps of the 6 Steps of the J-1 Visa Sponsorship ProcessJ-1 Visa Sponsorship Process
(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
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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
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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”
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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
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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
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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.
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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
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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
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Questions?Questions?
Exchange Visitor Sponsorship ProgramTel: (215) 823-2121Fax: (215) 386-9766