Widespread J-1 Visa Denials for Doctors in Pakistan

Reliable sources have been reporting a wave of denials of J-1 visas for international medical graduates (IMGs) applying at U.S. consular posts in Pakistan. The scenario involves Pakistani physicians requesting J-1 exchange visitor visas to begin U.S. medical residency programs at teaching hospitals in the United States.

J-1s for Medical Residency

The J-1 visa is, by far, the most common route for IMGs to engage in U.S. medical residency programs. All J-1s for such residency programs are sponsored through the Educational Commission for Foreign Medical Graduates (ECFMG). There are some hospitals willing to sponsor H1B temporary professional worker petitions for medical residents. These programs are in the minority. Additionally, due to certain further testing requirements, not all IMGs qualify for H1B status at the outset of their U.S. residency programs.

Examples: J-1 After B-1/B-2 Visits Resulting in Denials

The Murthy Law Firm has been contacted by a number of doctors regarding recent J-1 visa denials in Pakistan. The apparent concern underlying the denials is that these doctors previously used B-1/B-2 visitor visas to travel to the United States in order to take the required U.S. Medical Licensing Exams (USMLE). Portions of the USMLE, known as steps, are offered only in the United States.

Typically, the time in B-1/B-2 status is also used for attending residency interviews at U.S. hospitals as part of the selection process. These activities are entirely permissible on a B-1/B-2 visa, and the visitor’s visa is often issued to IMGs precisely for these purposes. The doctors facing these problems completed their respective B-1/B-2 visitor activities in the United States and departed the U.S. thereafter to comply with the B-1/B-2 requirements.

Apparent Confusion Regarding B-1/B-2 Followed by J-1

For reasons that are not entirely clear, the U.S. consulates in Pakistan are routinely denying J-1 visa applications for such IMGs, apparently based on a misunderstanding that there was something improper about traveling to the United States in B-1/B-2 status to sit for USMLE exams or to attend residency interviews. Consular officers apparently have also cancelled the J-1 visa applicants’ existing B-1/B-2 visas in such cases.

These denials are inconsistent with the applicable regulations and U.S. Department of State (DOS) guidance. They are also inconsistent with long-standing practices. U.S. consulates have issued B-1/B-2 visas for many years to allow IMGs to engage in the initial steps needed to qualify for and gain acceptance in medical residency programs. Those who obtained passing test scores and were selected for residencies often applied for J-1 visas thereafter. This is standard practice as a way for IMGs to receive U.S. medical training. A significant percentage of U.S. medical residency positions at teaching hospitals throughout the country are filled in this manner.

Timing Concerns for Medical Residency Programs

Residency programs at U.S. teaching hospitals traditionally start at the end of June or beginning of July each year. Physicians who have recently had their J-1 visas denied, therefore, have been placed in a precarious situation. Unless their residency programs are willing to defer their start dates until they can obtain the required J-1 visas, they risk losing their hard-earned positions. This also leaves hospitals with classes that are short of the usual number of residents. Hospitals rely on residents, and the selection process is lengthy and systematized.

Conclusion: Try to Avoid this Problem

While it is hoped that the stakeholder and other discussions with the DOS will lead to a resolution, this is taking some time and residency programs are slated to start orientations this month in anticipation of the formal start date on July 1st. Potential applicants who are not present in the United States should investigate the possibility of applying for the required visas at a U.S. consulate in a country other than Pakistan, if possible. Some applicants who are present in the United States in another status, may benefit by applying for a change of status to avoid travel and delays / denials associated with applying abroad, though this alternative has its own timing concerns. There currently are no ideal options, as we await a prompt and favorable resolution and issuance of J-1 visas to medical residents, absent a proper legal basis for such J-1 visa denials.

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