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F-1 Issues for Medical Residency

Applying to Programs that Sponsor the H-1B

One of the big drawbacks of being an F-1 medical student is that you must look for hospitals that sponsor the H-1B status and are cap-exempt* (most teaching hospitals are cap-exempt) for your residency.  Although this does not affect your competitiveness, it severely limits the options you have in applying to your choice hospitals and programs.

The following websites have information about hospitals that may sponsor the H-1B status.  This information is only to be used as a rough guide as it may be incomplete or outdated.  Contact the hospitals directly to verify information.

Thomas Jefferson University Hospital sponsors the H-1B status and is a cap-exempt institution.

*cap-exempt = no limit on the number of H-1B employees they can sponsor

Why won’t many hospitals sponsor the H-1B?

The H-1B sponsorship has more liability, paperwork, and financial burden, among other things for the employer.  Therefore, many hospitals will sponsor the J-1 status under ECFMG instead. 

Why should I avoid the J-1 status like the plague?

DO NOT get into the J-1 status if you are planning to establish your medical career in the United States.  Changing to the J-1 status will have the following consequences:

  • You will have a 2-year home residency requirement.
  • It is extremely difficult to get a waiver for this 2-year requirement.
  • This requirement must be fulfilled or waived before you can apply to change to the H-1B status, or a green card.
  • This requirement can only be waived if you can prove extreme hardship (i.e., persecution from your home country).  Being apart from children or spouse does not qualify as extreme hardship.
  • You can fulfill this 2-year requirement by working at a federally mandated hardship post in the U.S. for a minimum of 3 years (which is also difficult to obtain)
  • You can fulfill this requirement by residing in your home country for 2 years before returning to the U.S. to practice.

Transitioning from the F-1 OPT to H-1B Status

Unfortunately, there is currently no provision for OPT extensions for MD graduates.  In order to continue your residency in the U.S. you need apply for a change in immigration status during your OPT.

If you will stay at the same hospital for 2nd year residency, there will be no need to adjust your program to complete your first year residency by your OPT end date.   The hospital at which you will remain can file the H-1B for you to continue working there.

If you will go to another hospital for 2nd year residency, then you must work out a schedule with your first year program so that it ends on or before your OPT end date.  If this is not possible, you must request the hospital to sponsor you in the H-1B for the remaining time.  You would then transfer your H-1B sponsorship to the new hospital.