International Physician Immigration and Recruitment
Just as the demographics of the overall population are changing in the United States, so are the demographics of the nation’s medical workforce. Today, approximately one-quarter of physicians in active patient care in the United States are international medical graduates (IMGs). Some of these IMGs are U.S. citizens who graduated from a medical school located abroad. However, many of these physicians were born abroad, and came to the United States to complete medical residencies and fellowships. They must qualify for temporary visas in order to work in the U.S.
It is therefore important for hospitals, medical groups, academic centers, community health centers and other facilities who wish to recruit these physicians to have some understanding of U.S. immigration laws. What follows are a number of frequently asked questions concerning U.S. immigration laws as they pertain to internationally trained physicians who were born abroad.
The questions and answers were prepared by Carl Shusterman, a prominent immigration attorney based in Los Angeles whose 7-attorney law firm specializes in obtaining visas for health care employers located across the U.S. and with whom Merritt Hawkins has worked with for over 20 years.
Top Frequently Asked Immigration Questions and Answers
What Is an International Medical Graduate (IMG)?
Any person, U.S. citizen or otherwise, who attended a non-U.S. or a non-Canadian medical school.
How Many Residents Are IMGs?
Of the 24,000+ residents who complete U.S. medical residency training each year, over 6,000 are IMGs.
What Must IMGs Do to Practice in The U.S.?
A system is in place to ensure that IMGs have the same skill sets as U.S. or Canadian graduates. To practice in the U.S., IMGs must:
- Obtain the Educational Council of Foreign Medical Graduates (ECFMG) Certificate showing equivalent knowledge to U.S./Canadian med school graduates.
- To get an ECFMG Certificate they must pass USMLE I and II, and pass the ECFMG English language test. USMLE Part II has been split into two parts: CK (Clinical Knowledge) and CS (Clinical Skills) so that the old Clinical Skills Assessment (CSA) test is no longer given.
- In a number of states, physicians can take USMLE Part III before beginning their residency programs. Physicians who want to enter the U.S. on H-1B visas to do their residencies must have taken and passed USMLE I, II and III and received their ECFMG certification.
- After completion of their residency programs, IMGs may apply for state medical licenses.
What about Canadian Physicians?
Canadian doctors are a different ballgame. They are not considered IMGs. The Canadian exam (LMCC) is reciprocated for licensure in some 40+ U.S. states. However, to work in H-1B status, Canadian physicians must have passed one of the following U.S. examinations – the USMLE, FLEX, or the NBME. If they do, and once they obtain licensure in the relevant state, a medical facility may sponsor them for H-1B status.
For more information on visas and waivers, download our Immigration FAQ whitepaper. If you unique questions regarding your situation, watch Carl Shusterman’s eight online presentations at
www.shusterman.com or contact him directly at 213-623-4592 ext. 0.