Foreign Graduates and Documentation Requirements

The initial appointment process requires specific documents to meet accreditation and licensing standards. One of those requirements is a government-issued photo ID. MPR receives this documentation in a variety of different documents including driver’s license, passport and military IDs. Foreign graduates require even more documentation including a J-1, H-B1 Visa and Green Cards. Several different types of visas exist, but these are the two primarily seen in the medical community.

The J-1 visa is a non-immigrant visa. It is issued by the U.S. government for physicians wanting to participate in a medical training experience within the US. All applicants for the J-1 visa must meet eligibility criteria and be sponsored either by a private sector or government program. J-1 visas are issued for a specific period of time and documented on the DS-2019 form. The length of stay for any given J-1 visa is determined by the category of the visa (e.g. alien physician, intern, student, teacher, trainee).

The J-1 visa non-immigrant is subject to a two-year home country physical presence requirement, which requires the individual to return to their home country for at least two years at the end of the exchange visitor program. This is also known as the foreign residence requirements under U.S. law, Immigration and Nationality Act. If the individual is unable to return to the home country to fulfill the two-year requirement, the individual must obtain a J-1 waiver approved by the Department of Homeland Security prior to changing status in the U.S. or being issued a visa in certain categories for travel to the U.S.

There are five bases set in US immigration law under which an individual may apply for a waiver of this requirement. The individual may only apply under one waiver basis to qualify, which they are as follows:
1. No Objection Statement
2. Request by an Interested US Federal Government Agency
3. Persecution
4. Exceptional Hardship to a US Citizen (or lawful permanent resident) Spouse or Child of an Exchange Visitor: and
5. Request by a Designed State Public Health Department or its Equivalent

Dependents of a J-1 non-immigrant (spouse and/or children) are classified as J-2 visa non-immigrants. They are subject to the same laws and requirements of the J-1 visa non-immigrant but are not required to make a separate waiver request. They are automatically put under the J-1 non-immigrant’s application for waiver.

In 2011, new regulations were issued requiring a job offer prior to a visa interview for student visas from Bulgaria, Russia, Romania, Ukraine, Moldova and Belarus.

The H-1B visa is a non-immigrant visa. It is issued by the United States under the Immigration and Nationality Act, section 101(a)(15)(H) and allows US employers to temporarily employ foreign workers in specialty occupations. The regulations define a “specialty occupation” as requiring theoretical and practical application of a body of highly specialized knowledge in a field of human endeavor including but not limited to biotechnology, chemistry, medicine and health. Foreign applicants must possess at least a bachelor’s degree or its equivalent and state licensure, if required to practice.H-1B work-visas are limited to employment by a sponsoring employer. H-1B visas are limited to a three-year stay, extendable up to six years.

A Green Card holder (permanent resident) is someone who has been granted authorization to live and work in the United States on a permanent basis. As proof of that status, a person is granted a permanent resident card, commonly called a “Green Card.” You can become a permanent resident several different ways. Most individuals are sponsored by a family member or employer in the United States. Other individuals may become permanent residents through refugee or asylee status or other humanitarian programs. In some cases, you may be eligible to file for yourself. The application process can start after the individual receives the J-1 wavier approval.

A green card is issued to all permanent residents as proof that they are authorized to live and work in the United States. If you are a permanent resident age 18 or older, you are required to have a valid green card in your possession at all times. Current green cards are valid for 10 years, or 2 years in the case of a conditional resident, and must be renewed before the card expires.

The last stage of immigration is the path to U.S. Citizenship. If you are a green card holder of at least 5 years, you must meet the following requirements in order to apply for naturalization:

Be 18 or older at the time of filing
• Be a green card holder for at least 5 years
• Have lived within the state, or USCIS district with jurisdiction over the applicant’s place of residence, for at least 3 months prior to the date of filing the application
• Have continuous residence in the United States as a green card holder for at least 5 years immediately preceding the date of filing the application
• Be physically present in the United States for at least 30 months out of the 5 years immediately preceding the date of filing the application
• Reside continuously within the United States from the date of application for naturalization up to the time of naturalization
• Be able to read, write, and speak English and have knowledge and an understanding of U.S. history and government (civics).
• Be a person of good moral character, attached to the principles of the Constitution of the United States, and well disposed to the good order and happiness of the United States during all relevant periods under the law


Regardless of the type of visa that an individual holds, there are different expirations for each type. MPR will identify these documents at the time of initial appointment and update the files upon reappointment. If a provider is identified with an expired Visa or Green card, MPR will notify all applicable participating health care facilities.

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