Alien Physicians must:

  • Have adequate prior education and training to participate satisfactorily in the program for which they are coming to the United States;
  • Be able to adapt to the educational and cultural environment in which they will be receiving their education and training;
  • Have the background, needs and experiences suitable to the program;
  • Have competency in oral and written English;
  • Have passed either Parts I and II of the National Board of Medical Examiners Examination, the Foreign Medical Graduate Examination, Step I and Step II, or the Visa Qualifying Examination (VQE) prepared by the National Board of Medical Examiners, administered by the Educational Commission for Foreign Medical Graduates;
  • Provide a statement of need from the government of the country of their nationality or last legal permanent residence. Providing written assurance to the Secretary of Health and Human Services that there is a need in that country for persons with the skills the alien physician seeks to acquire and the alien physician has filed a written assurance with the government of this country that he/she will return upon completion of the training; and
  • An agreement or contract from a U.S. accredited medical school, an affiliated hospital or a scientific institution to provide the accredited graduate medical education, signed by the alien physician and the official responsible for the training.


School credit: Graduate medical education or training in a specialty or subspecialty occupation.

More information

Non-clinical exchange participants must have:

  • A designated United States university or academic medical center may issue an alien physician a Form DS-2019 to enable them to come to the United States for the purpose of observation, consultation, teaching or research if the sponsor signs and appends to the Form DS-2019 a certification which states, “this certifies that the program in which…is to be engaged is solely for the purpose of observation, consultation, teaching or research and that no element of patient care is involved;” or
  • The dean of the involved accredited U.S. medical school or his designee must certify the following five points:
    • The program is predominantly observation, consultation, teaching or research;
    • Any incidental patient contact will be under the direct supervision of a U.S. citizen or resident alien who is licensed to practice medicine in the State in which the activity is taking place;
    • The foreign national physician will not be given final responsibility for the diagnosis and treatment of patients;
    • Any activities will conform fully with the State licensing requirements and regulations for medical and health care professionals in the State in which the program is being pursued; and
    • Any experience gained will not be creditable towards any clinical requirements for medical specialty board certification.

Program Sponsors

Educational Commission for Foreign Medical Graduates:

The Department of State has designated the Educational Commission for Foreign Medical Graduates (ECFMG) as the only sponsor for all alien physicians who wish to pursue a program of graduate medical education or training.

ECFMG is required to:

  • Verify that the foreign national physicians meet J-1 eligibility requirements; and
  • Upon establishing an applicant’s eligibility, ECFMG issues Form DS-2019, Certificate of Eligibility for Exchange Visitor (J-1) Status. The physician may also request Form DS-2019 to enable dependents (spouse and unmarried, minor children) to apply for J-2 dependent status.


Host institutions are required to provide the J-1 physician with the approved clinical training. Each host institution designates a Training Program Liaison (TPL) who serves as the official representative to communicate with ECFMG.

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