Questions? Contact Us

Ann Dohn, MA

Director, Graduate Medical Education
Designated Institutional Official (DIO), ACGME
Training Program Liaison, ECFMG
Special Programs Coordinator, Medical Board of California
Institutional Official, NRMP 

650-723-5948 (office)

International Medical Graduates & J-1 Visas

NEW! J1 Visa training module available

Click to access on HealthStream

About J-1 Visas

  • Incoming and continuing J-1 visa house staff are required to obtain their J-1 visas before their training. Failure to submit the requested documentation will result in a delayed start date.
  • Outgoing J-1 house staff are required to complete mandatory tasks in the Exiting House Staff Checklist.
  • ECFMG requires applicants to pay the application fee through ECFMG’s On-line Applicant Status and Information System (OASIS), which can be accessed through the ECFMG website at Please note that the J-1 sponsorship application fee is non-refundable.
  • Stanford Health Care (SHC) Hospital/Lucile Packard Children’s Hospital (LPCH) support the use of the clinical Educational Commission for Foreign Medical Graduates (ECFMG) sponsored J-1 visa for clinical trainees.
  • For IMG medical licensing information, please see our CA MD License page and/or visit


About H1B Visas

  • Under some circumstances, trainees may be allowed to use H1B visa.
  • Use of the H1B visa is at the discretion of the Stanford Training Program and the Stanford Designated Institutional Official (DIO).
  • The cost of obtaining a H1B visa is the responsibility of the House Officer’s Stanford Training Program.


To Program Directors and Coordinators

Program leadership and coordinators must review the ECFMG certificate requirements to ensure the applicant is eligible to participate as a J-1 visa holder in the training program.

New U.S. Citizenship and Immigration Services (USCIS) Policy, Effective August 9, 2018

Violation of status become "unlawful presence"

On May 10, 2018, U.S. Citizenship and Immigration Services (USCIS) issued a new policy, effective August 9, 2018,  that creates major new penalties, including significant bars to attaining permanent resident status, to F-1 Students and J-1 Exchange Visitors (and although not discussed here, M-1 Vocational Students), as well as their dependent family members who violate their immigration status.  This is a major new development that reverses existing immigration policy dating back to 1997.  As a result, foreign nationals in F or J status should be aware of both this new initiative and the allowable scope and duration of their allowable immigration status, and devote increased attention to strictly maintaining their authorized immigration status.

When entering the United States, F-1 Students and J-1 Exchange Visitors are admitted for the duration of status (D/S), meaning that while a specific date does not appear on their I-94 forms, their period of authorized status is limited to the temporal duration appearing on their I-20 Certificate of Eligibility for Nonimmigrant Student Status or DS-2019 Certificate of Eligibility for Exchange Visitor (J-1) Status.  Thereafter, there are two underlying concepts in order to maintain F or J status:  (1) individuals in this status are admitted to the United States for temporary periods of time; and (2) individuals holding this status are limited in the activities they can pursue while in the United States. 

Previously, violations of F or J status would normally be regarded as a status violation, which would present certain inconveniences at the time either of changing into another temporary, non-immigrant visa status and/or attaining permanent resident status. More serious problems would arise only if an immigration judge or USCIS made a formal, affirmative determination that a status violation had occurred.  But in most situations, a violation of status would not rise to this level and would instead get essentially resolved over time.

But under this new directive, violations of status – including: nonimmigrant status overstays, unauthorized employment, failure to maintain required course loads, and other violations of status -  will be considered as “unlawful presence,” which is a far more serious situation from an immigration standpoint.  More specifically, accruals of 180 consecutive days in unlawful presence would result in a 3-year bar to a foreign national’s returning to the United States, and accruals of a year or more of unlawful presence would result in a 10-year bar.  While these draconian bars can in some instances be waived, USCIS has become increasingly restrictive in its approval of waivers for foreign nationals subject to the 3/10-year bars.

Furthermore, the mandatory Student and Exchange Visitor Information System (SEVIS) provides a much more effective tracking system to determine when violations occur of F-1 Student and J‑1 Exchange Visitor status. 

What makes this policy even more concerning is that USCIS will in most instances not provide any advance warning or issue any specific adjudication that would inform an F or J nonimmigrant that he/she has begun to accrue unlawful presence.  Rather, the determination as to whether a violation has occurred that will trigger a finding of “unlawful presence” will oftentimes occur either at the time that the foreign national seeks to adjust to permanent resident status or returns from a trip abroad.  This makes it even more important to proactively make sure that all activities and periods of residence occur in strict conformity with F or J status.

As noted above, this new policy will go into effect on August 9, 2018. 

In light of this new development, we feel it is important for affected foreign nationals to do the following:

  • Make sure that you firmly understand both the time limits as well as the scope of authorized activities within your visa classification.
  • Particularly, as of August 9, 2018, make sure that you are acting in a manner fully consistent with your visa status, since any unauthorized activity following that date will trigger the “unlawful presence” accrual periods.
  • Remember that these harsh consequences for a violation of status apply also to your dependent family members.
  • Please consult with the your appropriate advisors if you have any questions on whether or not you are maintaining fully your immigration status.


The J-1 Visa Process

When an international medical graduate (IMG) is accepted into a Stanford training program, the GME office will initiate the J-1 visa application for the IMG housestaff. The J-1 applicant has the following responsibilities:

  • Eligibility Requirements
  • Apply for a J-1 Visa
  • New/Arrival of J-1 Visa
  • Maintain a J-1 Visa
  • Expired J-1 Visa
  • End a J-1 Visa


The J-1 visa process is a time-sensitive process. All e-mails sent by Ann Dohn are considered high priority.


Eligibility Requirements

According to ECFMG, page 6:

Foreign nationals applying for sponsorship as J-1 “physicians” to participate in clinical programs of graduate medical education (GME) must meet the following general requirements:

  • Pass USMLE® Step 1, Step 2 Clinical Knowledge (CK) and Step 2 Clinical Skills (CS); or the former VQE, NBME® Part I and Part II, or FMGEMS; or an acceptable combination thereof. (Note: The former one-day ECFMG Examination and the Federation Licensing Examination (FLEX) do not meet the requirements for J-1 visa sponsorship.)
  • Hold a Standard ECFMG Certificate without expired examination dates, if applicable. (Note: Graduates of LCME-accredited U.S. and Canadian medical schools are not required to be ECFMG-certified.)
  • Hold a contract or an official letter of offer for a position in an approved graduate medical education or training program.
  • Provide a Statement of Need from the Ministry of Health of the country of nationality or most recent legal permanent residence. This statement must provide written assurance that the country needs specialists in the area in which the Exchange Visitor will receive training and that he/she will return to the country upon completion. If permanent residence is in a country other than that of citizenship, the Statement of Need must come from the country of most recent legal permanent residence.


Duration of Stay/Sponsorship Limits

ECFMG’s sponsorship for GME participation is limited to the time typically required to complete specialty/subspecialty training requirements as determined by the American Board of Medical Specialties (ABMS). The duration of sponsorship is further limited to a maximum of seven years. 

Frequently Asked Questions (FAQs)

I am attending a conference outside of the U.S. What do I need to know?

You must notify Ann Dohn 3-4 weeks in advance that you are leaving for a conference outside of the U.S. Your DS-2019 will be updated by Ann. According to ECFMG, to reenter the U.S. following international travel, you are required to bring a(n):

  • Passport, valid for at least six months beyond the program end date on the most recent Form DS-2019.
  • Valid J-1 or J-2 visa. (Note: A visa is not required for Canadian citizens seeking to reenter the United States.)
  • Original Form DS-2019 with travel signature in the “Travel Validation by Responsible Officer” box on lower right side of Form DS-2019. Only ECFMG personnel can provide the required travel validation signature. 

Please read more here when traveling to Canada, Mexico and adjacent islands of the U.S.  Learn more about outside travel of the U.S. here.