There is a proposal for a visa rule change September 25 by US Immigration and Customs Enforcement (ICE) that would affect those with visa classifications targeted as J-1. This rule has the potential to cause significant disruptions to the medical training of the more than 12,000 J-1 holding visas physicians at almost 750 teaching hospitals across the United States.

In addition, there would be a significant adverse effect on patient care, particularly to underserved populations. Many residents in New Jersey are training under J1 visas, and the proposed rule change that jeopardizes their status has direct consequences for care delivery in our state.

Specifically, the proposed change by ICE would eliminate "duration of status" as an authorized period of stay, replacing it with a specific end date. Currently, J-1 physicians' authorized period of stay is extended after they successfully complete the ECFMG/FAIMER annual review process.

If the proposed rule change is implemented, J-1 physicians' authorized period of stay would not be extended upon completion of the ECFMG|FAIMER annual review process. Instead, J-1 physicians would be required to complete an additional step each year of applying to the U.S. government for an extension of authorized stay which would create an impossible timeline for J-1 physicians and teaching hospitals.

To complete the additional step imposed by the rule change, J-1 physicians have two options:

  • They could apply for the extension through a U.S. Citizenship and Immigration Service (USCIS) Service Center. However, the current published processing times for such extensions at USCIS' five service centers range from 5 to 19 months, jeopardizing the ability of thousands of J-1 physicians to continue in their training programs on time.
  • J-1 physicians also could complete the additional step by leaving the United States each year and applying for the extension through a U.S. consulate abroad. This would upend scheduling continuity in their residency programs and would disrupt their training, create extended delays as they re-apply annually in their country of origin (acceptance back into the country might also not be guaranteed), and, during the current pandemic, international travel poses additional risks of viral transmission.

ACP is working closely with ECFMG|FAIMER which has created an "advocacy toolkit." The toolkit provides instructions and templates on how to provide comment including a sample letter that residents can also participate in sending. The public comment period for the proposed rule change closes October 26 and can be accessed here (https://www.federalregister.gov/documents/2020/09/25/2020-20845/establishing-a-fixed-time-period-of-admission-and-an-extension-of-stay-procedure-for-nonimmigrant).

Offering our perspectives as experienced clinicians is critical helping federal agencies make informed decisions that will have the outcomes they are designed to do. We must make our voices heard for the benefit of our residents and our patients.

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