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July/Aug/Sept/Oct 2002

This newsletter, edited by Theodore Sherman, Esq., and published strictly in an electronic format, contains information pertinent to immigration issues for physicians and scientists who desire to reside in the U.S. on a temporary or permanent basis.

Readers who wish to obtain more information on topics are encouraged to forward your queries to us by completing the online consultation form on our website. We will respond to your particular queries as soon as possible.

I regret the delay in issuance of this newsletter, as I have intended to have this newsletter issued at least bi-monthly. I have been working on substantial changes to our website (MDgreencard.com) to make it more user friendly, and so that it better addresses immigration issues affecting physicians and scientists. These changes should be reflected in the next few months in an improved website. Beginning in January 2003, the newsletter will be issued on a much more regular basis.

Current Immigration Climate in US: Changes continue to occur with respect to immigration procedures and processes in the US (see below for some of the more pertinent changes). Most of the changes are aimed at making the immigration process more difficult and therefore, less attractive, to individuals throughout the world, with special emphasis on individuals from countries deemed to harbor or support terrorism. However, some of the changes are indeed for the better (i.e. extension of H-1B visa beyond six-year limit in certain circumstances). For our physician and scientist clients, the negative changes to the immigration laws do little other than create some further inconvenience for those individuals from certain designated countries (Iran, Iraq, Sudan, Libya, Syria, Pakistan, Saudi Arabia, and Yemen). For example, one of our Syrian physician clients was required to wait for 35 extra days in Syria, prior to the issuance of his visa, so that the Embassy could complete a security check. To date, though, none of our clients have really had any serious immigration problems relating to changes in the law since the US Congress started tightening the process. Physicians and scientists are just not considered to be an 'at risk' group of individuals.

Table of Contents
Topics for Physicians / Scientists

1.1 Expansion of Conrad J1 Waiver Program

The US Congress has passed a bill which would increase the number of physicians the US States could sponsor for J1 waivers under the Conrad State program. Under this program, physicians on J1 visas (or previously on J1 visas) are able to obtain waivers of their two-year home residency requirements based on agreeing to work for three-years in an underserved community in the US Each particular US State has its own set of requirements for sponsorship of a J1 waiver, and the great majority limit sponsorship to primary care physicians.

In any event, prior to this soon-to-be-enacted law, US States were limited to sponsorship of 20 physicians. With the new law, each State will be able to sponsor 30 physicians. This increase is needed in view of the termination of the USDA J1 waiver program earlier this year.

Interestingly, a large number of US States who have Conrad Waiver programs (nearly all do) were even unable to fill the 20 spots with interested candidates. With 30 spots, even the busier States may find themselves with openings. This is certainly good news for our physician clients.

1.2 Decrease in Foreign Medical Graduates taking US Medical Licensing Exams

IMGs (international medical graduates) have been consistently represented 25% of both the physician workforce in the US as well as the graduate medical education population. IMGs indeed are part of the faculty in nearly every US medical institution and are highly regarded as some of the top physicians in the field.

In a recent study in the Journal of the American Medical Association (JAMA), it was reported that the number of IMGs registering for the USMLE (US Medical Licensing Examination) dropped more than 50% from 1995 to 2001, from 68,733 to 28,950. Yet, the quality of IMGs has improved as exam passage rates have increased significantly (from 57% to 68% for USMLE Step I).

The reasons for this decrease in exam registration rests mostly on the implementation of the Clinical Skills Exam (CSA), which was initiated by the ECFMG in 1998. The CSA exam, offered only in Philadelphia and Atlanta, at present, was developed to ensure that IMGs have sufficient basic clinical skills to succeed in US residency programs. This exam is quite exhaustive in that candidates must undergo ten exercises where they interact with patients in English and compose case notes.

The CSA exam has resulted in lower numbers of IMGs registering for USMLE, for a few reasons, including: (1) the high cost of the CSA - $ 1200 US (often more than our physician clients earn in a year in their home countries); (2) difficulties in obtaining a visit visa to the US to take the exam; and (3) the worry that some IMGs have that their knowledge of English is not sufficient to pass this exam.

Clinical skills exams are certainly important to ensure that physicians entering US residency programs are adequately prepared and trained (US medical graduates will even be required to pass a similar type of exam beginning in the fall of 2004). Changes to the CSA exam to make it available abroad and at less cost would certainly help the many IMGs who abandon their plans to train in the US due to issues relating to its high cost and difficulty in obtaining a visa.

1.3 Special Registration Procedures

As of September 11, 2002, the INS initiated a Special Alien Registration program to register non-U.S. permanent residents who are citizens or nationals of countries which are suspected of harboring terrorists or supporting terrorism. Not only do they have to get photographed and fingerprinted when they enter the US at an airport, but they also have to report after 30 days, as well as one year later, upon their arrival in the US. At the time of departure from the US, they also have to report to an INS authority at certain designated airports or ports of departure. Failure to comply with any registration requirements would result in their names being put in a national criminal database and also render them subject to deportation. At present, the Special Registration rule only applies to nationals of citizens of Iran, Iraq, Sudan, Libya and Syria (yet, citizens of Pakistan, Saudi Arabia, and Yemen between the ages of 16 and 45 may also be subject to such registration procedures).

Furthermore, registration would apply to any non-U.S. Permanent resident who has made unexplained trips to Iran, Iraq, Libya, Sudan, North Korea, Cuba, Afghanistan, Yemen, Egypt, Somalia, Pakistan, Indonesia, or Malaysia. It would also apply to other individuals who meet pre-existing criteria, especially if the individual's presence in the US warrants monitoring in the interest of national security, which would include an assessment of the person's behavior, demeanor and answers to questions.

If you are a physician/scientist from one of the countries noted above, please be sure to send me an email for more information on this special registration process, and what it means for you.

1.4 Checking INS case status on-line

The INS is slowly entering the information age. You are now able to check the status of your immigration case filed with the US Immigration & Naturalization Service by going to the following web-link:

https://egov.ins.usdoj.gov/graphics/cris/jsps/caseStat.jsp

1.5 Extending H-1B status beyond six-years in certain circumstances

In a very positive development for physicians/scientists in the US on H-1B visas, there is a bill pending in Congress, the 21st Century Department of Justice Appropriations Authorization Act, which has already been passed by the House and has just been passed by the Senate that would allow an H-1B nonimmigrant to file for a 7th year extension provided that a labor certification or an immigrant visa petition has been filed on behalf of the nonimmigrant for more than 365 days and is currently pending.

As many know, the H-1B visa is valid for only 6 years. Since labor certification applications, the first step in the green card process, are backlogged, many do not expect to see progress on their green card applications before the 6th year, and hence are forced to return home to await approval of their green cards.

The new law, once enacted, will allow one to file for a 7th year extension of the H-1B visa if a labor certification were filed 365 days earlier and is still pending without regard to the ability to file an immigrant petition also (which is a requirement of the current law). This provision would also allow those who left the US because of the 6-year limit to have a new H-1B petition approved and be able to return from abroad with a new visa or otherwise re-obtain H-1B status.

1.6 Reporting Change of Address to the INS

Over the past few months our office has received hundreds of calls from our clients and others concerning the INS requirements to report changes of address within the US Under previous law (eliminated in 1980), every alien in the US was required to report his address annually in January. The newly enacted requirement is that all non-U.S. citizens who are required to be registered are also required to report to the INS of any address change within 10 days of the change. Reporting change of address is as simple of completing Form AR-11 and submitting to the INS.

Due to the confusion surrounding who needed to comply with this address reporting requirement, more than 700,000 change of address cards were submitted to the INS in the first three weeks of the imposition of this requirement just a few months ago, and they have been receiving more than 10,000 per week since then. Needless to say, the INS themselves admitted that they just didn't have the manpower to process this mountain of paperwork. So, upon last check, nearly 1,000,000 change of address cards were stacked up at an INS office awaiting processing.

Although enacted with good intentions, the new INS address reporting requirement has resulted in a processing nightmare.

1.7 J1 (Hardship) Waiver Update

Since our last newsletter, we have successful outcomes in a number of hardship waiver cases. A few of the more noteworthy cases in which the INS has approved a J1 waiver based on exceptional hardship are summarized as follows:

With appropriate supporting documentation, J1 hardship waivers may be the waiver route of choice for many physicians. Please send me an email that sets forth your background, and I will evaluate your case and advise you of your likelihood of success.

1.8 Interesting Facts/Statistics Concerning US Immigration

(courtesy of the Economist 9/28/02 and JAMA 9/4/02)

The purpose of our newsletter is to provide current information and developments regarding immigration issues that affect physicians and scientists. This newsletter will be published bimonthly (six times per year), and is free of charge to interested individuals.

In coming issues, we will continue to expand the information provided as to reflect the ever-changing immigration regulations affecting physicians and scientists.

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