Getting into Residency: Issues Related to US Residencies
for Non-US Citizens


Visa Issues

If you are a US citizen or have a Green Card, you do not need a visa to carry out residency training in the US; you can apply freely to any desired US residency position.

If you are a Canadian citizen, Canadian permanent resident, or international student, you will require a visa to carry out residency training in the US.

J-1 Visa – exchange visitor visa commonly used for medical residency training

While it is relatively straightforward in terms of paperwork to get this visa, there are several important factors to be aware of:

  1. This visa has a 2-year home country requirement attached to it (you must return to your country of last legal residence for a minimum of two years following the completion of your residency prior to seeking more permanent visa status in the US).

  2. US residency training programs are often a year or two less in duration than their associated counterparts in Canada (i.e., Internal Medicine and Pediatrics), meaning that you cannot come directly back to practice your specialty in Canada; you would need to secure additional Canadian residency training in order to meet Canadian certification requirements.

  3. Because of the 2-year home country requirement, the J-1 visa application must be supported by the applicant’s home government (to ensure that the proposed training fits well with home country physician resource plans). This means that:

    1. If you are an international medical student, you must find out from your country of last legal residence, prior to applying to residency, whether or not they will support your J-1 visa application in your desired discipline (since it is that country to which you will have to return for two years prior to returning to the US). Start making inquiries as early as possible because the process can be lengthy.

    2. If you are an out-of-province Canadian student, you must find out from Health Canada, well in advance of applying to residency, whether or not your proposed residency training fits with physician resource plans from your home province so that Health Canada can support your J-1 visa application – most provinces have relatively flexible manpower priorities, but you must always check with Health Canada to be sure.

    3. If you are a QC resident, you must consult the “Politique des inscriptions dans les programmes de formation médicale postdoctorale” issued each year to determine whether or not your proposed residency training fits with QC’s physician resource plans. QC tends to be very restrictive, and only a limited number of specialties are available for J-1 visa support each year. Unfortunately, this list does change and is not released until late fall of your fourth year (after you will have submitted a US residency application and potentially even started interviewing).

Supported Disciplines: Match 2011

Family Medicine
Internal Medicine (General, Hematology, Medical Oncology)
General Surgery
Orthopedic Surgery

General Pediatrics (no subspecialties)
Anatomic Pathology
Psychiatry (including Pediatric Psychiatry)
Diagnostic Radiology

Click here for a special note on pediatrics.

H-1B Visa – temporary professional worker visa less commonly used for medical residency training

While this visa seems attractive on the surface since it has no home country requirement attached, there are complications:

  1. You must have passed USMLE Step 3 prior to getting this visa, and you cannot write Step 3 until you have your MD diploma in hand. By the time you write the exam, get the score, and complete the visa paperwork process, it is usually September/October following the July 1 residency start date, so you are beginning residency late, and the programs to which you are applying have to be ready to delay your residency start date.

  2. An H1-B visa application is employer-sponsored, and many residency programs are unwilling to undertake the associated responsibility, expense, and inconvenience. You will usually be able to find out from a residency program’s website whether or not they are “H1-B supportive”, but if it is not evident, you will have to call the program office directly.

A very small number of McGill graduates have succeeded in acquiring this type of visa, though it is a very labor-intensive process.

Next: Reciprocity of Training