Eleanor Fitzpatrick Director, House of Medicine Initiatives Global Education in Medicine Services

Transcription

1 Eleanor Fitzpatrick Director, House of Medicine Initiatives Global Education in Medicine Services Tracy Wallowicz Director, EVSP and Compliance Exchange Visitor Sponsorship Program 2017 AHME Institute May 11, 2017 Copyright 2017 by the Educational Commission for Foreign Medical Graduates. All rights reserved.

2 Session Overview ECFMG Services for IMGs and GME Programs IMG Recruitment Requirements and Timelines for Entry into GME J-1 Visa Sponsorship of Foreign National Physicians Emerging Issues / Hot Topics Q & A

3 ECFMG Vision Statement Improving world health through excellence in medical education in the context of ECFMG s core values of collaboration, professionalism and accountability. Programs Supporting IMGs and U.S. GME ECFMG Certification ECFMG Certificate Holders Office (ECHO) ERAS Support Services Certification Verification Services (CVS) Exchange Visitor Sponsorship Program (EVSP) International Programs Electronic Portfolio of International Credentials (EPIC) Global Educational Exchange in Medicine & the Health Professions (GEMx) Foundation for Advancement of International Medical Education and Research (FAIMER)

4 ECFMG Certification Medical Education Credentials Completion of medical school curriculum of at least 4 years School and graduation year listed in World Directory of Medical Schools ECFMG primary-source verification of medical diploma and transcript(s) United States Medical Licensing Examinations - USMLE Step 1 Basic Science Step 2 Clinical Knowledge (CK) Step 2 Clinical Skills (CS)

5 ECFMG Certificate Holders Office (ECHO) Free Resources for IMGs seeking ECFMG Certification Library of Information on U.S. GME, career planning etc. Webinars presented by experts from the academic medical community Subscriptions to E-Newsletters ECFMG continues to explore new ways to assist and support IMGs.

6 ERAS Support Services at ECFMG Designated Dean s Office for IMGs applying to U.S. GME In partnership with the Association of American Medical Colleges (AAMC) Provides Support and Guidance to IMG Applicants Collects, reviews, transmits supporting documentation to ERAS Direct communication and advising throughout the process Informational updates and webinars Assist International Medical Schools Submission of official documents electronically through ECFMG Medical School Web Portal (EMSWP) Support of ERAS Advisor On-going educational outreach programs and teleconferencing

7 IMGs and Foreign National Physicians in U.S. GME International Medical Graduates (IMGs) May be U.S. citizens or foreign nationals USMLE and ECFMG Certification Foreign National Physicians May be IMGs or U.S. medical school graduates Require visa sponsorship for GME (i.e., J-1, H-1B, other) U.S. Educational Track Accredited base residencies Accredited subspecialty programs Advanced unaccredited ( non-standard ) fellowships

8 Entry of IMGs into U.S. GME Process Complete medical school If IMG, complete ECFMG Certification Complete residency application process Electronic Residency Application System (ERAS) Interviews etc. National Residency Matching Program (NRMP) The Match Program issues GME contract/letter of offer If foreign national, secure appropriate visa status Commencement of residency training Timeframe May Previous year(s) August - February September - February March March March - July July

9 Recruiting Foreign National IMGs WHAT ARE YOUR CHALLENGES, BEST PRACTICES?

10 J-1 PROGRAM OVERVIEW

11 Purpose of J-1 Program Mutual Educational and Cultural Exchange Act of 1961 to increase mutual understanding between the people of the United States and the people of other countries by means of educational and cultural exchanges. Educational and cultural exchanges assist the Department of State in furthering the foreign policy objectives of the United States. The J-1 Exchange Visitor Program provides eligible foreign nationals with opportunities to participate in exchange programs in the United States and then return home to share their experiences.

12 J-1 Physician Category Refresher Temporary, Non-immigrant Visa (INA 214(b)) Requires full-time participation in a program of graduate medical education; not employment Strong ties to the home country and clear intent to return Statement of Need Issued by country of last legal permanent residence (LPR) LPR cannot be changed once in J status; any/all subsequent Statements of Need must be from same source New letter required for any change in specialty or subspecialty or if date restricted Imposes Two-year Home Residency Requirement (INA 212(e)) Statement of Need from country of last legal permanent residence (LPR) determines obligation J-1 physicians and accompanying J-2 dependents must return to country of LPR for two years before being eligible certain changes or adjustments in U.S. visa status

13 J-1 Physician Category Refresher Specific Activity Authorized Form DS-2019 and associated J-1 status authorizes a specific training activity, location and financial compensation Work outside of the training program (i.e., moonlighting ) is not permitted Defined Duration Sponsorship limited to the time typically required to complete a program as defined by the ACGME and/or an ABMS member-board Further limited to a maximum of seven years Requires Progression in Training Progressive levels of training required Repeat / remedial training limited to a maximum of 12 months with program director support Future sponsorship eligibility should not be presumed

14 J-1 Physician Category Refresher Change in Specialty Permissible once within first two years of obtaining J-1 status Upon entrance to a third year of sponsorship, a change of specialty is no longer permitted Insurance Requirements Health, accident, medical evacuation and repatriation of remains required for all J-1 / J-2 participants Must be maintained by J-1s / J-2s during entire U.S. stay See 30-day Grace Period J-1s / J-2s must depart the United States within 30 days of program completion No employment / training authorization during this period Does not apply to early departure (i.e., resignation or termination)

15 Sponsorship Limitations / Eligibility Waiver of Two-year Home Residency Requirement The J-1 program was designed to promote educational and cultural exchange; as such, J-1 participants are expected to return to the country of LPR upon program completion Receipt of a favorable waiver recommendation from the U.S. Department of State negates any eligibility to extend or renew J-1 sponsorship through ECFMG; an exception does allow for ECFMG to sponsor J-1s to prepare to sit for an ABMS member board exam Multiple, Successive Visa Classifications Physicians are advised that future ECFMG sponsorship may not be available to individuals with a recent history of holding different U.S. visa classifications J-1/J-2 physician couples must carefully plan training and corresponding timelines J-1 sponsorship eligibility should not be presumed

16 J-2 Dependents Subject to two-year home physical presence requirement Must hold required levels of health and accident insurance May apply for work authorization (EAD) but cannot support J-1 Sponsorship timeline depends entirely on J-1 principal May be eligible for J-1 sponsorship; conditions apply Must report permanent departure from the United States (if prior to J-1 program completion)

17 CROSS-CULTURAL COMPONENT OF J-1 PROGRAM

18 Cross-cultural Activities The J-1 Exchange Visitor Program is designed to facilitate educational and cultural exchange. As part of your J-1 program, you are expected to engage in enriching cross-cultural experiences. Such experiences provide the opportunity for you to share your culture while learning about the United States. How? Hospital social activities Local sporting events Volunteerism (may be one-time commitment or on-going) Community organizations and clubs Museums Local visitor centers EVSP s/tweets/facebook postings Local websites (i.e., visitphilly.com, citysearch.com) Local newspapers: community activities and events

19 ECFMG J-1 Physician Cross-cultural Engagement Efforts Activities during on-site visits Website Twitter and TPL surveys J-1 application field

20 HOST INSTITUTION RESPONSIBILITIES AND REPORTING

21 Overview of Host Institution Responsibilities Overall Host Institution Responsibilities Assign a Training Program Liaison (TPL) Issue contract and oversee training Ensure compliance with ACGME requirements regarding trainees Inform ECFMG of investigation, serious problem or issue with J-1 physician Not provide or support moonlighting for J-1 trainees physicians Specific TPL Responsibilities Complete onboarding and participate in training webinars Input accurate information into EVNet Provide ECFMG with up-to-date information on J-1 physicians Facilitate application process Timely reporting (arrival, leaves, incident, etc.)

22 Required Reporting to ECFMG Notification of visa delay / denial Any proposed amendment to contract o o Training level (e.g., acceleration, remediation) Start date (e.g., late arrival to program, licensure delay) Leaves of absence (e.g., medical, family) o Pre-notification, consultation with ECFMG Notification of resignation / termination o Program completion, early ending, grievance, appeal process, etc. Any change in residential address Any serious incident or allegation

23 WHAT ARE PEOPLE TALKING ABOUT? (CURRENT ISSUES AND HOT TOPICS!)

24 Gaps Between Training Programs Immigration Orders/Legislation J-2 to J-1 Change in Status Change of Category Other?

25 Important Links EVSP Pre-arrival Information EVSP Reference Guide Exchange Visitor Welcome Brochure The-Exchange-Visitor-Program.pdf Wilberforce Pamphlet English%20Online%20Reading% pdf

26 ECFMG Expert Resource & Collaborative Partner on IMGs Issues Eleanor Fitzpatrick Director, House of Medicine Initiatives Global Education in Medicine Services Tracy Wallowicz Director, EVSP and Compliance

27 Questions?