INS on Foreign Medical Graduates
1128 Standard Building
1370 Ontario Street
Cleveland, Ohio 44113
Dear Mr. Sharon:
This is in response to your fascimile dated January 19, concerning externships/observerships and/or electives offered to Foreign Medical Graduates (FMG’s) by U.S. hospitals. I apologize for the delay in responding to your inquiry.
You state that FMG’s will often request the opportunity to complete an externship/observership or an elective rotation in order to become familiar with the American medical system in relation to residency training. In turn, American medical facilities feel that being able to observe an FMG also enhances their ability to assess the applicant for a residency program. You have attached a copy of an extern policy which highlights the activities and duties expected of an extern, which include daily medical conferences, taking histories and physicals, daily rounds with a supervising resident, and teaching rounds with the ward attending. You also state that in an elective rotation, the FMG undertakes the same activities as a medical student from a United States medical school. You ask whether these activities would constitute unlawful employment and whether they could be undertaken on a B-1/B-2 or F-1 nonimmigrant visa.
Under current Service Operations Instructions at OI 214.2(b)(4), an alien who is otherwise classifiable as an H-3 nonimmigrant may be classified as a B-1 business visitor if he or she is a student at a foreign medical school and is coming to take an “elective clerkship” (defined as practical experience and instruction in the various disciplines of the practice of medicine under the supervision and direction of faculty physicians) at a United States medical school’s hospital as an approved part of the foreign medical school education.
It does not appear that the FMG’s in question would be classifiable as B-1 visitors for business, E-2 visitors for pleasure, or F-1 nonimmigrant students in order to pursue the activities described in your letter. The B-1 classification is appropriate only if the FMG’s would qualify under OI 214.2(b)(4). It appears that the FMG’s would not qualify under the IO because they are medical graduates and would not, therefore, be undertaking training as part of their foreign medical school education. The B-2 classification is appropriate only for aliens seeking admission to the United States in order to pursue activities relating to tourism, visiting friends or relatives, medical treatment, or attending conventions. Finally, the FMG’s would not be eligible for F-1 classification because it does not appear that they would be coming to the United States to engage in a full course of study at an approved United States educational institution.
With regard to your question whether the activities described constitute unlawful employment, I refer you to the Employment Labor Relations Division as this is an issue which falls within its area of responsibility. You may write to them at INS, 425 I Street, N.W. Washington, D.C. 20536.
I hope that this response has provided you with some guidance.
Sincerely,
Yvonne M. LaFleur, Chief
Business and Trade Services Branch
Benefits Division