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IMG Visa Issues International Medical Graduates and Students discussion US Visa issues.


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Old 11-09-2010
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Passport The USMLE Step 3 and the H1B Visa - Questions

Dear forum members,

I was researching the web about USMLE and what is takes to get a residency in USA, and my research resulted in a 3-year plan to get the residency I want.

Correct me if I am wrong and notify me if I am missing something, Please,

1- I expect to get ECFMG certified by April 2013 ( I will graduate by end of Feb 2013 when my diploma will be issued and step1 and 2 already taken earlier ), is that to be expected ? I mean once my diploma is issued when would I expect the ECFMG cert. to be out ?

2- Then I have from that date when ECFMG cert. comes out through Oct. 2013 to take Step 3 and apply via ERAS, right ?
I mean is it possible to apply for step 3, schedule for the exam, go take it and get the results all before I apply via ERAS to include step 3 in my application, all inside this time frame from April through Oct. 2013 ?

3- Suppose I don't get step 3 results by the time I see most reasonable to apply, and I applied anyway, I got the results before the IVs I mean I do IVs with step 3 results in hand, would that still be good ?

4- ECFMG cert. is an absolute requirement to take step 3, ok , but when I surfed over FSMB website I saw things that made me confused, like having to have 1-3 PGT years before you qualify to take step 3, which is weird since I am taking step 3 to get in a residency I mean to get to be in that PGT they require !!!

5- The state license thingy !! for an IMG to get to have his H-1b issued before a July 1st start ( in my case July 1st 2014 ) after paying for the expedition, he has to have a license first, and again in FSMB they require some post graduate training years before granting a license !! which doesn't go with what I read somewhere that after the match, it takes about 21 days to get a license ( 240$ ?!) then another 14 days to get expedited H-1b issued all before a July 1st start.
Which one should I believe ?

I would appreciate your answers , Thank you
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Default Step 3 after ECFMG certification

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Originally Posted by USMLErookie View Post
1- I expect to get ECFMG certified by April 2013 ( I will graduate by end of Feb 2013 when my diploma will be issued and step1 and 2 already taken earlier ), is that to be expected ? I mean once my diploma is issued when would I expect the ECFMG cert. to be out ?
I'd say it's safer to say that you'll get your ECFMG certificate by May 2013 as you have to take the CS also.
But remember, you can start preparing for Step 3 even before you get the ECFMG certificate and when it's ready you can take the exam.
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Default Time needed to prep for Step 3

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Originally Posted by USMLErookie View Post
2- Then I have from that date when ECFMG cert. comes out through Oct. 2013 to take Step 3 and apply via ERAS, right ?
I mean is it possible to apply for step 3, schedule for the exam, go take it and get the results all before I apply via ERAS to include step 3 in my application, all inside this time frame from April through Oct. 2013 ?
You can do that within that time frame. Preparing for Step 3 takes considerably less time than Step 1 or CK.
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Default Entering the match and Step 3 results pending

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Originally Posted by USMLErookie View Post
3- Suppose I don't get step 3 results by the time I see most reasonable to apply, and I applied anyway, I got the results before the IVs I mean I do IVs with step 3 results in hand, would that still be good ?
You can indicate in ERAS that you are awaiting the results and they will be updated automatically via ERAS once your results are out. So yes that's possible.
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Default Eligibility for Step 3

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Originally Posted by USMLErookie View Post
4- ECFMG cert. is an absolute requirement to take step 3, ok , but when I surfed over FSMB website I saw things that made me confused, like having to have 1-3 PGT years before you qualify to take step 3, which is weird since I am taking step 3 to get in a residency I mean to get to be in that PGT they require !!!
Some states require that you start residency before being eligible for Step 3 but many states do not have that requirement such California and Texas so you can apply for Step 3 in those states.
The other thing is that sometimes they mean the medical school by postgraduate training. Because here in USA there's graduate education (premed) followed by postgraduate education (med school).
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Default H1B Visa issued before residency start

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Originally Posted by USMLErookie View Post
5- The state license thingy !! for an IMG to get to have his H-1b issued before a July 1st start ( in my case July 1st 2014 ) after paying for the expedition, he has to have a license first, and again in FSMB they require some post graduate training years before granting a license !! which doesn't go with what I read somewhere that after the match, it takes about 21 days to get a license ( 240$ ?!) then another 14 days to get expedited H-1b issued all before a July 1st start.
Which one should I believe ?
Refer to my previous answer.
You are already considered to have postgraduate training once you graduate from medical school in your country.
So the second story you mentioned is the correct one.
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Quote:
Originally Posted by lee-usmle View Post
I'd say it's safer to say that you'll get your ECFMG certificate by May 2013 as you have to take the CS also.
But remember, you can start preparing for Step 3 even before you get the ECFMG certificate and when it's ready you can take the exam.
Truly grateful for replying to each question, Lee.

I expect to be done with Steps 1, 2 CK and CS way earlier than my graduation date, like in May 2012.
So considering I graduated end of Feb 2013 , I still will get the ECFMG cert. by May 2013, as you mentioned ?
I need to get the widest time frame I can have after cert. and before applying ( I would consider applying in aug-sept 2013, BTW is that late ? ) to get to include my step 3 results into my ERAS.

I guess this has some benefits like if step 3 results is in ERAS app. at the time of applying, program directors are more likely to put my app. at top of rank order list. and this is better than telling them that I am waiting for exam results since I read that its a disadvantage. Also it makes you get a lot of IVs isn't that right ?
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Quote:
Originally Posted by lee-usmle View Post
Some states require that you start residency before being eligible for Step 3 but many states do not have that requirement such California and Texas so you can apply for Step 3 in those states.
The other thing is that sometimes they mean the medical school by postgraduate training. Because here in USA there's graduate education (premed) followed by postgraduate education (med school).
How can I know that for a specific state/program ?
Well, I read NY doesn't require PGT( or some years of residency as of common understanding of PGT ) , but they do require PGT for granting a license !! source:FSMB
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Originally Posted by USMLErookie View Post
Truly grateful for replying to each question, Lee.

I expect to be done with Steps 1, 2 CK and CS way earlier than my graduation date, like in May 2012.
So considering I graduated end of Feb 2013 , I still will get the ECFMG cert. by May 2013, as you mentioned ?
I need to get the widest time frame I can have after cert. and before applying ( I would consider applying in aug-sept 2013, BTW is that late ? ) to get to include my step 3 results into my ERAS.

I guess this has some benefits like if step 3 results is in ERAS app. at the time of applying, program directors are more likely to put my app. at top of rank order list. and this is better than telling them that I am waiting for exam results since I read that its a disadvantage. Also it makes you get a lot of IVs isn't that right ?
Yes. that's right.
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How can I know that for a specific state/program ?
Well, I read NY doesn't require PGT (or some years of residency as of common understanding of PGT ) , but they do require PGT for granting a license !! source:FSMB
You don't need to apply for Step 3 in the state where you will take residency.
You can apply to step 3 in Texas and then apply to residency in NY, that's completely OK.
I think you should not worry about licensing issues for the time being. Just plan to take Step 3 and then apply for the match and hopefully they'll sponsor you with H1B Visa and the rest will come easy.
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Quote:
Originally Posted by lee-usmle View Post
Refer to my previous answer.
You are already considered to have postgraduate training once you graduate from medical school in your country.
So the second story you mentioned is the correct one.
OK, I get it that once I graduated from my school I am considered to have PGT but how ? and whose opinion ? since there is no proof that I did PGT, is it some sort of fooling the boards ? sorry but I am really confused .!

Did you mean by the correct story this one
Quote:
after the match, it takes about 21 days to get a license ( 240$ ?!) then another 14 days to get expedited H-1b issued all before a July 1st start.
?
But really how, since here is the confusion , how would for ex. the medical board at the state of NY ( which I intend to get a residency at ) grant me a license right after the match ( 21 days after ) without any PGT ? Is it that they sell the license for 240$ ? or are they messing with my head over there in FSMB ?
Finally,
What should I worry more about in my way to secure a residency spot on H-1B visa, starting right after ECFMG cert. thats expected by April/May 2013 ?
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Quote:
Originally Posted by lee-usmle View Post
You don't need to apply for Step 3 in the state where you will take residency.
You can apply to step 3 in Texas and then apply to residency in NY, that's completely OK.
I think you should not worry about licensing issues for the time being. Just plan to take Step 3 and then apply for the match and hopefully they'll sponsor you with H1B Visa and the rest will come easy.
Thanks Lee , really a helpful post.
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Default Forget about the postgraduate term

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Originally Posted by USMLErookie View Post
OK, I get it that once I graduated from my school I am considered to have PGT but how ? and whose opinion ? since there is no proof that I did PGT, is it some sort of fooling the boards ? sorry but I am really confused .!
Examples of States that do not require postgraduate training for Step 3 applicant:
Arkansas Check the official document
California Check the official document
Connecticut Check the official document
Delaware Check the official document
Florida Check the official document

So you can pass your USMLE Step 3 in any of these states so you can be H1B Visa eligible before going to interviews.
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But really how, since here is the confusion , how would for ex. the medical board at the state of NY ( which I intend to get a residency at ) grant me a license right after the match ( 21 days after ) without any PGT ? Is it that they sell the license for 240$ ? or are they messing with my head over there in FSMB ?
Please go to this page http://www.fsmb.org/pdf/step3/NY_online_instr.pdf
You will see it's mentioned that the NY Board does not have any postgraduate training requirement. Which means you can apply for their license on July 1st once you start your residency.
In fact they mentioned that in a yellow-highlighted text in that document.
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Finally,
What should I worry more about in my way to secure a residency spot on H-1B visa, starting right after ECFMG cert. thats expected by April/May 2013 ?
You need to worry about the fact that programs that are willing to sponsor H1B Visa are much less than the program that are not.
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Originally Posted by lee-usmle View Post
You need to worry about the fact that programs that are willing to sponsor H1B Visa are much less than the program that are not.
I have a question DR.lee-usmle:

Why would I take step 3 before applying to ERAS?.As far as i know,you can apply to ERAS once you are ECFMG certified...do u mean doing step 3 will significantly increase ur chance of getting into residency??
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I have a question DR.lee-usmle:

Why would I take step 3 before applying to ERAS?.As far as i know,you can apply to ERAS once you are ECFMG certified...do u mean doing step 3 will significantly increase ur chance of getting into residency??
No Step 3 does not increase your chances in getting residency if you are not looking for H1B Visa.
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Quote:
Originally Posted by lee-usmle View Post
Examples of States that do not require postgraduate training for Step 3 applicant:
Arkansas Check the official document
California Check the official document
Connecticut Check the official document
Delaware Check the official document
Florida Check the official document

So you can pass your USMLE Step 3 in any of these states so you can be H1B Visa eligible before going to interviews.
Ok ,
I can apply to one of these state medical boards , take the exam say in TX or NJ and having passed , I can for ex. apply for an h-1b residency in ? the same state I applied to ? or any state I want ? or to the state that is gonna grant me the license ?
My Understanding is , having passed step 3 ( regardless of where I applied to take the exam or where I sat and took for the exam ) I can include that with my ERAS app. to ? any place thats offering h-1b ? or only the places that offer licensing ( without req. ) first and also offering to sponsor h1-b ? this btw is gonna limit the choices at top of my rank order list to places in for ex. NY state ( where they have no restriction on granting license after signing an h-1b residency prog. after the match) , and that means I will get the visa issued before June 23 when I should be in NY getting ready to start the prog.

Is anything of all of that anywhere near right ?
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Originally Posted by lee-usmle View Post
Please go to this page http://www.fsmb.org/pdf/step3/NY_online_instr.pdf
You will see it's mentioned that the NY Board does not have any postgraduate training requirement. Which means you can apply for their license on July 1st once you start your residency.
In fact they mentioned that in a yellow-highlighted text in that document.
Oh I read this yellow-highlighted text earlier ,
But hold on a sec, How by any possible means will I start an H-1B sponsoring residency without getting the H-1B visa which I won't get until I get licensed which you say that I WILL STILL apply for by July 1st when the H-1B residency has already started?
OMG, this vicious circle is gonna kill me.

Here is the text,
Quote:
Licensure Application: A completed licensure application and fee must be submitted to the
New York State Education Department by July 1, 2011. NOTE: Before the Board will
approve an applicant to sit the USMLE Step 3, the licensure application and fee must be on
file and all professional and pre-professional education verified by the NYSED.
I dont get it,
Let's consider this hypothetical scenario on light of this text ,

Say I applied for step 3 ( in my case it is gonna at may 2013 ) AND applied for the license at the same time all in the state of NY, wouldn't my application for the license get rejected since it requires passed step 3 ?

Say I passed step 3 early before ERAS app. and included it in the app. and then got matched to a prog. thats willing to sponsor H-1B in the same state of NY ? they wouldn't give me visa, since they require at the TEXT that I should've applied for licensure at same time I applied for step 3 and paid all fees.

P.S. I read somewhere about temp. license is needed to issue the visa for the IMG to start his resid. at time , then apply for the full unrestricted license later during the residency when you already meet the requirements of the medical board of the state where you are doing your H-1B residency, usually of 1-3 PGTs.
So who is responsible for getting me this temp. license, me, an attorney, the hospital where I will be doing the prog., the state medical board or the USCIS ?
or should we all work together to get this thing done !!!! ???
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Originally Posted by USMLErookie View Post
Ok ,
I can apply to one of these state medical boards , take the exam say in TX or NJ and having passed , I can for ex. apply for an h-1b residency in ? the same state I applied to ? or any state I want ? or to the state that is gonna grant me the license ?
My Understanding is , having passed step 3 ( regardless of where I applied to take the exam or where I sat and took for the exam ) I can include that with my ERAS app. to ? any place thats offering h-1b ? or only the places that offer licensing ( without req. ) first and also offering to sponsor h1-b ? this btw is gonna limit the choices at top of my rank order list to places in for ex. NY state ( where they have no restriction on granting license after signing an h-1b residency prog. after the match) , and that means I will get the visa issued before June 23 when I should be in NY getting ready to start the prog.

Is anything of all of that anywhere near right ?
Yes. You can apply for step 3 in any state and you can use it in any other state, it doesn't matter.
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Oh I read this yellow-highlighted text earlier....
or should we all work together to get this thing done !!!! ???
I don't have an answer for this.
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I don't have an answer for this.
ok, thanks anyway, Lee
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Quote:
Originally Posted by USMLErookie View Post
Oh I read this yellow-highlighted text earlier ,
But hold on a sec, How by any possible means will I start an H-1B sponsoring residency without getting the H-1B visa which I won't get until I get licensed which you say that I WILL STILL apply for by July 1st when the H-1B residency has already started?
OMG, this vicious circle is gonna kill me.

Here is the text,

I dont get it,
Let's consider this hypothetical scenario on light of this text ,

Say I applied for step 3 ( in my case it is gonna at may 2013 ) AND applied for the license at the same time all in the state of NY, wouldn't my application for the license get rejected since it requires passed step 3 ?

Say I passed step 3 early before ERAS app. and included it in the app. and then got matched to a prog. thats willing to sponsor H-1B in the same state of NY ? they wouldn't give me visa, since they require at the TEXT that I should've applied for licensure at same time I applied for step 3 and paid all fees.

P.S. I read somewhere about temp. license is needed to issue the visa for the IMG to start his resid. at time , then apply for the full unrestricted license later during the residency when you already meet the requirements of the medical board of the state where you are doing your H-1B residency, usually of 1-3 PGTs.
So who is responsible for getting me this temp. license, me, an attorney, the hospital where I will be doing the prog., the state medical board or the USCIS ?
or should we all work together to get this thing done !!!! ???
Wow....I give you credit for thinking things in advance but you are making things waaayyy more complicated then they have to be.

Just apply for your step three with a medical board that doesn't demand so many details like application for licensure and all. California is very basic one use for purposes of applying for Step 3.

Remember, putting down a medical board does not mean that you have to apply for licensure there, nor does it mean you need to take your exam there. I found Cali to be easy. Only requirements is that Step 1, 2CK, and CS are complete. No PG training. No application for licensure needed.

Then get your permit. Take step 3 wherever you want. Once you are matched and you know you are going someplace in New York, apply for your temporary licensure. This is what most people do. Match is march. PG starts july. there is plenty of time to apply and your matched program usually helps speed up the process as well.

There is no point in applying for licensure when you don't know if you will be matched in New York or not. Furthermore, if you are an IMG, in NEW YORK, you are required to apply using FCVS service and getting them all your documents and all will take some time.

Remember the fee for licensure that you stated is only for temporary licensure. Full licensure comes after 1 year of PG training (for u.s. grads) and 3 years (for IMGs)

Hope i made sense!
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Originally Posted by missmbbs View Post
Wow....I give you credit for thinking things in advance but you are making things waaayyy more complicated then they have to be.

Just apply for your step three with a medical board that doesn't demand so many details like application for licensure and all. California is very basic one use for purposes of applying for Step 3.

Remember, putting down a medical board does not mean that you have to apply for licensure there, nor does it mean you need to take your exam there. I found Cali to be easy. Only requirements is that Step 1, 2CK, and CS are complete. No PG training. No application for licensure needed.

Then get your permit. Take step 3 wherever you want. Once you are matched and you know you are going someplace in New York, apply for your temporary licensure. This is what most people do. Match is march. PG starts july. there is plenty of time to apply and your matched program usually helps speed up the process as well.

There is no point in applying for licensure when you don't know if you will be matched in New York or not. Furthermore, if you are an IMG, in NEW YORK, you are required to apply using FCVS service and getting them all your documents and all will take some time.

Remember the fee for licensure that you stated is only for temporary licensure. Full licensure comes after 1 year of PG training (for u.s. grads) and 3 years (for IMGs)

Hope i made sense!
Thanks for your concern,
Now ok there is no problem in step 3 ( will take it in CA ).
The goal is to get in a program that sponsors H-1b, and they can't give you the visa unless you are licensed, so I guess I am gonna have to go with the temp. license right after the match results, now the question can be, is the info that I mentioned about the time and cost it takes to get the temp. license, correct ?; if so, that would mean I can get the temp. license needed for H-1b app. in 3 weeks or 4 at most after the match, then H1-b visa will take 14 days to be issued the expedited way, then I guess I will be ready for a July 1st start.

BTW, this temp. license, is it kind of a product you purchase and you get temporarily licensed ? I guess they made for this H-1b purpose, right ?
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Old 12-01-2010
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Originally Posted by USMLErookie View Post
BTW, this temp. license, is it kind of a product you purchase and you get temporarily licensed ? I guess they made for this H-1b purpose, right ?
Yes. It's made for the purpose of H1B Visa.
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  #26  
Old 12-01-2010
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Originally Posted by USMLErookie View Post

BTW, this temp. license, is it kind of a product you purchase and you get temporarily licensed ? I guess they made for this H-1b purpose, right ?
Actually it's not a product for H-1b purpose. It is for everyone! IMG or U.S. Graduate.

Basically to be able to practice medicine on your own, you have to be licensed. Simple as that right? Now, finishing med school you get a degree but you are not licensed. I dont know where you are studying, but I studied in India. After graduating, I got a "provisional license" from the board and with that we were allowed to intern (house surgeon). When I completed internship, I got full licensure.

In the U.S. it's the same. Instead of internship, it's PG. This temporary license allows you to work as a doctor in a Post Grad program. You pay a portion of the full license fee for it.

Let me try to use an example from before: In California a U.s. Grad needs 1 year post grad training to be fully licensed and an IMG 2 years.

As we know, most residencies are 3-4 years long. completing residency allows you to go for a board certification in your specialty of choice. However, suppose....for some reason, I dont want to finish my residency. I just wanted to do IM for some time so that i can be fully licensed to practice.

Well if i was a u.s. graduate, after 1 year of training, I could be fully licensed and just stop and open my own practice.

Of course, no one does this as they want to finish their training and get board certified which is also optional. you dont have to be, but it looks good for the papers.

but suppose you are an img and have practiced for years in your home country. do you really want to go through full training again? probably not, so you might opt to stop after 2 years and get your full licensure and not complete residency.

i hope this makes sense and i didnt confuse you.
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  #27  
Old 12-01-2010
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Your post was absolutely helpful, though the whole thing about the licensure inquiry is that I have to be licensed ( temporarily in my case ) to get the H-1b visa.
When I saw, on FSMB, the requirements for licensure, I was surprised since by no means can an IMG have 3 years of PGT in a residency program that itself requires a license to grant you H-1b visa needed to enter US to start that same program.
Anyway, later I learnt about this temp. license thing and all problems solved.

Thank you
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