ACGME Responds to Proposal to Eliminate “Duration of Status” for J-1 Visa Holders

On September 25, 2020, the US Immigration and Customs Enforcement, Department of Homeland Security (DHS) published a proposed rule that would eliminate “duration of status” as an authorized period of stay for certain nonimmigrant visas. One of the visas affected is the J-1, the most common visa classification used by physicians in US medical training programs who are citizens of other countries.

Under current rules, a provision known as “duration of status” gives J-1 physicians an authorized period of stay that corresponds to the period of their approved visa sponsorship, as issued by the Educational Commission for Foreign Medical Graduates and the Foundation for the Advancement of International Medical Education and Research (ECFMG | FAIMER).

The proposed rule would eliminate “duration of status” and replace it with a specific end date for the authorized period of stay, requiring J-1 physicians to apply to the US government for an extension of authorized stay for each year of their training program. This will be an additional step, after and in addition to annual review by ECFMG | FAIMER.

If implemented, the rule change will disrupt the training of the more than 12,000 foreign national physicians training in J-1 visa status. Although the proposed rule will allow J-1 physicians to stay in their programs for 240 days while waiting for their applications to be processed, this creates uncertainty for J-1 physicians and the teaching hospitals that rely on their services. J-1 physicians whose applications are not completed in the 240-day window will be required to leave their training programs immediately.

The ACGME joined the nation’s leading organizations in medical education and health care to oppose the proposed rule and request that physicians be deemed exempt from the proposed rule.

• On October 26, the ACGME, ECFMG | FAIMER, American Hospital Association, American Medical Association, Association of American Medical Colleges, and National Resident Matching Program submitted detailed comments to the Department of Homeland Security in opposition to the rule change and requested that J-1 physicians be exempted.
• These joint comments followed an October 9, 2020 sign-on letter to DHS, as well as March 27, 2020 sign-on letter to DHS and the Department of State raising concerns at first notice of the anticipated rule change.
• In addition, as a member of the Coalition for Physician Accountability, the ACGME joined a Coalition resolution opposing the rule and recommending an exemption for physicians.

The ACGME has made clear through these correspondences that the proposed rule is unnecessary and has the potential to stress an already strained health care system further as it battles COVID-19 amidst a growing physician shortage. The proposal would negatively affect patient care and the medical education of both visa holders and the remaining residents and fellows, reducing the US supply of physicians during a critical time in the nation’s health.