U.S. Public Law 94-484, effective January 10, 1978, requires that J-1 physician applicants provide a letter of need from the Ministry of Health of the country of most recent legal permanent residence. Such a letter must provide written assurance, satisfactory to the Secretary of the United States Department of Health and Human Services, that there is a need in that country for persons with the skills the alien physician seeks to acquire.
If the applicant is a permanent resident of a country other than that of citizenship, the Statement of Need (SoN) must come from the Ministry of Health of the country of most recent legal permanent residence.
In cases in which a new or updated SoN is required, an original, official SoN issued directly from the Ministry of Health in the country of most recent legal permanent residence must be submitted directly to ECFMG. To be accepted by ECFMG, the original SoN must be received in the original, sealed envelope of the Ministry of Health. In addition, the Ministry of Health official issuing the letter must place it in a Ministry of Health envelope and stamp the outside flap with the issuing government seal. The document should be forwarded directly to ECFMG; if the sealed envelope is opened, ECFMG will not accept the SoN. Electronic or scanned copies of the SoN will not be accepted by ECFMG.
SoNs in sealed Ministry of Health envelopes must be mailed directly to ECFMG either by the Ministry of Health or the applicant. Use of a courier service is recommended. The mailing address is: EVSP/ECFMG, 3624 Market Street, Philadelphia, PA 19104 USA.
Additionally, per the U.S. Code of Federal Regulations (CFR), the SoN must:
- Be issued by the federal/central office of the applicant’s country of most recent legal permanent residence
- Be issued on official Ministry of Health letterhead and addressed to ECFMG
- Exactly follow prescribed wording outlined in the CFR §62.27
- Align with the training specialty/subspecialty being pursued
- Contain the official stamp or seal of the issuing government and dated signature of issuing official on the SoN
- Be issued in English; if not issued in English, a certified word-for-word English translation is required (again, please note that the SoN and any translation must follow regulatory prescribed language)
Any SoN that does not meet all of the above-specified requirements will not be accepted. If the original SoN is not issued in English, the Ministry of Health may provide a copy of the SoN to the applicant for the purpose of obtaining an English translation. The certified English translation may either be submitted in the sealed envelope with the original SoN or it may be submitted to ECFMG separately. Both the original SoN and a certified English translation, if applicable, are required as part of the application.
Sample Statement of Need
Statement of Need Instructions for Ministry of Health Officials
Statement of Need FAQs
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