Proposed ICE Change Will Severely Impact Health Care Delivery During COVID-19 Pandemic and Beyond, Leading Health Care Organizations Say

Five of the nation’s leading organizations in medical education and health care oppose a proposed Immigration and Customs Enforcement (ICE) rule change that will impact more than 12,000 foreign national physicians training in the United States in J-1 visa status. This change will severely hinder health care delivery during the COVID-19 pandemic and into the future.

Earlier this year, ECFMG®|FAIMER® was joined by the Accreditation Council for Graduate Medical Education (ACGME), American Hospital Association (AHA), American Medical Association (AMA), and Association of American Medical Colleges (AAMC) in opposition to this rule change that has the potential to stress an already strained health care system further as it battles COVID-19 amidst a growing physician shortage. Collectively these organizations asked that ICE exclude J-1 physicians from the rule change.

“If implemented, this will affect thousands of physicians who already have been thoroughly vetted and are serving in nearly 750 teaching hospitals across the nation,” said ECFMG|FAIMER President and CEO William W. Pinsky, MD. “It is a misguided policy for J-1 physicians and will have the unintended consequence of disrupting patient care, especially in underserved areas.”

The proposed change was published in the Federal Register on September 25, opening a 30-day public comment period. In light of this development, the organizations now are working to renew their objection and to urge members of the medical education and health care communities, and policymakers to ask ICE to exclude J-1 physicians from the proposed rule change. ECFMG|FAIMER and allied organizations are calling on the health care community to mobilize in response to ensure ICE reevaluates the proposed rule change and ensures a strong frontline health policy. More information is available at

The proposed rule change will alter the process used by F, I, and J visa holders to extend their period of authorized stay in the United States. Specifically, it will eliminate “duration of status” as an authorized period of stay, replacing it with a specific end date and the additional requirement to apply through the U.S. government each year to extend this end date. The five organizations agree that the proposed change is redundant for J-1 physicians and will not accomplish its stated goal of reducing visa overstay rates, since J-1 physicians already are monitored closely.

For nearly 50 years, ECFMG|FAIMER has been designated by the Department of State (DOS) as the sole J-1 visa sponsor for physicians in U.S. training programs. In this role, ECFMG|FAIMER already coordinates closely with DOS and with U.S. teaching hospitals to monitor J-1 physicians carefully throughout the academic year. Additionally, under the current process, J-1 physicians are required to apply annually to ECFMG|FAIMER to extend their visa sponsorship. This required annual renewal process already ensures a careful review by ECFMG|FAIMER in order to assure DOS that these physicians are compliant with J-1 visa requirements and progressing through their training programs as planned. When ECFMG|FAIMER completes this annual review and renews a J-1 physician’s visa sponsorship for an additional year of training, the physician’s authorized period of stay is extended for the “duration of status” of the renewed ECFMG|FAIMER visa sponsorship.

If the change is implemented, the physicians’ authorized period of stay would not be extended after the annual ECFMG|FAIMER review and renewal of J-1 visa sponsorship. Instead, J-1 physicians would be required to apply for an extension of stay, after and in addition to renewing their sponsorship annually with ECFMG|FAIMER, either through a U.S. Citizenship and Immigration Service (USCIS) Service Center in the United States or through a consulate abroad. Currently, the published processing time at USCIS’ five Service Centers ranges from five to 19 months. Based on current USCIS processing times, thousands of J-1 physicians will be unable to continue their training programs and provide patient care. Similarly, annual travel abroad to extend visa status during residency and fellowship would be problematic due to its likelihood to disrupt training and, in effect, patient care.