On September 14, a federal court postponed implementation of the Department of Homeland Security (DHS) final rule that would have ended the longstanding Duration of Status (D/S) framework for J-1 exchange visitors, including J-1 physicians participating in U.S. graduate medical education (GME).
The rule was scheduled to take effect September 15, 2026. As a result of the court’s order, the existing D/S framework remains in effect nationwide for J-1 physicians at this time.
What the Court Decided
In Presidents’ Alliance on Higher Education and Immigration v. U.S. Department of Homeland Security, the U.S. District Court for the District of Massachusetts postponed the effective date of the DHS final rule under Section 705 of the Administrative Procedure Act.
The court also prohibited DHS and U.S. Immigration and Customs Enforcement from implementing the rule while the postponement remains in effect. The court did not vacate or permanently invalidate the rule, and the underlying litigation continues.
For J-1 physicians and their teaching hospitals, the important immediate point is that the changes scheduled to begin September 15 are not taking effect at this time.
What This Means for J-1 Physicians
J-1 physicians should continue to follow the requirements that applied before September 15. Most importantly:
- J-1 physicians continue to be admitted to the United States for Duration of Status, or D/S. The fixed periods of admission contemplated by the DHS rule are not currently in effect.
- J-1 physicians do not need to file an application with U.S. Citizenship and Immigration Services (USCIS) for an extension of stay solely because of the postponed rule.
- Physicians should continue to maintain valid J-1 status and comply with the requirements of the Exchange Visitor Program and Intealth sponsorship.
- Physicians traveling internationally should continue to review their electronic Form I-94 after returning to the United States and confirm that the “Admit Until Date” reflects D/S.
- The court’s order does not change existing requirements related to J-1 visa issuance, travel, maintenance of status, or Intealth sponsorship.
What This Means for Teaching Hospitals and Training Programs
Teaching hospitals and Training Program Liaisons (TPLs) should continue operating under the existing J-1 physician sponsorship framework. In particular, the new USCIS extension-of-stay process contemplated by the final rule is not currently required for J-1 physicians who need additional time to continue an authorized GME program.
Programs should continue to:
- Work with Intealth on sponsorship and continuation of sponsorship through established processes. J-1 physicians with multi-year Form(s) DS-2019 will still be required to file an annual application with Intealth; additional details are forthcoming.
- Report required changes in a J-1 physician’s training, including changes in program, training dates, site of activity, leaves of absence, remediation, termination, or other reportable events.
- Ensure physicians maintain appropriate documentation throughout their training.
- Remind physicians returning from international travel to review their Form I-94 and confirm that they were admitted in J-1 status for D/S.
- Contact Intealth if a physician receives an I-94 showing a specific expiration date rather than D/S or encounters another issue affecting J-1 status.
What About Multi-Year Form(s) DS-2019?
The court’s order does not impact or invalidate Form(s) DS-2019 that Intealth has already issued with multi-year program dates.
Intealth undertook the multi-year Form DS-2019 initiative in preparation for the DHS rule and to better align sponsorship documentation with the anticipated duration of physicians’ GME programs. However, we anticipate continuing to issue multi-year forms regardless of the eventual outcome of this matter. Should D/S remain in place or the fixed end date process be ultimately implemented, multi-year forms will continue to be issued.
J-1 physicians and programs should not take action to shorten, replace, or otherwise modify an existing Form DS-2019 solely because the DHS rule has been postponed.
International Travel
J-1 physicians may continue to travel internationally subject to the usual requirements for J-1 travel and reentry. Please refer to our Travel page for more details.
Because the DHS rule had been scheduled to take effect September 15, physicians returning to the United States should pay particular attention to their Form I-94. Under the current framework, J-1 physicians should generally continue to be admitted for D/S.
A physician whose I-94 contains a specific “Admit Until Date” rather than D/S should contact Intealth promptly for guidance.
What Happens Next
The court’s action is a postponement, not a final resolution of the rule. The court concluded that preliminary relief was warranted and postponed the rule’s effective date while the litigation continues. Requests to vacate the rule or enter summary judgment were denied without prejudice, meaning those issues may be considered later in the litigation.
Further court action, an appeal, or additional federal guidance could change the situation. Accordingly, Intealth will continue to monitor the litigation and guidance from DHS, USCIS, U.S. Customs and Border Protection, and the Department of State.
For Now: No Change to the Existing J-1 Physician Framework
For J-1 physicians and teaching hospitals, the immediate message is straightforward:
The September 15 transition to fixed periods of admission has been postponed. J-1 physicians remain under the D/S framework, and programs and physicians should continue following existing Intealth sponsorship processes unless and until additional guidance is issued.
Intealth will communicate promptly with J-1 physicians and TPLs if further developments require changes to current processes.
