The Devastating Impact of ICE’s Proposed Rule Change on U.S. Health Care

Important Update on Duration of Status

In September 2020, U.S. Immigration and Customs Enforcement (ICE) of the U.S. Department of Homeland Security (DHS) proposed a visa rule change that would eliminate “duration of status” for certain nonimmigrant visas, including J visa holders. ECFMG|FAIMER monitored the proposed change closely, partnered with other academic medical organizations, and led advocacy efforts to exclude J-1 physicians from the rule change, if implemented.

Under the Biden administration, we do not expect the rule change to be acted on as it was originally proposed last September. This development is important for both current and prospective J-1 physicians as well as U.S. teaching hospitals. We will continue to provide you with updates on immigration issues pertinent to U.S. GME. If you have any additional questions, please contact us at

Overview of the Proposed Rule Change

A new proposal from U.S. Immigration and Customs Enforcement (ICE) would eliminate “duration of status” as an authorized period of stay for certain nonimmigrant visas (F, I, and J), a rule change that will have an immediate and devastating impact on U.S. health care during one of the most severe pandemics in our nation’s history.

Right now, more than 12,000 highly qualified foreign national physicians are providing critical health care services as they train in our nation’s teaching hospitals in J-1 visa status. If implemented, the rule change will disrupt the training of these J-1 physicians and the patient care that they provide.

As this proposed rule change enters a public comment period, September 25, 2020-October 26, 2020, all stakeholders have the opportunity to submit feedback before ICE makes a final decision on the proposed rule.

ECFMG|FAIMER and other leaders in medical education and health care—the Accreditation Council for Graduate Medical Education, American Hospital Association, American Medical Association, and Association of American Medical Colleges—oppose this change. ECFMG|FAIMER is urging all members of the medical community to make their voices heard and let ICE know why J-1 physicians must be excluded from this change.

Who is at Risk and What is at Stake
The American Public

Even as the COVID-19 pandemic has shined a light on an increasingly overburdened health care system, the heroic efforts of our physicians and other health care workers have inspired our nation and helped get us through this challenging time. J-1 physicians have been a critical part of this, working tirelessly across the front lines.

The duration of status rule change would limit the ability of thousands of physicians to contribute life-saving care when Americans need it most.

J-1 Physicians in the United States

J-1 physicians training in the United States are an essential part of the U.S. health care system. More than 12,000 J-1 physicians train in more than 50 medical specialties and related subspecialties. While training, they provide supervised patient care at nearly 750 teaching hospitals in 51 states and provinces.

Training programs last from one to seven years, depending on the medical specialty or subspecialty. The current duration of status provision allows J-1 physicians to extend their authorized stay in the United States for subsequent years of training at the same time that they renew their visa sponsorship annually with ECFMG|FAIMER, a rigorous review process that confirms their continuing eligibility.

The proposed rule change would replace “duration of status” with a specific end date and the additional requirement to apply through the U.S. government each year to extend this end date. The current published processing time for such an extension application ranges from five to 19 months. With the majority of residency/fellowship contracts issued only three to five months in advance of the July 1 start of each new academic year, the proposed change would create an impossible timeline, and do so on a recurring, annual basis. Consequently, thousands of J-1 physicians would be unable to continue in their training programs on July 1 each year.

The Health Care System and COVID-19 Pandemic

The U.S. health care system is facing an unprecedented strain on resources in light of the COVID-19 pandemic, in addition to a growing physician shortage that predates the pandemic. For decades, J-1 physicians have played an essential role in ensuring quality and accessible health care in the United States.

J-1 physicians who train in the United States are highly qualified and are carefully monitored by ECFMG|FAIMER, the sole visa sponsor for these physicians for nearly 50 years. Our nation’s success in battling the pandemic depends on the continued contributions of J-1 physicians to U.S. health care.

ECFMG|FAIMER Taking Action

ECFMG|FAIMER is working aggressively and collaborating with other organizations in medical education and health care to advocate for an exemption to the proposed rule change for J-1 physicians. On behalf of ECFMG|FAIMER, we are grateful for the more than 12,000 J-1 physicians who play a vital role in our nation’s health care system, and we will continue to advocate on their behalf.

If you have any questions about the proposed rule change, please see our Frequently Asked Questions or contact us at

Back to top