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US H1B visa for foreign doctors

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This guide deals with H-1B visas for foreign doctors and physicians who would like to work in the US.

Before the Immigration Act of 1990, the only way for physicians to come to the US to engage in graduate medical training was to enter in J-1 status.  But the 1990 Act dropped this requirement and for many years now physicians have been able to use the H-1B visa to join residency and fellowship programs.

Doctors who are seeking employment in the US should bear in mind that there are special licensing requirements, and because of this start planning before the completion of medical school. Getting an H-1B visa is not always easy and even getting H-1B status is not free from problems. With adequate preparation, however, and the help of, a foreign national physician should be able to get employment authorization in the US, especially in medically underserved areas or health professional shortage areas.

H-1B Visas and research

If you are a foreign medical graduate coming to the US to teach or perform research, and only a small amount of patient care is involved, you will have to show that you have received a medical education and are licensed in your home country. You must also show that you have received an appropriate license by the state where you will be working if patient care will be performed.

H-1B Visas and clinical practice

You can also use an H-1B if you wish to engage in a clinical practice or engage in graduate medical training. You generally must meet a number of requirements including the following:

  • You must have a license or other authorization required by the state where you will practice;
  • You must have an unrestricted license to practice medicine in your country or have graduated from a foreign or US medical school; and
  • You must passed the appropriate examinations.


As mentioned above, you must be properly licensed. All states require physicians to be licensed to practice medicine, including physicians working in residency or fellowship programs. Some states do not permit physicians to sit for USMLE Step 3 prior to engaging in graduate medical training and in such states the J-1 visa is the main option.

The H-1B requirements of the 1990 Act also require a physician to show that he or she possesses a state license "or other authorization" in order to perform patient care as well as a full and unrestricted license to practice in a foreign country or proof of graduation from a foreign medical school.

Note that some states will not issue a license without proof of the issuance of a visa. The Catch-22 can be avoided by getting a letter from the state licensing board documenting that the only thing standing in the way of issuing a license is the visa itself. Usually this letter will satisfy USCIS.


As noted above, a physician needs to have passed one of the required medical examinations:

  • Federation Licensing Examination (FLEX) parts I and II, or an "equivalent examination as determined by the Secretary of Health and Human Services";
  • National Board of Medical Examiners (NBME), Parts I, II and III;
  • or The United States Medical Licensing Examination (USMLE), Steps 1, 2 & 3

For many years, the USMLE has been the exclusive examination. Passage of earlier examinations is still recognized, but "mixing and matching" of examinations is not permitted for H-1B purposes. Note that the Licentiate Medical Certificate of Canada is NOT equivalent to the FLEX or USMLE for H-1B purposes.

  • Physicians are also required to document competency in English and passage of the Test of English as a Foreign Language will suffice for this purpose.


Doctors who have graduated from US medical schools only need to show they have graduated from a US medical school and that they possess the appropriate state license. Also, most of the above requirements above are waived for doctors who are of national or international renown in their area of specialization and who have graduated from a foreign medical school.