Foreign Medical Graduates

In addition to the meeting UW criteria for H-1B sponsorship, graduates of foreign medical schools (including graduates of Canadian Medical Schools) must meet the following requirements to qualify for H-1B status in order to practice medicine in the United States, or undertake clinical training in a residency or fellowship. Documentation must be included in the H-1B petition. Foreign graduates of U.S. medical schools are exempt from items 1 and 2 since they are not considered Foreign Medical Graduates.

1. Have passed the Federation Licensing Examination (FLEX) or an “equivalent examination.” Only two exams are equivalent to the FLEX for H-1B purposes:
   • National Board of Medical Examiners (NBME) Parts I, II, and III
   • United States Medical Licensing Examination (USMLE), Steps 1, 2, and 3
2. Show competency in oral and written English by passing an English proficiency examination acceptable to the Educational Commission for Foreign Medical Graduates (ECFMG). Currently ECFMG accepts and evaluates the scores on the Test of English as a Foreign Language (TOEFL).
3. Have a license issued by the state in which the Foreign Medical Graduate will practice medicine or receive graduate medical education or training.

For foreign medical graduates who come to the U.S. on H-1B visas to teach or conduct research, the special requirements listed above need not be met, provided no patient care will be performed except that which is incidental to their teaching and research responsibilities. The terms "incidental" and "patient care" are not defined in the immigration regulations. Therefore, what constitutes "patient care" as well as what level of care is "incidental" should be carefully considered. UW representatives involved in this evaluation might include ISS, the Dean of the Medical School, the Chair of the department , and the Health Sciences Attorney General's Office. The H-1B petition should point out that any patient care will be incidental to the physician's teaching and/or research activities.

Graduates of foreign medical schools who will not engage in any activities that might involve patient care do not have to show eligibility for clinical care. The H-1B petition should point out that the job will not involve any patient care services.