International Medical Graduates in Nephrology: A Guide for Trainees and Programs

Published:August 02, 2020DOI:
      A significant portion of the nephrology workforce has traditionally consisted of non-United States (US) citizen international medical graduates and international research trainees. Although international medical graduates are offered opportunities for training and professional growth that are beyond those available in their countries of origin, they typically encounter barriers to transition from training to practice and early-stage career development. In this article, we describe the exchange visitor and temporary worker visas granted to foreign trainees in the United States, focusing on the transition from training to nephrology practice and/or research. While we provide general recommendations on how to navigate this tedious and unpredictable process for both programs and trainees, consultation with immigration attorneys is indispensable for a successful outcome. Trainees are therefore encouraged to seek continuous support from their programs/sponsors and assistance from immigration representatives at their training institutions. We provide a positive message to emphasize that there are many pathways to arrive at the desired post-training destination.

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        • Mullan F.
        • Politzer R.M.
        • Davis C.H.
        Medical migration and the physician workforce.
        Int Med graduates Am Med. 1995; 273 (JAMA): 1521-1527
        • Pinsky W.W.
        The importance of international medical graduates in the United States.
        Ann Intern Med. 2017; 166: 840-841
        • Austin T.
        • Fragomen J.
        • Shannon C.
        • Montalvo D.
        Immigration Employment Compliance Handbook.
        Thomson Reuters, Westlaw, Chapters 1 and 4, Eagan, MN2020
        • Majeed M.H.
        • Saeed F.
        Denying visas to Doctors in the United States.
        N Engl J Med. 2017; 376: 889-890
        • Meghani S.H.
        • Rajput V.
        Perspective: the need for practice socialization of international medical graduates--an exemplar from pain medicine.
        Acad Med. 2011; 86: 571-574
        • American Society of Nephrology
        Nephrology fellows' Survey.
        Date: 2019
        Date accessed: April 12, 2020
        • AJKD Blog
        Nephrology workforce Crisis: Don't Forget international medical graduates (IMG).
        • American Society of Nephrology
        Why are international medical graduates not choosing nephrology?.
        • Berns J.S.
        • Ghosn M.
        • Altamirano R.R.
        International medical graduates in nephrology: Roles, rules, and Future Risks.
        Am J Kidney Dis. 2018; 72: 113-117
        • US Department of State
        J-1 visa.
        Date accessed: April 12, 2020
        • Austin T.
        • Fragomen J.
        • Shannon C.
        • Montalvo D.
        H-1B Handbook.
        Thomson Reuters, Westlaw, Chapters 1 - 5, Eagan, MN2020
        • Kennedy A.
        The Politics of Skilled immigration: Explaining the ups and Downs of the US H-1B visa program.
        Int Migration Rev. 2019; 53: 346-370
        • American Society of Nephrology
        Grants and funding: transition to independence.
        Date accessed: April 12, 2020
        • National Kidney Foundation
        Research grants.
        • American Diabetes Association
        Research and grants.
        • American Heart Association
        Research programs.
        • Polycystic Kidney Disease Foundation
        Research funding.
        • U.S. Citizenship and Immigration Services
        (Chapter 45 Waiver of Section 212(e) Foreign Residence Requirement)
        • Citizenship U.S.
        • Immigration Services
        Conrad 30 waiver program.
        • Appalachian Regional Commission
        J-1 visa waivers.
        • Delta Regional Authority
        Delta Doctors.
        • US Department of State
        Research scholar program.
        • American Kidney Foundation
        Clinical scientist in nephrology program.