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J-1 Visa

The major drawback to the J-1 visa is its two-year home return requirement, which stipulates that upon graduating from your fellowship program you will need to spend two years working in Canada before you can be considered for employment in the USA. There is, however, a waiver program for those who would like to work in an underserved area or have “special skills” not otherwise available within the American workforce pool. This mostly applies to those with a research curriculum and is very state-dependent. The waiver program for the two-year home return requirement to the J-1 Visa is called the “Conrad 30 J1 Program”. Anecdotally, I know of Canadian fellows who have graduated on a J-1 visa and went on to work in academia in Las Vegas (Nevada) and Yale (Connecticut). The waiver may be harder to obtain for states that are in higher demand, such as New York and California. Another disadvantage of the J-1 is that it needs to be renewed on a yearly basis (although the second is usually much easier that when doing an application from scratch). 

Statement of Need (SON)

For those on a J-1 Visa, once you have been accepted into your fellowship program, you should apply for a “Statement of Need” (SON) from Health Canada as soon as possible, but less than 1 year before your expected starting date. As per Health Canada, Statements of Need confirm there is a need for the medical skills in Canada and that the medical graduates who are pursuing postgraduate medical education in the US have confirmed they intend to return to Canada and practice medicine in the field of medicine in which they will receive the training. This should go without saying, but it’s worth reiterating that a Statement of Need is NOT a guarantee of employment in your desired specialty or practice location upon return to Canada. Most will apply for a Category A SON which applies to “A Medical graduate currently enrolled in a Canadian specialty or subspecialty residency training program who wishes to pursue a fellowship in the U.S.” Notably, applicants for an SON must be Canadian Citizens or Permanent Residents. List of required documents for SON (Check the Health Canada website for updates: https://www.canada.ca/en/health-canada/services/health-care-system/health-human-resources/statements-need-postgraduate-medical-training-united-states.html):

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  1. Application Form

  2. Proof of Canadian Citizenship/Permanent Residency

  3. Letter of Offer or Training Contract 

  4. Consent to the Disclosure of Personal Information to Provincial and Territorial Governments for Recruitment Purposes [Optional]

OASIS

OASIS (On-line Applicant Status and Information System) is the online platform used by the ECFMG to accept applications for the J-1 visa. Your program must start your J-1 application themselves in OASIS (the online application platform used by the J-1 application program). Make sure they are aware of this. Once your program has completed their part of the application, you should receive a notification requesting to upload a series of documents (for me it was March, for a start date of July 1). This might vary for you, but for me the documents required included: 

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  1. A contract with my fellowship program stipulating: Start/end date of training, you speciality and sub-speciality, and your remuneration

  2. Statement of Need 

  3. Curriculum Vitae

  4. Copy of your passport

  5. Copy of your diploma (with a certified translation if not in English)

  6. Passport-size picture

  7. English Language proficiency attestation form: This needs to be signed by the fellowship program director “inviting” you to the USA.

  8. Training Program Description form: To be signed by the fellowship program director

SEVIS I-901

Once your documents are uploaded into the J-1 online platform OASIS, you will be asked to make a payment to process your application ($USD 220 as of 2021). After making the payment, you will be issued a proof of payment called “SEVIS I-901”. Make sure you keep a copy for your files and bring a printed paper copy on the day that you cross into the USA.

DS-2019

The DS-2019, or “Certificate of Eligibility for Exchange Visitor Status (J-Nonimmigrant)”. At the time of writing this (2023), you needed to bring the original, signed (usually with blue ink) paper copy: a) upon arrival to the USA, and b) each time your returned to the USA while on a J-1 visa. At the time of last updating this website, there were talks of allowing fellows to provide an electronic copy of their DS-2019 rather than the original signed paper version upon crossing the border. At the time of last updating this website, there were talks of allowing fellows to provide an electronic copy of their DS-2019 rather than the original signed paper version upon crossing the border. Please check before travelling whether you need to bring a paper version of the DS-2019 with you in order to be allowed back into the USA!

Crossing the Border into the USA

Please make sure you cross-check this information with DHS and ECFMG, but, as of writing this website, there were important consideration when you first cross the border into the USA with the expectation of starting your fellowship there. This is not your routine border crossing, and you need to bring more than just your passport. The “reason” for this is that your date of arrival into the USA needs to be updated into the ECFMG files, for your J-1 to get “activated”. You must cross less than 30 days before your expected fellowship start date (i.e., Your start date at your program must be within 30 days from the date your cross the border/arrive in the USA). If possible, entering the USA 2-3 weeks before the start of your program might not a be a bad idea, and would give you time to settle and take care of some administrative tasks that can only be completed once you are physically in the USA (e.g., make an appointment for a social security number, obtain your ACLS/BLS certification, complete your workplace occupational health requirements). Upon entering the USA, consider bringing with you:

  1. DS-2019: Now, this can get a little Kafkaesque, but don't let yourself be discouraged: the J-1 visa is mailed to your program in the USA, which means that you must ensure that your program mails it to you (in Canada) upon receiving it in order for you to be able to bring it upon crossing the border. (N.B., at the time of last updating this website, there were talks of allowing fellows to provide an electronic copy of their DS-2019 rather than the original signed paper version upon crossing the border, which would alleviate the need for the program to mail the physical copy to the fellow). 

  2. SEVIS I-901 Proof of payment 

  3. Copy of your work contract

  4. Itemized list of goods you are moving into the USA (If you are moving more than just your luggage into the USA). If you are using a professional moving service they will provide you with a copy of that list for you to bring at the border.

  5. Proof of vaccination (as needed, check updates--this was during the COVID Pandemic)

  6. Your passport

I-94

The I-94 is a record of your entries into the USA for the last 10 years, updated by the Department of Homeland Security (DHS). The DHS website mentions that this is electronically updated and sent to ECFMG when you cross the border. From my experience, there is a bit of variability to this process and this is not always true: some people (usually who crossed by land) are given a paper form to update into OASIS, some (that was my case) had to print the I-94 once they were in the USA from the DHS website and then upload it "manually" into OASIS. 

  1. If you are using a moving company and you are entering the USA by air, you will need to send a picture of your updated I-94 to the moving company as soon as you have crossed the border. They will print it and bring it with themselves when the truck crosses the border. 

Validation of initial arrival

Validation of Initial Arrival in J-1 Status: As soon as possible after arriving to the USA, you should ask your fellowship Training Program Liaison (TPL) to complete this form and upload it into OASIS. https://www.ecfmg.org/evsp/arrival.pdf

Background Check

This will depend on your fellowship program and state, many work with a third party for this (e.g., Certiphi™). Please check with your own program to see what their requirements are. 

I-9 Form: Employment Eligibility Verification Form

The I-9 form is a form which your employer (i.e., your fellowship program) will complete to confirm your identity and that you are legally allowed to work within the USA. Many fellowship programs (including mine) worked with a third-party for completing the I-9, while others used the E-verify system from DHS. A few weeks prior to my fellowship start date, I received an email with a link to make an in person appointment at one of the Fieldprint ™ offices. On the day of the appointment, my fingerprint were taken and copies were made of my documents. Please confirm what you need to bring beforehand, but for me I had to bring:

  1. A printed copy of the I-94 form

  2. The original DS-2019 form

  3. A copy of your Canadian Passport​​

J-1 Travel Exemption

While you are in the USA on a J-1 visa, you will likely want to leave the country to visit family, go on vacation, etc. In order to do this, you will need to have the “Travel exemption” part of your DS-2019 completed. I did this 2-3 weeks after my arrival. Note that you need to mail them the original DS-2019 form (there were talks of changing this to an electronic process in an, as of then, elusive future), which means that during this time you will be unable to:

  1. Submit any forms that require an original DS-2019.

  2. Travel outside of the USA.

Here is an example to help you understand the process: I arrived in the USA on June 13, and was done applying for my I-9 and social security number (both of which require the DS-2019) around mid-July. After this was done, I sent my DS-2019 in order to receive its travel exemption “seal of approval”. This took less than two weeks, so that I had received the travel exemption around the beginning of August. From mid-July to the beginning of August, I could not leave the USA since I was not in possession of the paper copy of the DS-2019(or more accurately I would have been able to leave but unable to return to the USA had I left without this exemption). N.B., the address at which you need to mail the DS-2019 to obtain the travel exemption was on the DS-2019 form itself. 

Visa Renewal

Visa Renewal: If you are staying for more than one year on a J-1 visa, for instance if you are doing a two-year fellowship, towards the end of the first year, you will need to renew your J-1 visa. This is, fortunately, a lot less painful the second time around. As of 2022, I was required to upload the following into the OASIS ECFMG website: 

  1. Statement of Need (SON): If the name of your fellowship is different for your second year, you will need a new SON (in my case my first year of fellowship was in “Clinical Neurophysiology” and the second in “Epilepsy”, so I had to apply for a new SON). 

  2. Contract or letter of offer

  3. Form I-644: Supplementary Statement for Graduate Medical Trainees (Essentially, a J-1 renewal form)

  4. I-94: New one with a record of your times of entry for the last year you have been in the USA on the J-1.

  5. Training Program Description: Needs to be completed by fellowship program director

  6. Payment (As of 2022, this was $USD 350)

Some words of (hard-earned) wisdom

  1. If in doubt, just bring more documents than not enough on this day. I just kept a file with all of my immigration documents which I brought to these kinds of appointment.

  2. Make sure you have copies of everything in case you lose it!

  3. Don't assume that your fellowship program will know how to handle all of the immigration process, especially if they are not used to having Canadian fellows

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