Intealth ECFMG

Educational Commission for Foreign Medical Graduates

ECFMG Sponsorship Types


ACGME-accredited Clinical Training


Physicians sponsored as exchange visitors for participation in Accreditation Council for Graduate Medical Education (ACGME)-accredited clinical programs or directly associated fellowship programs of graduate medical education or training are categorized as J-1 “(alien) physicians.” Training must be undertaken within an ACGME-accredited Sponsoring Institution.

ALIEN PHYSICIAN (Clinical Training Program): As defined in the U.S. Code of Federal Regulations: An “alien physician is...a foreign medical graduate seeking to pursue graduate medical education or training at accredited schools or medical or scientific institutions” [22CFR62.27(a)]. The term graduate medical education is further defined as “a program in which the alien physician will receive graduate medical education or training, which generally consists of a residency or fellowship program involving health care services to patients, but does not include programs involving observation, consultation, teaching or research in which there is no or only incidental patient care. This program may consist of a medical specialty or a directly related medical subspecialty or both...” [22CFR62.2].

More information about the “physician” category is available on the U.S. Department of State website at https://j1visa.state.gov/programs/physician/ .

Review the ACGME-accredited clinical training checklists for information on the application process and requirements.

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Non-Standard Clinical Training


Non-standard training programs are advanced clinical subspecialty disciplines or pathways for which Accreditation Council for Graduate Medical Education (ACGME) accreditation and/or American Board of Medical Specialties (ABMS) Member Board certification is unavailable. If ACGME accreditation is available in the discipline being pursued but your institution’s program is not accredited, the program does not qualify under the non-standard provision for J-1 trainees.

Programs seeking to enroll J-1 physicians in non-standard training for the 2022/2023 academic year must ensure that the following requirements are met:

  • ABMS Member Board recognition for the specific advanced subspecialty discipline being pursued. See the list of Recognized Non-standard Subspecialty Disciplines. Only those disciplines listed qualify for ECFMG sponsorship. The ABMS Member Boards are no longer writing individual letters or recognizing new disciplines. See Pending Transition to ACGME Recognition for Sponsoring Institutions below for more information.
  • Confirmation that the Sponsoring Institution’s Graduate Medical Education Committee (GMEC) has approved the non-standard training program and associated program description. GMEC approval is evidenced through completion and submission of the GMEC & Parent Program Verification Form.
  • Non-standard training must take place at an ACGME-accredited Sponsoring Institution and at the primary clinical site of activity for the associated ACGME-accredited “parent” program. Both must apply. To search for a specific ACGME-accredited program and its “primary clinical site(s),” refer to https://apps.acgme.org/ads/public/ .

Review the non-standard clinical training checklists for information on the application process and requirements.

Pending Transition to ACGME Recognition for Sponsoring Institutions

With the publication of a Federal Register Notice on April 19, 2021, the U.S. Department of State officially acknowledged a change in the administrative recognition of non-standard training programs. Historically, all non-standard disciplines were required to be endorsed by an appropriate ABMS Member Board to be considered for J-1 sponsorship.

In the future state, ACGME, the primary national accreditor of graduate medical education programs and the institutions that sponsor them, will recognize Sponsoring Institutions offering non-standard training opportunities to J-1 physicians. An ACGME process for approval of ACGME-accredited Sponsoring Institutions to conduct non-standard programs will be announced in 2022. Institutional Recognition is distinct and separate from the ACGME accreditation processes.

Non-Standard Clinical Training FAQs

1. What is a “parent” program?

The “parent” program is the affiliated ACGME-accredited specialty or subspecialty for the non-standard discipline. Non-standard programs must be linked to the most closely related specialty or subspecialty (e.g., the parent program for leukemia fellowship would be hematology/oncology, not internal medicine). Non-standard training must take place at the primary clinical site for the affiliated parent program.

2. Do research programs qualify under the non-standard provision?

Non-standard fellowships are clinical training programs; physicians sponsored in the J-1 “alien physician” category cannot engage in long-term, independent research projects nor can sponsorship under the non-standard provision be extended for research programs. Similarly, the originally defined duration of the non-standard program cannot be extended for research.

3. Do academic/research tracks qualify under the non-standard provision?

Sponsorship for one additional year beyond the ACGME-accredited length of a training program may be permissible if the academic/research track was predefined as a component of the ACGME-accredited program and documented as such prior to an applicant’s entry into the accredited program. For additional information, see Eligibility Requirements for J-1 Visa Sponsorship within Academic/Research Tracks.

Recognized Non-standard Subspecialty Disciplines

Summary of Discussions

The following document summarizes the criteria that were agreed upon by the U.S. Department of State, ECFMG, and representatives of the academic medical community for sponsorship in non-standard programs, effective July 1, 2003.

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Research Scholar


The category of “research scholar” is specifically defined in the U.S. Code of Federal Regulations as follows:

RESEARCH SCHOLAR (Non-clinical Program): A “research scholar is…an individual primarily conducting research, observing, or consulting in connection with a research project…” [22CFR62.4(f)].

ECFMG sponsors J-1 exchange visitors in the research scholar category for up to five years of full-time participation in non-clinical programs consisting of observation, consultation, teaching, or research. Unlike those sponsored in the J-1 “alien physician” category for clinical training, research scholar participants generally are not required to pass U.S. medical licensing exams and are not required to be ECFMG certified. As such, J-1 research scholars are limited to activities involving no patient contact or incidental patient contact.

ECFMG is the only agency authorized to sponsor alien physicians for J-1 status; however, many U.S. hospitals and training institutions are designated by the U.S. Department of State (DoS) to sponsor J-1 research scholars. ECFMG, therefore, only provides research sponsorship to those physicians participating in programs at hospitals or institutions that do not have their own J-1 research designation.

J-1 research scholars may or may not be subject to the two-year home-country physical presence (foreign residence) requirement . Generally, J-1 research scholars are subject to §212(e) of the Immigration and Nationality Act, as amended, when either of the following applies:

  • A research scholar's specialized knowledge and skill are on the Exchange Visitor Skills List , under his/her country, as published by the DoS.
  • The research program in which a research scholar is to be engaged is funded, in whole or in part, either directly or indirectly, by the U.S. government or the government of the exchange visitor for the express purpose of exchange.

There is currently no provision for a J-1 physician who has participated in any clinical training under ECFMG sponsorship to request a change of category to the J-1 research scholar category. However, a change in category from research scholar to alien physician is possible under certain circumstances. Find the requirements for a change of category request and more information at https://www.ecfmg.org/evsp/evspcocmemo.pdf.

Review the research scholar checklists for information on the application process and requirements.

More information about the research scholar category is available on the DoS website at https://j1visa.state.gov/programs/research-scholar .

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J-2 Dependent


ECFMG is authorized to sponsor the spouse and/or unmarried minor children of a J-1 physician for entry into the United States under J-2 visa status. A minor child is defined as one under the age of 21. A J-1 physician’s parents, siblings, extended family members, and nannies are not eligible for sponsorship as J-2 dependents.

J-2 dependents must:

  • Maintain a valid passport
  • Secure and maintain required health and accident insurance as detailed on the Mandatory Medical Insurance page
  • Notify ECFMG of plans to permanently depart the United States prior to the J-1 spouse/parent or change U.S. visa status
  • Live with the J-1 physician (at the same U.S. residential address)
  • Adhere to all U.S. laws

J-2 dependent sponsorship can be requested:

  • At the time of application for J-1 sponsorship, OR
  • At any time via the J-1 Visa Sponsorship section of OASIS, under the “Dependents” tab

A copy of the dependent’s passport biographic page and evidence of the family relationship (i.e., marriage, birth, or adoption certificate) with English translation, if applicable, must be uploaded in support of any dependent sponsorship request.

Please see the instructions sheet for more information on how to acquire J-2 status once Form DS-2019 has been issued by ECFMG. J-1 physicians are not required to notify ECFMG of newly arrived J-2 dependents.

J-2 dependents are eligible to apply for an Employment Authorization Document (EAD) card through U.S. Citizenship and Immigration Services (USCIS). Once an EAD card is issued, the J-2 dependent is then eligible to apply for a Social Security number through the Social Security Administration. If employed, income derived from the spouse’s employment cannot be used to support the J-1 physician and/or the family.

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[Last update: March 17, 2021]

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