Dear Mentor:

How can a doctor sponsor help me with a visa?

I am doing my internship presently. I would like to know about the help that can be offered by a sponsor, who is also a doctor, regarding a visa. Should I take the USMLE [US Medical License Exam] and then apply, or should I do the GRE [Graduate Record Exam], try to get to the US and then do the USMLE?

Sponsoring for Medical Residency, Bangalore, Karnataka, India

Dear Sponsoring for Medical Residency:

We surmise from your inquiry that you are currently doing your medical internship in India, leading to the completion of your MBBS (the first degree in medicine) program. We are assuming that you wish to continue in the medical profession in the US and eventually become a practicing physician. To practice medicine, you need to be licensed, which requires the completion of a residency program - 3 to 4 years in duration depending on your specialization - in the US. Our reply deals with the stated scenario.

The Graduate Record Exam (GRE), a standardized exam, has nothing to do with your situation. The GRE is typically required for pursuing graduate (Master's or doctoral) degree programs in engineering, computer science, humanities and sciences, and many business programs. It has nothing to do with studies in medicine.

You are required to complete the USMLE before you can enter a residency program in the US. We are not sure for what purpose your sponsor would be willing to sponsor you. Your sponsor can not sponsor you for the residency - that is, offer you a residency position - officially until you have completed the USMLE.

As you may know, the USMLE is a 3-step process. Steps 1 and 2 can be completed in many parts of the world, including India. Step 3 must be completed in the US. You must come to the US as a visitor to complete this last step. To obtain a visitor's visa to the US, you would be required to demonstrate, to the US immigration officials in India, your ability to sustain yourself financially during your stay in the US. It is here that a sponsorship from a financially sound person in the US - a family member or a close friend - can help.

You must keep in mind that the nature of your visit to the US is officially and legally temporary. You are explicitly not allowed to work or undertake medical residency in the US. But you know your intentions are different, and so do the US immigration officials in India. They have seen many of these cases before. It is "a wink and a nod" game. You must stick to the line that you intend to visit the US temporarily. Any indication to the contrary and you would be denied a visitor's visa. The US is a free country and you have the right to change your mind or plans once you have arrived in the US.

A successful completion of the USMLE will make you eligible for a medical residency. At this stage, your sponsor can offer you a residency position. Otherwise, you would have to search for a residency position yourself, and your sponsor can help you with the search. Once you are offered a residency position, you must officially convert your visitor's visa to a visa that allows you to remain in the US and pursue residency. Typically this visa type is J1. Residency is a paying position - effectively an employment - so you don't need a sponsorship for financial purposes. You do however need a sponsorship from the prospective hospital, where you have been offered residency, to get your visa converted.

Since there are many steps in the entire process - each with its own risks - of leaving from India to starting a residency program, the overall financial risk is substantial. But it is standard operating procedure for physicians who have been trained elsewhere. About one-fourth of the physicians practicing in the US have had their initial training elsewhere. You may also wish to read an earlier Dear Mentor: column: How do I do a medical residency in the US?

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