Most foreign physicians come to work in United States either on a J-1 visa or an H-1B visa. While the H-1B visa may be considered to offer a greater benefit, the J-1 visa might be the only option offered by certain medical facilities or schools.

Most foreign physicians who come to the U.S. on a J-1 visa do so for graduate-level medical education. Among the many strict requirements of the J-1, physicians who complete their training while on a J-1 visa must return to their home country for two years before being able to return to the United States  to work or to see permanent residence (it is possible to have the two-year requirement waived; we will discuss this in an upcoming article). From the vantage point of the medical employer, the J-1 visa is more advantageous than the H-1B visa, including:

• The employer does not have to sponsor the foreign physician;
• There is no immigration-related record-keeping requirement;
• There is no prevailing wage requirement;
• There are no fees that have to be paid as with an H-1B visa.

Foreign physicians who enter the U.S. on an H-1B work visa must be sponsored by their prospective employer. For the employer's part, they must abide by certain record-keeping requirements, post notices to employees, pay a prevailing wage, and pay fees to the government. The H1-B is approved for only a maximum of three years, with the possibility of a three year extension. In addition to having to meet state licensing requirements, in order to qualify for an H1-B visa a foreign physician must pass the U.S. Medical Licensing Examination (USMLE) Parts 1, 2, and 3, unless they are renowned in their profession.

One of the greatest advantages with the H-1B visa for foreign physicians is that, unlike with the J-1 visa, there is no two-year return requirement. Furthermore, on an H-1B a physician has the option of working part-time or full-time, and can even moonlight. On the other hand, while a J-1 physician's spouse can work in the United States, an H-1B physician's spouse cannot.

Every medical or health facility creates its own policies about whether a foreign physician must obtain a J-1 visa or if they will be sponsored on an H-1B visa. With the H-1B, even though it comes with increased liability on the part of the employer, its availability could attract higher quality foreign professionals.

It must be pointed out that there is a limit on H-1B visa that are issued in any given year. If an H-1B is not available when a medical facility seeks to bring on a foreign physician, then the J-1 visa may be the only option. However, the H-1B visa limit is not applicable to universities or to non-profit hospitals and other non-profit entities affiliated with universities.