There are over a dozen categories of “exchange visitors” (i.e., individuals with J-1 immigration status) in the US participating in opportunities varying from au pair to medical scientist. Although individuals in J-1 status can be employees, many are not, and the Department of State (which specifically governs what it calls the “J-1 Exchange Visitor Program”) is quite clear that the J-1 Exchange Visitor Program should not be thought of as an “employment visa.” Employment happens to be a benefit incidental to holding J-1 immigration status, but the Department of State designed J-1 status expressly to allow internationals to visit the US for a specific time, participate in a specific activity, then return to their home country and share that knowledge.

J-1 is one of the most flexible immigration statuses as far as funding: J-1 exchange visitors can be fully paid by UAB, fully sponsored by their home country government, fully sponsored by their own personal funds or nearly any combination thereof. Conversely, J-1 is one of the most restrictive immigration statuses for the length of time in the US, participation in clinical activity, and repeat participation.

Onboarding a J-1 Scholar

IME and Immunization Clearance (CLINICAL SPACE ONLY)

If your prospective exchange visitor will not have access to UAB Hospital or any other clinical setting, please proceed to the next step.

If your prospective exchange visitor will have access to the OR, animal labs, or any clinical setting, please send a copy of the offer/invitation letter to International Medical Education (IME) for appropriate clearance first. IME controls the number of individuals allowed in UAB clinical spaces and is responsible for ensuring that the immunization and workplace safety protocols are followed. It can take approximately 90 days to clear IME and receive the immigration document necessary for the exchange visitor to enter the US.

What Documents are Needed?

Initial Appointment

We cannot issue the DS-2019 until we receive all the documents and forms from the Exchange Visitor and the Department. We request to receive ALL documents at least 2 months before the desired start date.

As the Department inviting the Exchange Visitor on campus, you are responsible for providing:

  • International Staff Appointment Form completed and signed
  • Offer letter
    • For Visiting Scientist, Visiting Scholar or other – ISSS has a template available
    • For Postdoctoral Fellows – please provide the letter from the Office of Postdoctoral Education

The Department remains responsible to create a profile in Oracle and check the I-9 (Employment Eligibility Verification document) with HR or our office. Contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information about I-9.

Extension

J-1 Research Scholars and Professors can remain in the US for a maximum of 5 years. The position held at UAB must remain compliant with the J-1 regulations to seek an extension.

J-1 Short-Term Scholars can remain in the US for a maximum of 6 months. No extension beyond the 6 months can be granted.

J-1 Student Interns can remain in the US for a maximum of 12 months per degree.

To request an extension, please contact our office at least 1 month before the current end date as listed on the DS-2019. Please note that this end date is the last day the Exchange Visitor will be authorized to work on UAB campus. ISSS office will need:

  • J-1 Reappointment Packet - to be completed by UAB department
  • Extension offer letter – to be issued by UAB – the extension letter must list the new dates of appointment, the subject of the research (you should continue the same type of research you were initially conducting) and the salary (if paid by UAB).
    • Postdoctoral fellows – you can request an extension letter from the Office of Postdoctoral Education (OPE)
    • Other – you can use the same template as before OR request a template from the ISSS Office
  • Proof of Funding
    • If paid by UAB – the extension letter will serve as proof
    • If not paid by UAB – ISSS Office need updated proof of sufficient funding
  • Proof of continuous health insurance – to be provided by the Exchange Visitor for him/herself and his/her family (if any).

Once the DS-2019 is extended, the Exchange Visitor is authorized to stay in the US and continue to work.

The Department remains responsible to update Oracle and check the I-9 (Employment Eligibility Verification document) with HR or our office. Contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information about I-9.

Transfer within UAB

If an Exchange Visitor transfers lab within UAB, ISSS Office must update SEVIS to reflect the correct appointment. Therefore, the new department must follow these steps:

  • Contact ISSS office at This email address is being protected from spambots. You need JavaScript enabled to view it. as soon as possible
  • Complete a new International Staff Appointment Form
  • Provide a new offer letter
    • Postdoctoral fellows – you can request an extension letter from the Office of Postdoctoral Education (OPE)
    • Other – you can use the same template as before OR request a template from the ISSS Office

After receiving these documents and review them, ISSS Office will update SEVIS and issue an updated DS-2019 for the Exchange Visitor and his/her family (if any).

The Department remains responsible to update Oracle and check the I-9 (Employment Eligibility Verification document) with HR or our office. Contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information about I-9.

Five-Point Letter

As a Research Scholar, Professor, Short-Term Scholar or Student Intern, the Exchange Visitor is normally NOT authorized to have patient contact.

However, in certain cases, an Exchange Visitor physician participating in a program of observation, consultation, teaching or research may need to have limited patient contact in order to carry out those objectives. If the patient contact is incidental to those objectives, a physician participating in a non-clinical exchange program can engage in incidental patient contact.

Example of acceptable activities:

  • doing a diagnostic examination in the presence of a senior physician who repeats the examination or ensures at every step that it is done correctly and the proper diagnostic information is obtained;
  • being present during therapies and treatment with opportunities for hands on experience in ways that do not compromise the care of the patient;
  • being present in the operating room and having limited patient contact, but not performing procedures.

If the Exchange Visitor needs to be authorized to have incidental patient contact, we need to collect a specific document called Five-Point Letter, signed by the Faculty Sponsor, the Faculty Chair and the Dean of the School of Medicine or his designee. The letter will specifically define the boundaries of the authorized patient contact.

Please contact the ISSS Office if you need to get such a letter.

When Can the Exchange Visitor Be on Campus?

Exact start dates can be hard to pinpoint. ISSS must receive all forms and documents AT LEAST 2 MONTHS prior to the exchange visitor’s scheduled start date at UAB.

ISSS can issue the DS-2019 approximately two weeks after receiving ALL necessary documents from both the exchange visitor and the department. Once we generate the DS-2019, the exchange visitor can go online and book a visa interview appointment at a US embassy or consulate abroad. Visa appointment wait times vary widely depending on the time of year and the embassy or consulate chosen and can be viewed here.

It can take a week or so to receive the visa after the appointment, and some exchange visitors may be selected for administrative processing (more information about administrative processing is available on the Department of State website – scroll to get to the appropriate question). A good rule of thumb is to plan on a start date and then add 30 days. In case of an unforeseen event, we may be able to change the dates, however, the start date listed on the DS-2019 is meant to be a firm start date at UAB.

The Exchange Visitor may enter the US up to 30 days before or after the start date listed on the DS-2019. We advise that they arrive about 1 or 2 weeks early to get settle and accomplish various administrative tasks before starting their research or internship.

How Much Will It Cost?

Nothing, unless the department wishes to reimburse the exchange visitor for the cost of the J-1 SEVIS fee, visa application fee, and/or English Proficiency Test fee.

After the DS-2019 Is Generated

We ship the DS-2019 and a pre-arrival packet of information, including a free SIM card, to the exchange visitor using the departmental UPS/FedEx account. Exchange visitors must present the blue-ink signed hard copy DS-2019 at their visa appointment at a US embassy or consulate abroad in order to obtain a J-1 visa to enter the US.

The Department is responsible to create the ACT document in Oracle and request a dummy SSN to the financial affairs. Our office can assist for the I-9 (please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information).

Please keep in touch with the Exchange Visitor and ISSS Office about the arrival in the US so we can schedule an Orientation.

Onboarding a J-1 Alien Physician (Resident or Fellow)

The Educational Commission for Foreign Medical Graduates (ECFMG) is the only institution approved by the US Department of State to sponsor international medical graduates to enter the US on J-1 exchange visitor visas in the "Alien Physician" category to participate in clinical training for residencies and fellowships. UAB’s ECFMG Training Program Liaisons (TPLs) work very closely with UAB’s Office of Graduate Medical Education to facilitate the J-1 onboarding process. ALL requirements are dictated by ECFMG. We cannot change the timing, order, or requirements. ISSS serves only as the liaison between ECFMG, the incoming exchange visitor physician, GME, and the UAB department/Program Coordinator.

J-1 residents and fellows have J-1 immigration status pursuant to a Form DS-2019 just like J-1 Research Scholars—they are just in a different J-1 category that allows for clinical contact during graduate medical education. There are many steps involved in obtaining a Form DS-2019, and all of them are controlled by ECFMG. Unlike for J-1 Research Scholars, ISSS does not generate Form DS-2019 for J-1 residents and fellows: only ECFMG can do this. Everything is dependent on ECFMG.

Initial J-1 Application

The physicians that are not in the US yet need to submit an initial application. The general process is as below:

  • UAB Department/Program initiates contact with ISSS to inform us of incoming international physicians.
  • Depending on each individual situation, the Program and the physician will provide the required documents – see the table below to access the checklist that fits each specific situation.
  • ISSS reviews the documents provided.
  • ISSS creates an online Appointment Profile on UAB’s TPL portal (EVNet) and uploads supporting documents.
  • ECFMG emails physicians to complete their part of application online and pay administrative fees through their portal (OASIS).
  • After the application is completed and the fees paid, ECFMG issues the Form DS-2019 within 4-6 weeks.
  • ECFMG sends the DS-2019 to ISSS (the DS-2019 is the form the physician must present at a US consulate to obtain a J-1 visa).
  • ISSS contacts physician to collect the DS-2019 (or mails the DS-2019 to the physician, if the physician is outside the US).

Things to remember:

  • Inform ISSS if the program is ACGME accredited or not;
  • Inform ISSS if the physician will be paid by both HSF and UAB;
  • The contract or offer letter must list the following information:
    • Exact title of the fellowship
    • Start and end dates – ECFMG review the application on a yearly basis
    • PGY level
    • Salary – if the physician will be paid by both UAB and HSF, the repartition between the 2 institution must be listed

Continued J-1 Application

Physicians that are already sponsored by ECFMG (even if they are coming from another institution in the US) are considered to continue their training. The process is pretty similar to the initial process.

Please note that ISSS Office is able to start the extension process before the new salaries for the upcoming year are published. However, it is always best practice to wait for the new salaries to be released by the GME Office. If the Physician requires an early extension, please be aware that ECFMG will not issue the new DS-2109 more than 6 months before the end of the current one (example – if the current DS-2019 expires on June 30, 2019, the new extended DS-2019 will not be issued before January 1, 2020).

Chart for ECFMG Documents Checklist

Program Type Application Type When to Use Checklist
ACGME - accredited Clinical Training Program   Initial ECFMG sponsorship Applicant is not currently sponsored by ECFMG and seeks to engage in an ACGME-accredited training program. View Checklist
Continuation of ECFMG sponsorship Applicant is currently sponsored by ECFMG and seeks to engage in an ACGME-accredited training program. View Checklist
Non-Standard Clinical Training Program
NOTE – UAB and ECFMG must confirm that the Program can be sponsored by ECFMG  
Initial ECFMG sponsorship Applicant is not currently sponsored by ECFMG and seeks to engage in a “non-standard” training program. View Checklist
Continuation of ECFMG sponsorship Applicant is currently sponsored by ECFMG and seeks to engage in a “non-standard” training program. View Checklist
ACGME - accredited or Non-Standard Clinical Training Program Request for a Change of J-1 Visa Category Applicant is currently in the US as a “J1 Research Scholar” and seeks to engage in a clinical training program.
Also applies if the applicant’s research program was completed within 6 months before the clinical training program start date.
View Checklist
Board Exam Continuation of ECFMG sponsorship to sit for an ABMS member board examination Applicant is currently sponsored by ECFMG and seeks an extension of sponsorship to sit for an ABMS member board exam. View Checklist

Onboarding a J-1 Student Intern

Overview:

The J-1 Student Intern category is available only to foreign students currently enrolled and pursuing a degree at a post-secondary academic institution outside the United States. The US internship must fulfill the educational objectives for the student’s current degree program abroad.

J-1 Student Interns can be paid or unpaid. They just cannot work in unskilled or casual labor positions, in positions that require or involve childcare or elder care, or in any kind of position that involves medical patient care or contact. Student Interns also cannot work in positions that require more than 20 percent clerical or office support work.

Documents Needed:

  • International Exchange Visitor Staff Appointment packet with applicable documents listed.
  • Training/Internship Placement Plan (DS-7002). Complete all sections as much as possible and email the document in PDF format for ISSS review. No signatures are required at this stage.
  • A copy of an official appointment letter stating the internship start and end dates, a description of the duties to be performed, and the experience to be gained.
  • Visual Compliance Letter (STEM departments only). This will help lessen (but not entirely eliminate) the chance of J-1 Student Interns being selected for administrative processing.

Email all materials and supplemental documents to This email address is being protected from spambots. You need JavaScript enabled to view it..

English Proficiency and Health Insurance Requirements

UAB is, in the Department of State parlance, an “exchange visitor sponsor.” We pay a fee every two years and certify to the Department of State that we follow all regulations governing the privilege of being allowed to generate Form DS-2019 for an exchange visitor to apply for a visa and enter the US. Failure to follow the Department of State regulations can result in the revocation of UAB’s designation as a J-1 exchange visitor sponsor and the end of being able to host J-1 exchange visitors at UAB.

We cannot issue a Form DS-2019 without documentation that the exchange visitor has both a minimum level of English proficiency and a minimum level of insurance coverage. The department is not responsible for providing ISSS with this documentation—the exchange visitor is.

English Proficiency Verification

Department of State regulations at 22 CFR 62.10(a)(2) require documentation of English proficiency sufficient to “function on a day-to-day basis in the [academic] environment.” Proficiency must be “determined by an objective measurement of English language proficiency.” Exchange visitors who are native English speakers or residents/citizens of a country where English is an official language are of course exempt from this requirement.

For the safety and quality of experience for both the exchange visitor and the wider UAB community, ISSS cannot rely solely on subjective English proficiency determinations derived from interviews by the UAB supervisor or faculty member who is inviting the exchange visitor.

The Department of State’s concern is that “good English communication skills are essential to ensure the health, safety, and welfare of exchange visitors. Moreover, the Department continues to find that too many exchange visitors lack sufficient English proficiency to perform their jobs or complete their academic programs; to navigate daily life in the United States; to read and comprehend program materials; to understand fully their responsibilities, rights, and protections; and to know how to obtain assistance, if necessary.” - State Department rule 10/06/2014

Acceptable methods of English verification for J-1 purposes at UAB are:

  • Proof of graduation from a four-year institution where the curriculum was conducted in English
  • Signed documentation from an English language school confirming oral and reading comprehension proficiency
  • Evidence of passing a recognized English language exam, such as the TOEFL (minimum iBT of 77), IETLS (minimum 6.0 overall with at least 5.5 on each section), or PTEA (minimum 51)
  • Passing score on UAB's J-1 Visiting Scholar English Language Proficiency Test (EPT)

Health Insurance Requirements

Department of State regulations have likewise long required exchange visitors to be enrolled in health insurance that meets certain statutory minimums. Even if your exchange visitor will be a postdoc, or otherwise covered by UAB health insurance after employee orientation or an open enrollment period, the visitor still must provide ISSS with proof of insurance coverage for the first month of time in the US. All exchange visitors are informed of this before they arrive. If someone breaks their arm in the first month, it will be difficult to explain to the emergency room that their insurance will kick in a month later and be retroactive. All exchange visitors must be covered from the moment they set foot in the US.