Government Medical College Chandigarh Old Students Association



Which visa is better, J1 or H1?

I found this info on one of the usmle forums and I thought it might be useful for a lot of us.


I have seen a lot of posts about visa issues on the forum; comparing H1 and J1 visa and questions about H1 visa duration.

I think I have something to add here for all of you who are looking for some kind of visa. I have personally through the process and currently doing cardiology fellowship on H1 visa; and I have gathered a lot of information about this issues that may be helpful for those of you who are just preparing to apply.

1. A very good number and mixture (meaning big universities to small community) programs sponsor H visa. Those programs who do not sponsor H visa do it as they do not know what it is and how easy it is to do it. Legally it is never a big deal. Only handful of programs really ever had legal issues; and that too due to their laxities and now they do not sponsor H visa any more. I have seen many times, even programs that say they will offer only J visa eventually sponsor H visa after the match! (all you have to do is to let them know that process is actually simpler than J visa!). Programs that do not sponsor H visa are not BETTER programs; they just don't know the process.

2. The biggest advantage of H visa is that at the end of residency/fellowship you have much better chance of a better employment opportunity compared to J visa and also you have to do that job only for 1-2 years; not 5 years. I will explain this by examples: at the end of residency many of my colleagues who were going for jobs/green cards were offered job at institutions like Cleveland clinic, William Beaumont hospital etc. who will sponsor their green card. (these are not extraordinary candidates). I don't think you can get J waiver at such top notch places! they are getting a great start of their jot career; and that too they have to do only for 1-2 years; after that they may stay there or do something else. You do not have that liberty with J visa. (the way this 1-2 year duration works is: they start green card process right away; it takes 4-5 months for labor certification PERM processing, then another 6 months for I140 and once I 140 is approved you can change employers on portability while awaiting I 485 which takes variable time from 1-3 years. Also once I 140 is approved you can travel in and out of US without any visa on Advance Parole document and you can also get EAD). With J1 visa, you simply have to do at least three years of waiver (only few people are lucky to get it at a decent place) and then you start with the same H visa unless you are at a VA hospital where you can work for another two years and file for Green card under NIW at least 5 years of working in underserved area and may be more.

3. Another burning question is what do you do after six years on H visa: There are a lot of options!!

Option 1: If you are in a three year fellowship program, and if you find an employer 18 months in advance to file for green card (which is not difficult at all) then you can get your labor certification done and I 140 Filed (not approved) before the beginning of last year of fellowship; then you can keep extending your H visa till GC gets approved totally and again same rules apply for the process as I described above.

Option 2: If you have a lot of publications, you can file for EB1 category green card on you own during fellowship and if that gets approved, Bingo..! you got it. Not for everyone but many people do meet the criteria (there are ten criteria and you should meet three of them, they are listed on

Option 3: Lets talk about the worst case scenario: you get employer just close to the end of your fellowship (and trust me, you will get that!! even in internal medicine people get 4-5 local employers hunting behind them) you still can file for green card and start working, all you can not do is; you can not extend your H visa and so you can not travel outside US till I 140 gets approved (total one year from the start of process), at which time you will get EAD and Advance Parole and then you can travel freely. During this entire period you are not on any status; just pending green card.

Compare to what will happen with J visa: You still have to find waiver job, that usually is in primary care; and again you have to do it at least 3 years and then go for H visa and green card processing just as mentioned above OR another 2 years and NIW greencard.

4. Getting fellowship on H visa: It is not impossible or even more difficult to get fellowship on H visa. I can tell my own experience: out of 170 cardiology programs in the country 90 sponsors H visa and similar number sponsors J visa!! If you are a good candidate, visa is not an issue. Even the programs that do not sponsor H visa for internal medicine will sponsor H visa for fellowship!! (example SUNY Syracuse and there are quite a few on this list).

I actually come to the forum as and when I can find some time. Currently my medicine boards are near and also I am on a steep learning curve for new fellowship so not finding a lot of time. Will be happy to answer questions; but you have to be patient for that. I wanted to come back to the forum after my boards (Aug 24) but i thought that this issue needed clarification before many of you apply.

Good Luck.





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