U.S. Immigration & Border Entry2020-09-27T16:49:01-07:00

U.S. Immigration & Border Entry to Obtain Clinical Experiences

Regardless of your U.S. immigration status, entering the United States requires everyone to be interviewed by a U.S. Customs and Border Protection Officer. For nearly everyone, this is stressful, but nearly always uneventful. You may be asked about the purpose of your visit, what are you bringing with you, who will you be staying with, how long is your visit and when will you be leaving. For medical students and graduates, this experience can be extra stressful due to the protected nature of the practice of medicine in the United States, and the need for appropriate visas for your type and purpose of visit. Below you will find the most commonly asked questions by our Members, and our responses. However, please note that we are not a law firm and our employees are not acting as your attorney. The information contained in the Site is general information and should not be construed as legal advice to be applied to any specific factual situation. If you have any legal questions or are seeking legal advice, we recommend that you seek the help of an immigration attorney:

How is COVID-19 going to affect my U.S. entry?2020-09-27T17:09:19-07:00

On March 11, 2020, the World Health Organization (WHO) upgraded the coronavirus (COVID-19) from a Public Health Emergency of International Concern (PHEIC) to a pandemic. Given the health and safety risks, ACMedical is recommending that Members traveling within and in-between the following countries review the travel guidance and health advisories issued by relevant governmental and health authorities. We are providing a list of resources for your convenience:

I want to enter the U.S. to gain ‘Hands-on Clinical Experiences’, is this okay?2020-09-27T16:48:50-07:00

The word ‘Hands-on’ is defined differently depending on who you are speaking with:

  • As generally defined by U.S. medical residency programs:  To residency program, hands-on does not mean you diagnosed, treated, discussed treatments, prescribed, or accepted things in return for your presence in front of that patient, but instead it is much more innocent than that: Hands-on to residency programs, when speaking about U.S. clinical experiences, generally means you were insured, you spoke with patients to ask about their history and why they are there, and exchanged ideas with the clinic and physicians without practicing medicine of any kind.
  • As defined by the U.S. Customs and Border Patrol, and all U.S. State Medical Boards: Hands-on is the practice of medicine, which requires a medical license (training or full). Even for medical students, using trigger words such as ‘hands-on’ or ‘practice’ or ‘training’ or ‘residency’ while attempting to enter the U.S. on a visitor visa (B1 or B2) may force the U.S. CBP Officer to deny your entry into the United States until such time that you have the correct type of visa (J1 or H1B or other) for training.

AmeriClerkships advises against usage of the word ‘hands-on’ for any of its clinical experiences, unless you are absolutely referring to the actual practice of medicine during residency or after residency graduation.

What is the purpose of my visit if I am enrolled in ‘U.S. Elective Clerkships’, and asked by a U.S. CBP Officer?2020-09-27T16:42:03-07:00

If entering the U.S. to gain U.S. clinical experience as a medical student during your clinical years of medical education (equivalent to 3rd or 4th years of a U.S. medical school), your purpose of entering the United States is to start U.S. Elective Clerkships which you have enrolled in. Note:

  1. Contact AmeriClerkships to see if you qualify for an AmeriClerkships Letter of Enrollment; once you receive it, read it, familiarize yourself with its content;
  2. Be truthful;
  3. Read about immigration laws pertaining to ‘Medical Clerkships’ which are ‘For Credit’ at https://fam.state.gov/fam/09FAM/09FAM040202.html, and use these to further support your entry into the U.S.:
    1. 9 FAM 402.2-5(E)(3) (U) Clerkship (CT:VISA-933; 08-30-2019): (U) Medical Clerkship: An alien who is studying at a foreign medical school and seeks to enter the United States temporarily in order to take an “elective clerkship” at a U.S. medical school’s hospital without remuneration from the hospital. The medical clerkship is only for medical students pursuing their normal third or fourth year internship in a U.S. medical school as part of a foreign medical school degree. (An “elective clerkship” affords practical experience and instructions in the various disciplines of medicine under the supervision and direction of faculty physicians at a U.S. medical school’s hospital as an approved part of the alien’s foreign medical school education. It does not apply to graduate medical training, which is restricted by INA 212(e) and normally requires a J-visa.)
  4. Even for medical students, using trigger words such as ‘hands-on’ or ‘practice’ or ‘training’ or ‘residency’ while attempting to enter the U.S. on a visitor visa (B1 or B2) may force the U.S. CBP Officer to deny your entry into the United States until such time that you have the correct type of visa (J1 or H1B or other) for training.
What is the purpose of my visit if I am enrolled in a ‘U.S. Clinical Observerships’, and asked by a U.S. CBP Officer?2020-09-27T16:39:34-07:00

One of the biggest mistakes made by visiting medical students and graduates is that they oversell themselves, or exaggerate what they will be doing. Most make these mistakes due to language barriers, or usage of certain trigger words too loosely (e.g. ‘hands-on’ or ‘practice’ or ‘training’, which requires a J1 or H1B or other training types of visas). Being interviewed by the U.S. CBP Officer is not a residency or a job interview; they want to be sure that you have the correct type of visa, that you can support yourself, and that you are being truthful. Therefore:

  1. Contact AmeriClerkships to see if you qualify for an AmeriClerkships Letter of Enrollment; once you receive it, read it, familiarize yourself with its content;
  2. Be truthful;
  3. Read about immigration laws pertaining to ‘Clinical Observerships’ (Medical Doctors) or ‘Vocational Activities’ (Medical Students) which are both ‘Not for Credit’ at https://fam.state.gov/fam/09FAM/09FAM040202.html, and use these as the reasons for your U.S. entry.
    1. 9 FAM 402.2-5(E)(3) (U) Clerkship (U) Clerkship (CT:VISA-933; 08-30-2019): (U) Business or other Professional or Vocational Activities: An alien who is coming to the United States merely and exclusively to observe the conduct of business or other professional or vocational activity may be classified B-1, provided the alien pays for his or her own expenses. However, aliens, often students, who seek to gain practical experience through on-the-job training or clerkships must qualify under INA 101(a)(15)(H) or INA 101(a)(15)(L), or when an appropriate exchange visitors program exists (J). Provided certain requirements are met, interns at embassies, consulates, miscellaneous foreign government offices (MFGOs), missions to international organizations, or international organizations may qualify for A-2, G-1, G-2, G-3, or G-4 visas. See 9 FAM 402.3-5(D)(1) and 9 FAM 402.3-7(B).
    2. 9 FAM 402.2-5(F)(3) (U) Medical Doctor (CT:VISA-738; 02-08-2019) (U): A medical doctor whose purpose for coming to the United States is to observe U.S. medical practices and consult with colleagues on latest techniques, provided no remuneration is received from a U.S. source and no patient care is involved. Failure to pass the Foreign Medical Graduate Examination (FMGE) is irrelevant in such a case.
  4. Using trigger words such as ‘hands-on’ or ‘practice’ or ‘training’ or ‘residency’ while attempting to enter the U.S. on a visitor visa (B1 or B2) may force the U.S. CBP Officer to deny your entry into the United States until such time that you have the correct type of visa (J1 or H1B or other) for training.
What type of U.S. visa for U.S. Hands-on Clinicals?2021-03-21T17:08:07-07:00

For ‘Hands-on Clerkship’:

  • Hands-on typically refers to the actual practice of medicine, which will require that you are either a part of an ACGME accredited medical residency program and sponsored by that program and the ECFMG, or have completed an ACGME residency and are now practicing independently as a licensed physician. We do not recommend any medical student or medical graduate to refer to the U.S. clinicals as ‘hands-on’ unless the main purpose of their U.S. entry is to start a U.S. ACGME medical residency program that they have matched into.
  • 9 FAM 402.2-5(E)(3) (U) Clerkship (CT:VISA-933; 08-30-2019) a. (U): Except as in the cases described below, aliens who wish to obtain hands-on clerkship experience are not deemed to fall within B-1 visa classification.
  • Visa: J1 or H1-B or other, but not B1
What type of U.S. visa for U.S. Clinical Observerships or Externships?2021-03-21T17:08:22-07:00

There is not a category for ‘Externships’, however, for ‘Observerships’ or other ‘Vocational Activities’:

  • Used by: International Medical Students or Graduates doing ‘Not for Credit’ clinical observerships or clinical experiences
  • 9 FAM 402.2-5(E)(3) (U) Clerkship (U) Clerkship (CT:VISA-933; 08-30-2019): (U) Business or other Professional or Vocational Activities: An alien who is coming to the United States merely and exclusively to observe the conduct of business or other professional or vocational activity may be classified B-1, provided the alien pays for his or her own expenses. However, aliens, often students, who seek to gain practical experience through on-the-job training or clerkships must qualify under INA 101(a)(15)(H) or INA 101(a)(15)(L), or when an appropriate exchange visitors program exists (J). Provided certain requirements are met, interns at embassies, consulates, miscellaneous foreign government offices (MFGOs), missions to international organizations, or international organizations may qualify for A-2, G-1, G-2, G-3, or G-4 visas. See 9 FAM 402.3-5(D)(1) and 9 FAM 402.3-7(B).
  • 9 FAM 402.2-5(F)(3) (U) Medical Doctor (CT:VISA-738; 02-08-2019) (U): A medical doctor whose purpose for coming to the United States is to observe U.S. medical practices and consult with colleagues on latest techniques, provided no remuneration is received from a U.S. source and no patient care is involved. Failure to pass the Foreign Medical Graduate Examination (FMGE) is irrelevant in such a case.
  • Visa: B-1 Business
What type of U.S. visa for U.S. Elective Clerkships?2021-03-21T17:08:57-07:00

For ‘Elective Clerkships’:

  • Used by: International Medical Students doing ‘For Credit’ clinical electives
  • 9 FAM 402.2-5(E)(3) (U) Clerkship (CT:VISA-933; 08-30-2019): (U) Medical Clerkship:  An alien who is studying at a foreign medical school and seeks to enter the United States temporarily in order to take an “elective clerkship” at a U.S. medical school’s hospital without remuneration from the hospital.  The medical clerkship is only for medical students pursuing their normal third or fourth year internship in a U.S. medical school as part of a foreign medical school degree.  (An “elective clerkship” affords practical experience and instructions in the various disciplines of medicine under the supervision and direction of faculty physicians at a U.S. medical school’s hospital as an approved part of the alien’s foreign medical school education.  It does not apply to graduate medical training, which is restricted by INA 212(e) and normally requires a J-visa.)
  • Visa: B-1 Business
Does my visa for research allow me to do rotations?2019-02-04T15:26:47-07:00

It depends on the type of visa you have, what type of ‘rotation’, what type of ‘research’ and if on a J1 for research, then will your ’employer’ (the institution who sponsored your J1 visa for research) will provide you with enough uninterrupted time so that you can obtain US clinical experience while also working at that facility. If you are in the United States on an F1 (i.e. for learning English language, or USMLE studies), then it may not be legal for you to also engage in a for-credit type clinical clerkship or elective.

My Letter of Enrollment says “observership”; I want hands-on experiences before residency and need this changed.2020-09-27T16:58:41-07:00

Our Letters of Enrollment are written in compliance with “9 FAM 402.2 (U) TOURISTS AND BUSINESS VISITORS AND MEXICAN BORDER CROSSING CARDS – B VISAS AND BCCS (CT:VISA-1151; 09-14-2020) (Office of Origin: CA/VO)“, therefore if you are a medical student or graduate gaining not-for-credit clinical experiences, your LOE will refer to that as an “Observership”. This will not be changed, AND we certainly recommend against the usage of the terms ‘hands-on’ or ‘training’ or ‘practice’, unless you are a U.S. medical resident or licensed physician.

Does my visa status allow me access into the United States for rotations?2019-02-04T15:27:18-07:00

Each visa status carries a different set of requirements; if you are unsure of your status and ability to come to the United States, the best and only way to be 100% confident is to consult an immigration attorney.

Does AmeriClerkships sponsor U.S. visas? How can AmeriClerkships help me secure a U.S. visa?2020-09-27T16:18:50-07:00

While AmeriClerkships does not sponsor visas, our company can issue a document called a Letter of Enrollment to present during a vista interview. This document will outline the nature of the clinical rotations you will be completing through our company, detailing items like the location, start and end dates, addresses and other qualifying information. This will serves as proof of your enrollment and can assist with showing the reason for your visit to the United States. This Letter of Enrollment does not contain any legal advice and any AMS Member who has any legal questions or who desires legal advice should contact a qualified attorney.

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