Sec. 514.27   Alien physicians.
(a) Purpose. Pursuant to the Mutual Educational and Cultural
Exchange Act, as amended by the Health Care Professions Act,
Public Law 94-484, the Agency facilitates exchanges for foreign
medical graduates seeking to pursue graduate medical education or
training at accredited schools of medicine or scientific
institutions. The Agency also facilitates exchanges of foreign
medical graduates seeking to pursue programs involving
observation, consultation, teaching, or research activities.
(b) Clinical exchange programs. The Educational Commission for
Foreign Medical Graduates must sponsor alien physicians who wish
to pursue programs of graduate medical education or training
conducted by accredited U.S. schools of medicine or scientific
institutions. Such Foreign Medical
Graduates shall:
(1) Have adequate prior education and training to participate
satisfactorily in the program for which they are coming to the
United States;
(2) Be able to adapt to the educational and cultural environment
in which they will be receiving their education or training;
(3) Have the background, needs, and experiences suitable to the
program as required in Sec. 514.10(a)(1);
(4) Have competency in oral and written English;
(5) Have passed either Parts I and II of the National Board of
Medical Examiners Examination, the Foreign Medical Graduate
Examination in the Medical Sciences, the United States Medical
Licensing Examination, Step I and Step II, or the Visa Qualifying
Examination (VQE) prepared by the National Board of Medical
Examiners, administered by the Educational Commission for
Foreign Medical Graduates. [NB--Graduates of a school of medicine
accredited by the Liaison Committee on Medical Education are
exempted by law from the requirement of passing either Parts I
and II of the National Board of Medical Examiners Examination or
the Visa Qualifying Examination (VQE)]; and
(6) Provide a statement of need from the government of the
country of their nationality or last legal permanent residence.
Such statement must provide written assurance, satisfactory to
the Secretary of Health and Human Services, that there is a need
in that country for persons with the skills the alien physician
seeks to acquire and shall be submitted to the Educational
Commission for Foreign Medical Graduates by the participant's
government. The statement of need must bear the seal of the
concerned government and be signed by a duly designated official
of the government. The text of such statement of need shall read
as follows:
Name of applicant for Visa: ___. There currently exists in
(Country) a need for qualified medical practitioners in the
specialty of ___.  (Name of applicant for Visa) has filed a
written assurance with the government of this country that he/she
will return to this country upon completion of training in the
United States and intends to enter the practice of medicine in
the
specialty for which training is being sought. Stamp (or Seal and
signature) of issuing official of named country.
Dated:-----------------------------------------------------------
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Official of Named Country.
(7) Submit an agreement or contract from a U.S. accredited
medical school, an affiliated hospital, or a scientific
institution to provide the accredited graduate medical education.
The agreement or contract must be signed by both the alien
physician and the official responsible for the training.
(c) Non-clinical exchange programs. (1) A United States
university or academic medical center which has been designated
an exchange visitor program by the Director of the United States
Information Agency is authorized to issue From IAP-66 to alien
physicians to enable them to come to the United States for the
purposes of observation, consultation, teaching, or research
if:
 
(i) The responsible officer or duly designated alternate of the
exchange visitor program involved signs and appends to the Form
IAP-66 a certification which states "this certifies that the
program in which (name of physician) is to be engaged is solely
for the purpose of observation, consultation, teaching, or
research and that no element of patient care is involved" or
(ii) The dean of the involved accredited United States medical
school or his or her designee certifies to the following five
points and such certification is appended to the Form IAP-66
issued to the perspective exchange visitor alien physician:
(A) The program in which (name of physician) will participate is
predominantly involved with observation, consultation, teaching,
or research.
(B) Any incidental patient contact involving the alien physician
will be under the direct supervision of a physician who is a U.S.
citizen or resident alien and who is licensed to practice
medicine in the State of ___.
(C) The alien physician will not be given final responsibility
for the diagnosis and treatment of patients.
(D) Any activities of the alien physician will conform fully with
the State licensing requirements and regulations for medical and
health care professionals in the State in which the alien
physician is pursuing the program.
(E) Any experience gained in this program will not be creditable
towards any clinical requirements for medical specialty board
certification.
(2) The Educational Commission for Foreign Medical Graduates may
also issue Form IAP-66 to alien physicians who are coming to the
United States to participate in a program of observation,
consultation, teaching, or research provided the required letter
of certification as outlined in this paragraph is appended to the
Form IAP-66.
(d) Public health and preventive medicine programs. A United
States university, academic medical center, school of public
health, or other public health institution which has been
designated as an exchange visitor program sponsor by the Director
of the United States Information Agency is authorized to issue
Forms IAP-66 to alien physicians to enable them to come
to the United States for the purpose of entering into those
programs which do not include any clinical activities involving
direct patient care.  Under these circumstances, the special
eligibility requirements listed in paragraphs (b) and (c) of this
section need not be met. The responsible officer or alternate
responsible officer of the exchange visitor program involved
shall append a certification to the Form IAP-66 which states.
This certifies that the program in which (name of physician) is
to be engaged does not include any clinical activities involving
direct patient care.
(e) Duration of participation. (1) The duration of an alien
physician's participation in a program of graduate medical
education or training as described in paragraph (b) of this
section is limited to the time typically required to complete
such program. Duration shall be determined by the Director of the
United States Information Agency at the time of the alien
physician's entry into the United States. Such determination
shall be based on criteria established in coordination with the
Secretary of Health and Human Services and which take into
consideration the requirements of the various medical specialty
boards as evidenced in the Director of Medical Specialties
published by Marquis Who's Who for the American Board
of Medical Specialties.
(2) Duration of participation is limited to seven years unless
the alien physician has demonstrated to the satisfaction of the
Director that the country to which the alien physician will
return at the end of additional specialty education or training
has an exceptional need for an individual with such additional
qualification.
(3) Subject to the limitations set forth above, duration of
participation may, for good cause shown, be extended beyond the
period of actual training or education to include the time
necessary to take an examination required for certification by a
specialty board.
(4) The Director may include within the duration of participation
a period of supervised medical practice in the United States if
such practice is an eligibility requirement for certification by
a specialty board.
(i) Alien physicians shall be permitted to undertake graduate
medical education or training in a specialty or subspecialty
program whose board requirements are not published in the
Director of Medical Specialists if the Board requirements are
certified to the Director and to the Educational Commission for
Foreign Medical Graduates by the Executive Secretary of the
cognizant component board of the American Board of Medical
Specialties.
(ii) The Director may, for good cause shown, grant an extension
of the program to permit an alien physician to repeat one year of
clinical medical training.
(5) The alien physician must furnish the Attorney General each
year with an affidavit (Form I-644) that attests the alien
physician:
(i) Is in good standing in the program of graduate medical
education or training in which the alien physician is
participating; and
(ii) Will return to the country of his nationality or last legal
permanent resident upon completion of the education or training
for which he came to the United States.
(f) Change of program. The alien physician may, once and not
later than two years after the date the alien physician enters
the United States as an exchange visitor or acquires exchange
visitor status, change his designated program of graduate medical
education or training if the Director approves the change and if
the requirements of paragraphs Sec. 514.27(b) and Sec. 514.27(e)
of this section are met for the newly designated specialty.
(g) Applicability of section 212(e) of the Immigration and
Nationality Act.
(1) Any exchange visitor physician coming to the United States on
or after January 10, 1977 for the purpose of receiving graduate
medical education or training is automatically subject to the
two-year home-country physical presence requirement of section
212(e) of the Immigration and Nationality Act, as amended. Such
physicians are not eligible to be considered for section 212(e)
waivers on the basis of "No Objection" statements issued by
their governments.
(2) Alien physicians coming to the United States for the purpose
of observation, consultation, teaching, or research are not
automatically subject to the two-year home-country physical
presence requirement of section 212(e) of the Immigration and
Nationality Act, as amended, but may be subject to this
requirement if they are governmentally financed or pursuing a
field of study set forth on their countries' Exchange Visitor
Skills List. Such alien physicians are eligible for consideration
of waivers under section 212(e) of the Immigration and
Nationality Act, as amended, on the basis of "No Objection"
statements submitted by their governments in their behalf through
diplomatic channels to the Director of the United States
Information Agency.
[58 FR 15196, Mar. 19, 1993; 58 FR 48448, Sept. 16, 1993]