How to Work in the U.S. As a Foreign-Educated Physician

Becoming a physician is one of the longest and most arduous processes that an individual can undertake, but it is often found to be a very rewarding career. If you’ve received your medical education in a country outside of the United States, you may be wondering how to bring your credentials to the U.S. and become a practicing physician. After all, this process can be rewarding as physicians benefit from one of the highest-paid occupations in the United States; the U.S. Bureau of Labor Statistics estimates that physicians make around $208,000 per year on average.

To take advantage of these benefits and move your practice to the U.S., you will need to complete several steps. Our guide helps you review this process and answers vital questions such as:

• What Is the Process for Working in the U.S. As a Foreign-Educated Physician?
• How Much Does It Cost to Work as a Foreign-Educated Physician in the U.S.?
• How Long Does It Take To Work as a Foreign-Educated Physician in the U.S.?
• Are There Any Restrictions to Working as a Foreign-Educated Physician in the U.S.?
• What Are the State-Specific Requirements for Foreign-Educated Physicians?
• What Are the Immigration Requirements for Foreign-Educated Physicians?
• Where Can I Get a Certified Translation?

What Is the Process for Working in the U.S. As a Foreign-Educated Physician?

This process has several different steps that are essential to complete before you become eligible for state licensing, something that every physician must have in order to practice in their chosen state. Keep in mind that state licensing regulations vary by state, so make sure to choose the state you wish to work in and review its licensing board for more detailed information.

The following steps help you work in the U.S. as a foreign-educated physician:

1. To start the process of practicing as a physician in the U.S., you will need to register with the Educational Commission for Foreign Medical Graduates (ECFMG). This organization helps graduates of foreign medical programs understand what they need to start working in the U.S. The ECFMG will help you with the process of evaluating your foreign credentials, verifying your English ability (having results from either the Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS) will help with this), and matching you with a residency program.
   All foreign medical graduates will be required to take a residency program of at least three years before they are eligible to be licensed and to practice in the United States. Reference the ECFMG’s website for more detailed information on applications, fees, and guidance throughout this process.
2. While you are registering with the ECFMG and waiting to be matched with a residency program, you will need to start preparing for the United States Medical Licensing Examination (USMLE). This exam has three main steps and requires several months of preparation for each step; you will need to travel to take the clinical skills portion of this exam at one of the five test centers located in the United States. Other portions of the exam are given in test centers outside of the U.S. More information is found on the USMLE website.
3. After you have completed the USMLE and all other steps the ECFMG requires, you will receive ECFMG certification. You can then use this certification to apply and interview for residency programs. In some cases, it helps to complete a post-graduate observership program in the United States before applying for residency. Doing so helps build up your U.S. contacts and gain valuable recommendations from practicing U.S. physicians in your chosen medical field.
4. Once you are matched with a residency program and complete your three years of residency, you will then be eligible to apply for state licensing. State licensing boards vary in what they require as part of your licensing application, but you should be prepared to submit information from your ECFMG registration, documents and details from your residency program, your USMLE test scores, and other examination scores. You may need to complete additional state ethics exams and pay fees to obtain your license. After you are licensed in your state, you can officially practice as a physician.

Make sure you stay up to date with immigration requirements throughout this process. You may find that you are eligible for several different visa types to help you travel to the U.S. for exams, study and complete residency in the United States, and then permanently work in your chosen state.

It’s important to consult with an immigration lawyer for the best advice on which visa or green card applications best fit your circumstances so you can achieve your goal of being a foreign-educated physician in the U.S. without too much stress.

How Much Does It Cost to Work as a Foreign-Educated Physician in the U.S.?

The cost of working as a physician in the United States is not inexpensive, but it is considered an investment into your future career. While it’s true you will be paid during your residency program, this salary is not that high when compared to the salary of a full-time physician. The main costs associated with becoming a physician in the U.S. come from the examination and immigration steps.

You will need to pay for registration with the ECFMG in order to be placed in a residency, something that requires plenty of applications and fees. The average person spends around $7,500 in fees to be placed and matched with a residency program. You will need to ensure you have enough to pay for living expenses in the U.S. and any applicable visa fees for traveling to and working in your chosen state.

The USMLE is required of every individual wishing to work as a physician in their chosen state; initial registrations for this exam total an average of $1,500, and the exam fees themselves are around $2,300 for all components. You will need to include the cost of traveling to the U.S. to take the clinical skills part of the USMLE at one of the designated test centers if you are outside of the U.S.

State licensing fees vary, but they generally average around $300 to $500. Depending on the state, you might be required to pay for ongoing education or license renewal fees every few years.

Make sure to include the cost of visa or green card applications in your total and the cost of legal immigration assistance. On average, the immigration process costs several thousand dollars from start to finish.

How Long Does It Take To Work as a Foreign-Educated Physician in the U.S.?

The process for working in the United States as a foreign-educated physician is extensive due to the many lengthy steps that you will need to complete. All foreign-educated medical professionals will need to complete the USMLE and a residency in the United States to be eligible for licensing, and this is a process that takes three years at a minimum. You may also need to complete additional medical courses depending on state regulations, and this can add several months to this process.

Applying for state licensing after you have completed all of these initial requirements may take another few months depending on your chosen state’s application process and additional requirements.

You will also need to consider the time it might take to complete the visa or green card processes; these applications take an average of 13 to 24 months to fully process depending on your situation. An immigration lawyer can provide you with further assistance with this timeline.

Are There Any Restrictions to Working as a Foreign-Educated Physician in the U.S.?

After you have registered with the ECFMG, completed the United States Medical Licensing Examination, finished all necessary education and residency steps, and received state licensing in the state you wish to work, you will be able to fully practice as a foreign-educated physician without issue.

Make sure that you stay up to date with any ongoing state licensing requirements, such as continuing education and license renewal fees, and that you pay attention to any restrictions or requirements that your visa or green card might have.

What Are the State-Specific Requirements for Foreign-Educated Physicians?

The final step in becoming a physician in the United States is obtaining a license to practice in your chosen state. Each state handles licensing differently, so it’s important to check with your state’s licensing board ahead of time to understand which additional steps you might need to complete to be eligible for licensing. You can use the collection of state licensing board data provided by the Federation of State Medical Board for more detailed information.

In general, most states will ask you to submit an application; many accept a uniform application. You will often be asked to submit test scores, such as any applicable TOEFL or IELTS score and your results from the USMLE. You might also need to submit transcripts, documents from the ECFMG or your residency program, and certified translations of your original documents.

Most states do charge a fee for licensing, and you will need to pay attention to whether or not there are any ongoing education and license renewal requirements in your state that you will need to keep up with.

What Are the Immigration Requirements for Foreign-Educated Physicians?

Individuals that are interested in immigrating as physicians have a few different options to choose from. It’s important to select the best visa for your situation, as most individuals will need to obtain a student visa or other visa type that allows them to study in the U.S. After the completion of your medical studies and residency in the United States, you will most likely need to transition to a working visa or an employment-based visa, or you will need to apply for a green card, also known as a permanent resident card.

Speak with an immigration lawyer to find out which visa or combination of visas is the best for your situation and to receive guidance throughout the immigration process.

Where Can I Get a Certified Translation?

Obtaining a certified translation of your original documents is an important step in becoming a physician in the United States. You will need these certified translations to obtain reliable credential evaluations and even as part of state licensing or visa applications. It’s important to be sure that you have a reliable and accurate translation of your documents so every other step of this process goes smoothly.

Visit our online store to obtain a certified translation of your important documents such as:

• Diplomas
• Academic transcripts
• Business licenses and certifications
• Resumes and employment records
• Birth certificates

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