For medical residency, there are really only 2 Visa options for International Medical Graduates (IMGs): the J1 and the H1b visa.

I have looked into both possibilities, and it is really a trade-off. There are good things about both visas, but if you want to stay in the US after you finish your training, the H1 option is the only one that will let you apply for a Green Card right after finishing residency or fellowship.

J1 Visa

This visa was created as an Exchange Visitor Program. Therefore, there are several limitations to this.

• For clinical visas (for residency for example), there is a 2-year home residency requirement, which means after your training you have to return to your original country for 2 years before you can even apply for any other visa. Even if you do not finish your training, marry an US citizen, have a baby in the US, you will still have this home-residency requirement. You can pursue a J1 waiver option, more information here
• You can not receive income other than what your residency program is paying. That means you can not moonlight (work at local ERs or hospitals for extra income).
• You have to renew it every year
• You can have this visa for 3 years, extendable up to 7 years total.

There are, however, good aspects of this visa

• It is a lot easier to obtain
• Processing is relatively fast
• A dependent (spouse) may work and earn income in the US
• Fees are low and you will not need a lawyer to apply
• Often the more prestigious programs only offer this visa, so if you are willing to get this visa, you can potentially get a better position

H1 Visa

This is a temporary worker’s visa. It is a good alternative to the J1, but there are also limitations:

• Much more difficult to get.
• Fewer programs offer this option
• There is an annual cap to the amount of H1 visas offered per year.
• Dependents (spouses) are not allowed to work and earn extra income.
• You will need an immigration lawyer to apply for this visa, since the process is so complicated.
• The fees are substantially higher.
• You will probably need the Premium processing option, plus your lawyers fees. It usually costs several thousand dollars for the whole process
• It can take several months for this visa to be processed
• Fellowship programs usually do NOT like H1 visa applicants.
• You can have this visa for 3 years, extendable up to 6 years.

Advantages of this visa

• You can apply for a different visa at any time: green card for example.
• When you finish your residency training, you do not have to return to your home country for 2 years. You can apply for your Green Card right away if you have an employer.