С 2026 года для врачей-иностранцев в США отменяется статус «продолжительность обучения», что усложнит работу медицинских учреждений

- with readers working within the Advertising & Public Relations and Technology industries The Department of Homeland Security’s new rule eliminating “duration of status” for F, J and I nonimmigrants will have significant implications for healthcare organizations that sponsor and train international physicians. Beginning Sept. 15, 2026, J-1 physicians will be admitted for a fixed period of stay rather than for the duration of their training program, creating new filing requirements, compliance obligations and workforce planning considerations. To help healthcare employers prepare, we spoke with Garfinkel Immigration Law Firm Associate Attorney Brian Daza, a member of the Firm’s Healthcare Specialty Practice Group. Why is the elimination of duration of status especially significant for foreign national physicians and healthcare institutions? Brian Daza: The rule creates two major challenges. First, it introduces significant new administrative responsibilities. Under the previous duration of status framework, healthcare institutions primarily needed to monitor the expiration of a physician’s Form DS-2019, which is renewed annually through the Educational Commission for Foreign Medical Graduates (ECFMG) and the Department of State. USCIS generally was not involved in that process. Under the new rule, physicians will now receive a Form I-94 with a specific admission end date. Healthcare organizations will need to monitor both documents, and if a physician’s training extends beyond four years, an extension of stay application with USCIS will be required. That creates additional compliance responsibilities for institutions while also placing more responsibility on physicians to ensure timely filings. Second, the four-year admission limit presents challenges for graduate medical education. Many residency programs alone last four years or longer, and international medical graduates frequently complete one or more fellowships after residency. Physicians pursuing subspecialty training may therefore need to request an extension simply to complete their planned education. Why could the four-year maximum admission period be particularly challenging for physicians completing residencies and fellowships? BD: Physicians who need more than four years of training will generally need to file the Form I-539 with USCIS to request an extension of stay. While a timely filed application is expected to provide a 240-day automatic extension, processing times remain a key concern. As a result of this new extension requirement, USCIS will experience increased filing volume and physicians could face uncertainty while waiting for decisions, potentially affecting their training schedules and work authorization. Longer term, the rule could also discourage some international physicians from pursuing advanced training in the United States. Because the United States remains a global leader in graduate medical education, additional immigration hurdles may influence where physicians choose to complete their training. How will the rule affect J-1 physicians who are already completing graduate medical training in the United States? BD: Physicians who are already in the United States under the current duration of status framework generally may continue under the transition provisions as long as they do not travel internationally after the rule takes effect. However, physicians who travel after Sept. 15, 2026, will receive a Form I-94 with a fixed admission end date and become subject to the new extension requirements. Those most likely to feel the effects first are physicians who need more than four years to complete their training. For example, those in the middle of residency who are participating in longer programs or intend to complete a fellowship afterward, as they are more likely to exceed the four-year admission period and therefore must seek an extension. What will a J-1 physician need to do if their medical training extends beyond the expiration date on their Form I-94? BD: Physicians will generally need to file Form I-539 with USCIS before the expiration date listed on their Form I-94. The application carries a filing fee and must be submitted on time. Filing well before the expiration date is advisable because a timely filed application is expected to provide up to a 240-day extension while USCIS processes the request. At this time, clarity is still needed as to if premium processing is available for these applications. If filing volumes increase significantly, processing times could become an important consideration for physicians and healthcare employers alike, if premium processing is unavailable. What happens if USCIS has not adjudicated an extension request before the next stage of training begins? BD: A timely filed application should provide a 240-day extension while the request remains pending. The larger question is what happens if USCIS has not issued a decision by the end of that period. If the rules are applied similarly to other immigration categories, physicians may be permitted to remain in the United States while the application is pending but may not be authorized to continue working until the extension is approved. If the application is approved, work authorization would resume immediately. If it is denied, the physician would generally need to depart the United States. How might the rule affect physicians transitioning from residency to fellowship? BD: Physicians completing both residency and fellowship training in the United States are among those most likely to encounter the four-year admission limit. If additional time is required, physicians will need to request an extension of stay and demonstrate that circumstances justify remaining beyond four years. Because those decisions are discretionary, there is still uncertainty regarding how USCIS will evaluate these requests in practice. What new responsibilities will healthcare institutions, GME offices and program administrators have? BD: Healthcare organizations should expect significantly more administrative work. Previously, institutions primarily monitored annual Form DS-2019 renewals. Going forward, they will also need to track Form I-94 expiration dates and determine whether extension applications must be filed before those dates expire. Organizations should also decide who will be responsible for preparing and filing Form I-539 applications (physician directly or program administrator), whether filing fees will be covered by the institution or the physician, and how these new processes will fit into existing compliance procedures. Because physicians sometimes complete portions of their training at different institutions, administrators should also understand how much prior time a physician has already spent in J-1 status when evaluating future extension needs. Could the rule create staffing or patient care disruptions if an extension is delayed or denied? BD: Yes. The extent of this effect will depend on how USCIS processes these extension requests. If J-1 extension applications become subject to lengthy processing times because of increased filing volumes, delays could affect physician training schedules and workforce planning. Hospitals and healthcare systems should begin preparing now for the possibility that immigration processing timelines could become another factor affecting physician staffing. Could the new framework affect J-1 waivers, H-1B petitions and other post-training immigration strategies? BD: It certainly has the potential to influence long-term immigration planning. If obtaining extensions beyond four years becomes difficult, more physicians may consider pursuing J-1 waivers earlier in their training to transition to H-1B status. There are also unanswered questions about how the rule could affect certain board-related J-1 extensions that physicians have historically used while completing licensing examinations or waiting for J-1 waiver processing. Additional government guidance will be important in understanding how these situations will be handled under the new framework. Does the rule create additional concerns for J-2 spouses and children? BD: Yes. J-2 dependents will also receive Forms I-94 with specific expiration dates that must be monitored. While healthcare institutions will likely focus on the physician’s immigration status, physicians and their family members themselves will need to ensure that extension applications are also filed on time. What should healthcare organizations communicate to current and incoming J-1 physicians before the rule takes effect? BD: First, physicians should understand that this rule exists and that they will need to monitor the expiration date on every new Form I-94 issued after Sept. 15, 2026. Healthcare organizations should also remind physicians who currently benefit from the transition provisions to carefully consider the immigration consequences of international travel. Most importantly, institutions should establish clear internal procedures identifying who will monitor immigration deadlines, who will prepare extension applications and who will be responsible for associated filing costs. Clear communication and defined responsibilities will be essential under the new framework. What steps should healthcare organizations take now to prepare for the Sept. 15, 2026, effective date? BD: Healthcare organizations should begin preparing immediately. That includes identifying physicians who are most likely to require extension applications, incorporating Form I-94 expiration dates into existing compliance tracking systems and determining how prior time spent in J-1 status will be documented. Organizations should also establish internal policies addressing responsibility for Form I-539 filings, associated costs and communication with physicians. Taking these steps now could better position institutions for a smoother transition once the rule takes effect. FURTHER READING: What the end of ‘duration of status’ means for colleges, universities, international students and scholars We operate a free-to-view policy, asking only that you register in order to read all of our content. 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