Good evening, I am an MS3 just starting to discover the excitement of radiology on my radiology selective. I am contemplating radiology as a career, but I have low Step 1 score (227) and I am also an international student requiring H1B visa for residency (I attend a top 40 US allopathic school and am not Canadian). Is radiology still an option realistic to consider given my circumstances (I hope to match into a university program)? What can I do now as I start my third year going forward to increase my competitiveness? Thank you for all your help!
H1B And J1 Visa Issue
The answer to the question of your chance for getting into a program may hinge on the next few questions I am going to ask you. Why is it that you require an H1B vs. a J1 for getting a residency? What kind of visa do you currently have? This may make a big difference because universities are much less likely to support a resident with an H1B visa since it costs the university a lot of legal fees and time to support a candidate to obtain the H1B visa. Also, the federal government limits the numbers of H1B visas. Therefore, you significantly limit the playing field of choices of programs to apply.
Some of the larger academic university programs may allow applicants with an H1B visa. But, many smaller programs like ours do not take applicants with H1B visas for the reasons I mentioned (with a few rare exceptions). When applying, if you can’t get a J1 visa, I would definitely call the individual programs to see which ones would take an H1B visa.
Biggest Positives In Your Application
So, what do you have going for you? First, the fact that you are graduating from an American medical school will help your situation immensely. We, as program directors, selfishly like to get applications from American medical schools. At least we can vouch for the quality of the institution and compare to other applicants. Second, your scores are not bad. Many programs have cutoffs around 220 or 225. So, it should allow you to meet that requirement at many programs.
In addition to the recommendations above, I would also consider taking the next USMLE early, studying hard, and perhaps completing a USMLE Step II course so that you can show improvement from your 1st USMLE examination to the next one. Program directors like to see improving scores going in the right direction.
Why The Visa May Be The Biggest Issue
Unfortunately, the visa issue may the biggest impediment to getting a radiology residency slot. I would like to refer you to my article called The Alphabet Soup Of Residency Visas And The Radiology Alternate Pathway: A Guide For The Foreign Radiology Residency Applicant at the link above:
Thanks for the great question. I would be specifically interested in why you need an H1B. Let me know if there is any other information that you think I can help you with. I will post it on the website at some point because I think it would be useful for other applicants in your situation as well.
Barry Julius, MD
Dear Dr. Julius,
Thank you for your reply and great advice.
I am currently on an F1 student visa and was advised against a J1 visa by my immigration attorney because of the requirement to return to my home country for 2 years. I am Singaporean and have been looking into the H1B1 visa for Singaporeans. It is similar to H1B, but has its own cap that has never been filled historically, can be obtained anytime throughout the year, and only requires the employer to file LCA (I-129 is not needed).
I am under the impression that it would be easier to approach programs that offer H1B already to ask about sponsoring for H1B1 visa, than programs that offer J1, since they may not be familiar with the H type visa. Is this likely to be true?
Also, how and when would you advise me to contact programs and discuss visa-specific issues/requests. Should this be done before I submit my residency application?
Thank you for all your help.
Thanks for the additional information. That allows me to understand the issues that you have and why you need an H1B1.
I would definitely make sure to contact the residency programs and the Graduate Medical Education (GME) office prior to applying because many of the programs will not even look at a candidate who has to get an H1B or H1B1 visa for a residency slot. Most programs are set up for the J1 visa. If you need an H1B or H1B1 visa to get into a program, it puts you into a different application pool.
You certainly don’t want to waste your time and money applying to those programs that only take J1s and not H1Bs. It makes sense to contact each of the individual radiology programs and the GME office prior to applying to save you a headache. Typically, the person to speak with would be one of the folks in the GME office who handles visa issues. And, you probably want to speak to the residency coordinator because occasionally the individual program policy can potentially differ from the GME office. ( the program may not take a resident with a visa issue, but the GME office may say it is OK) At our institution, this person is a secretary and is very knowledgeable about all things visa related since she has been doing it for a long time.
Hope that gives you a little bit more insight about when to contact the program and who to contact.
Barry Julius, MD