New Guidance on Permissible Training Activities for J-1 Physicians During COVID-19

Dear DIOs:

In another positive development, ECFMG|FAIMER received guidance from the U.S. Department of State earlier today that describes permissible training activities for J-1 physicians during the COVID-19 pandemic. We have bolded key points for your quick reference. Please use the guidance below to inform any changes that are made to the training program of a J-1 physician in response to COVID-19.

To provide an opportunity to address any questions you may have for EVSP about this or other COVID-19 related matters, we have scheduled a live Q&A webinar for noon on Tuesday, April 7. Click here to save the event and login instructions to your calendar program.

Thank you,

Tracy Wallowicz
Assistant Vice President, U.S. Graduate Medical Education Services
From the U.S. Department of State
Received April 2, 2020

The Department approves ECFMG’s request that exchange visitor (J-1) physicians in clinical programs may engage in any/all medical training activities deemed appropriate by the teaching hospitals (formerly called Sponsoring Institutions) in keeping with ACGME requirements and state licensing requirements. Specifically, the U.S. Department of State has no concerns with J-1 physicians engaging in alternate rotations and clinical assignments during the pandemic as deemed appropriate by a Sponsoring Institution’s Designated Institutional Official (DIO) and/or program director provided that all activities adhere to ACGME requirements outlined in its Response to Pandemic Crisis, including, but not limited to:  (1) activities are conducted under appropriate supervision; (2) activities adhere to established work hour requirements; (3) activities are conducted within an individual resident trainee’s area of knowledge and the trainee possesses the skills to provide the needed services.

Under the Exchange Visitor Program regulations at section 62.27 governing the alien physician program, the purpose of the program is to “facilitate exchanges for foreign medical graduates seeking to pursue graduate medical education or training at accredited schools of medicine or scientific institutions.” Under clinical exchange programs, alien physicians enter into an agreement or contract with the accredited institution to engage in graduate medical education. Where these agreements accommodate other types of medical training activity in response to a crisis, ECA believes the regulations clearly permit a flexible approach to temporary activities by these alien physicians that are still in line with the expected medical training activities of the program. However, ECA does not recommend applying this flexibility to alien physicians in non-clinical programs under 62.27(c), because such alien physicians have not been certified by ECFMG for patient care. ECA emphasizes to the ECFMG that while there is flexibility under the regulations for alien physicians to perform different medical training activities under the exchange program to meet emergency needs, this is not a waiver of the regulations.

We appreciate all that you have done during this time and thank you for bringing this matter to our attention.
Join the Live COVID-19 Webinar for Host Institutions
EVSP will hold a live webinar for DIOs, Program Directors, and Training Program Liaisons (TPLs) to address questions related to the COVID-19 pandemic and impacts on J-1 physicians. Details and login information is as follows:
  • Date: Tuesday, April 7, 2020
  • Time: 12:00 pm, Eastern Daylight Time (New York, GMT-04:00)
  • Session number: 790 162 587
  • Session password: This session does not require a password.
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