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  • Hiring FMG/IMG to private practice

    Does anyone have experience hiring an IMG / FMG to a private practice?
    I am guessing that he is doing residency under J-1 currently.

    He is asking that the new employer pay for an H-1b visa and to take care of immigration atty and fees to obtain a green card.
    Is this usual practice? We haven't hired anyone in this situation before and would appreciate some guidance. I think the hesitation is that we have no idea how certain the price is to obtain all of this.

  • #2
    Those seem like pretty standard fees that you can figure out. And for whether or not you should pay them, that all depends on your local supply/demand.

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    • #3
      Any reason you can’t find a US med school grad who is at least as well qualified? Who’s going to pay the extra costs to the practice / hospital for visa and immigration compliance issues?

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      • #4
        There isn’t any trouble finding a US grad. This person just has strong ties to the city and came applying for a job, and he seems to be a qualified candidate. The immigration status is just a little wrinkle that we were not aware of until an offer was made.

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        • #5
          I know places cover those fees but they are usually hard to recruit to places that will take anyone willing to work. If you are offering a desirable job and will have applicants to choose from I would not offer to pay the fees. Unless this applicant is exceptional in some way or you negotiate out something else like a starting bonus. It seems silly but some people actually care what money is labeled for.

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          • #6
            Good for you guys for maybe being willing to overlook these hassles. 0% chance I, or anyone in my practice, would offer this guy a job.

            That said, there is no way you should pay those fees unless there’s a supply and demand issue in the new hire’s favor, as mentioned above.

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            • #7
              He wouldn’t be able to leave for three years if you hire him. In order for him to get the visa you’d have to prove that you couldn’t hire a citizen or LPR and the office should be in an underserved area.

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              • #8
                Thanks for the replies. I’m thinking it would be fair if we offered to pay up to a given amount (like a signing bonus), but unless the hospital or another practice in town has some experience, it may be more than we want to handle. It sounds like he may have a J-1 for residency and will have to have a job lined up and visa secured by graduation or he has to return to home country for 2 years. ?
                We’re just trying to make sure we’re not being taken advantage of in some way.

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                • #9
                  I agree with the others that it would be a tough sell given the unnecessary hassle.

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                  • #10
                    This is almost certainly more than you want to handle, and is ethically questionable.

                    He's on a J1 visa. J1s are educational visas. Legally, he is required to either go back to his home country for two years after completing training, or take a waiver job for two years. Waiver jobs are specifically in underserved, hard-to-recruit areas. He is trying to circumvent that requirement by having an H1B set up before he finishes residency. H1Bs have the requirement that the sponsoring employer prove they cannot hire a citizen for this job. That's not a rubber-stamp requirement, you actually have to provide a fair amount of proof. They also carry with them a salary requirement, that is, for each job you have to prove you are paying the person a certain amount. This also must be in line with what you are paying everyone else in that job who works for you. That amount is not on the low end of the salary range for a profession. This is to ensure that people are not hiring foreign workers because they are cheaper than Americans. When my wife hired an H1B engineer, she had to raise the salary for *all* of her junior engineers to satisfy the requirements.

                    In other words, hiring an H1B is a great deal of effort and expense. Most employers are either already set up to hire foreign grads, or won't do it. The fact that this individual wasn't specifically searching out employers who already offer H1Bs, or J1 waiver jobs, and didn't even bring up the visa issue until after you made an offer is, not to put too fine a point on it, sketchy as *&^@. My best guess is that he's counting on you not understanding that this is a HUGE ask. It also, frankly, may be an impossible one -- you've said you can hire an American citizen for the job without difficulty. That automatically disqualifies you from offering an H1B.

                    There are many, many excellent foreign-born doctors in the US who came over on J1s, did their waiver time, and then went and got whatever job they wanted. This guy has decided he doesn't want to do that. He's asking you to put a great deal of effort into helping him circumvent the system. My advice is to not.

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                    • #11
                      Originally posted by tigeri View Post
                      There isn’t any trouble finding a US grad.
                      There’s your answer. An H1B visa shouldn’t apply.

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                      • #12
                        Also, the sheer gall of a) not disclosing the requirement for visa sponsorship until after an offer has been made, b) asking for an H1b specifically to circumvent the waiver requirements for J1s, and then c) asking the employer to pay for an immigration attorney to deal with all of this just blows my mind.

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                        • #13
                          Originally posted by Sigrid View Post
                          Also, the sheer gall of a) not disclosing the requirement for visa sponsorship until after an offer has been made, b) asking for an H1b specifically to circumvent the waiver requirements for J1s, and then c) asking the employer to pay for an immigration attorney to deal with all of this just blows my mind.
                          I am not disputing or disagreeing with anything you are saying

                          but h1B and J1 waiver can run simultaneously , once you get J1 waiver through Dept of State you get H1B and work for 3 years( I think) in underserved area. Any immigration attorney can help . Also, it is very common for employer to pay for immigration related expenses . These jobs are in underserved areas and I think to offer H1B, you should have a job for which no American citizen or permanent resident is available. Immigration attorneys can give you correct advice , if you desire . My 2 cents.

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                          • #14
                            Originally posted by uksho View Post

                            I am not disputing or disagreeing with anything you are saying

                            but h1B and J1 waiver can run simultaneously , once you get J1 waiver through Dept of State you get H1B and work for 3 years( I think) in underserved area. Any immigration attorney can help . Also, it is very common for employer to pay for immigration related expenses . These jobs are in underserved areas and I think to offer H1B, you should have a job for which no American citizen or permanent resident is available. Immigration attorneys can give you correct advice , if you desire . My 2 cents.
                            I'm not disputing that a) H1bs and J1 waivers can run simultaneously, or b) immigration attorneys are usually necessary in these cases. But he's not on a J1 waiver, he's on a J1, and he's asking this of a practice who doesn't offer J1 waivers or H1bs, and is therefore not set up to handle either the paperwork or the expense. And he's asking them to not only learn all about it, but also cover 100% of the expense.

                            There is a reason most employers aren't willing to sponsor visas. They are a huge hassle, they generally require a lawyer, and they are expensive. People who require waiver jobs and visas know this.

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                            • #15
                              Originally posted by Sigrid View Post

                              I'm not disputing that a) H1bs and J1 waivers can run simultaneously, or b) immigration attorneys are usually necessary in these cases. But he's not on a J1 waiver, he's on a J1, and he's asking this of a practice who doesn't offer J1 waivers or H1bs, and is therefore not set up to handle either the paperwork or the expense. And he's asking them to not only learn all about it, but also cover 100% of the expense.

                              There is a reason most employers aren't willing to sponsor visas. They are a huge hassle, they generally require a lawyer, and they are expensive. People who require waiver jobs and visas know this.
                              Agree with you that candidates are well aware of their visa situation and in my opinion as well , they should disclose this in the beginning .

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