How does the H1B visa process work? Is it an option for all medical residents and fellows?

The courts and the US Immigration Service have determined that medical fellowship and residencies qualify as ‘specialty occupations’ (i.e. those occupations requiring at least a four year degree as a minimum requirement for the position).

An H-1B visa is sponsored by an employer. The residency program acts as the IMG’s first employer in the United States, but when IMGs complete training, they can be sponsored by another employer, such as a medical group. The medical group does not have to be in a shortage area — another advantage of the H-1B. While working for a medical group on an H-1B, IMGs can begin the process of obtaining a green card, allowing them to stay in the United States permanently.