Immigration to the USA

The USA ranks the number one country in the world as an immigration destination. In 2002, the U.S. Census Bureau pegged the country's foreign-born population at 11.5 percent, not far off the historic high of 15 percent in 1910. In 2006, the number of immigrants totaled 37.5 million. Three-quarters of immigrants surveyed by Public Agenda said they intend to make the U.S. their permanent home. If they had to do it over again, 80 percent of immigrants say they would still come to the U.S. The American Dream is the belief that through hard work and determination, any United States immigrant can achieve a better life, usually in terms of financial prosperity and enhanced personal freedom of choice. 

However, immigration to the United States can be a controversial issue. An important obstacle to the international recognition of qualifications is a lack of information and understanding of other nations’ education systems and qualifications. That is why our evaluators perform thorough research on every individual application for credential evaluation to better match American standards. We can help you to make your story a success by offering our services, working directly with you or with your lawyer. Reliable and standardized evaluation of foreign credentials, prepared by our professionals based on educational credentials you earned in you native country could be your passport for employment or continuing education in the United States. We do comparative analysis to determine an equivalency of your education to American standards. These reports are prepared after solid research of different World educational systems and in compliance with the General Guiding Principles of Good Practice for Educational Credential Evaluation, set by the National Association of Credential Evaluation Services (NACES), and accepted in the United States by Immigration Services, many academic institutions, employers, and professional licensure boards.

US Education System

The United States is a federal republic with a decentralized system of education. The titles and designations of U.S. study programs and types or levels of educational institutions are not set forth in law or protected or reserved, and therefore may vary from place to place. Program content and the name of the subject concentration often varies from institution to institution, so U.S. educators and employers usually examine student records in order to determine what an individual has in fact studied and what they are qualified to do at the degree level which they have completed. A few degrees in professional subjects are closely regulated by state governments and professional associations and have uniform content if awarded by an accredited institution. U.S. educators and employers do not evaluate quality on the basis of fixed assumptions about uniform content, but rather on a case-by-case basis using standard assessment approaches to analyze often quite different individual situations.

Credential Evaluation

Degree, diploma, and credit recognition are not performed or regulated by the federal government. Recognition is not usually done by state or local governments, either, except in the case of professional licensure. Instead, the federal government and other levels of government rely on, and recognize, the evaluations of foreign academic, professional, and vocational credentials performed by the delegated competent authorities at the institutional level and in the private sector. Not all U.S. institutions, employers, and licensing authorities perform evaluations of non-US diplomas, credits, or qualifications. In many cases this work is delegated to private credential evaluation services, and the resulting evaluations are recognized as valid.
The U.S. government does not recommend or endorse any individual credential evaluation service or group of services, and does not conduct evaluations or make recognition decisions.

Types of Credential Evaluation

Document-by Document equivalency report provides evaluation for each educational document submitted (such as Diploma, Academic Transcript, or Certificate) including name of the degree and name of the institution, program duration, entrance criteria, and graduation year. It can also include work experience to determine educational equivalencies based on regulatory guidelines for clients seeking to meet U.S. immigration requirements (for example, H-1B visa petitioners) or Grade Points Average (GPA), calculated on a US 4.0 scale, as needed.

This type of evaluation is required for college or university admission if transferred credits and completed courses are not relevant, employment, and immigration.

Course-by Course equivalency report, in addition to evaluation of academic credentials, provides full description of interdisciplinary curriculum of academic study including conversion of hours to US credits, conversion of grades to US grades, and calculation of the Grade Points Average (GPA), calculated on a US 4.0 scale, to determine the educational equivalent within the U.S. educational system.

Course-by Course equivalency report is required for continuing education, employment, immigration, licensing, and military enlistments.

Each equivalency report is prepared on case-to-case basis and contains details and summary of each academic credential and comparable USA equivalency, suggested by the agency.

Accreditation and Individual Certification and Licensure

Foreign medical professionals seeking employment in the US should know that there are special licensing requirements in every State. Certification and licensure in the USA are under control of individual states. Every medical graduate must apply for a license in the state(s) in which they intend to practice. Accrediting organizations play a significant support role in the certification and licensure of individuals who complete programs in specific fields (such as Medicine, Dentistry, Nursing, Law, or Engineering). Specifically, many states require that applying individual has graduated from an accredited program in order to sit for certification and licensure examinations.

Getting an H-1B visa is not always easy and even getting H-1B status is not free from problems. With adequate preparation, however a foreign graduated physician, dentist, or nurse should be able to get employment authorization in the US, especially in medically underserved areas or health professional shortage areas. The Shortage Designation Branch in the HRSA (Health Resources and Business Administration) Bureau of Health Professions National Center for Health Workforce Analysis develops shortage designation criteria and uses them to decide whether or not a geographic area or population group is a Health Professional Shortage Area or a Medically Underserved Area or Population. Weekly updates by State/ County/ Medical Discipline are available at HRSA web site.

It might help to know some basic data:
•    Physicians in the USA: 794,893.
•    Foreign graduate doctors in the USA: 185,234 (from 127 countries).
•    Percentage of foreign doctors in U.S. training programs: 24%.

This is not a new phenomenon. Foreign physicians have made up about this percentage of our doctor population for years. A sizable portion work in medically underserved communities and small towns. The shortage of doctors in the USA is expected to grow to as much as 200,000 by 2020. (USA TODAY).

You can find some useful immigration guides detailing commercial US visa categories, including B1, H1B, L1, E1, E2 visas, J1 exchange visitor visa, H1B visa for doctors, and US green cards, on the web.

How to get a License to practice Medicine in the United States

Foreign Medical Doctors

Even though foreign doctors have earned full rights to practice medicine in their native country, they have to go through the following qualification process in the United States:

1.    Pass the tests to get Educational Commission for Foreign Medical Graduates (ECFMG) certification. The purpose of ECFMG Certification is to assess the readiness of foreign medical graduates to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). To be certified by ECFMG, a candidate must pass a series of exams meeting ECFMG's medical educational credential requirements. These requirements include providing ECFMG with copies of medical education credentials, which ECFMG will verify directly with candidate’s medical school. See ECFMG Certification.
2.    Undertake residency-training program.
3.    Pass the 3rd and final exam of the United States Medical Licensing Examination (USMLE).
4.    Apply for a license to practice medicine in a particular state.

International Dentists

International Dentists must satisfy educational requirements to be licensed. Many states require graduation from accredited or approved dental schools, referring to accreditation or approval by the Commission on Dental Accreditation (CDA) of the American Dental Association (ADA). Note that many Canadian dental schools are approved through the Canadian Dental Association. The term “international dentist” generally refers to a dentist who has graduated from a dental school other than in the United States or Canada. 29 states require graduation from an accredited or approved school for licensure. [Minnesota has an allowance for a determination of educational equivalency.] 18 other states and the District of Columbia require additional training in a CDA-accredited program for licensure. Note however that roughly half of the accredited schools in the U.S. have provisions for foreign dental graduates to apply to transfer in with advanced standing. 42 states and DC will license a dentist after they have been licensed in another state and have practiced for a certain period.

Foreign Educated Nurses

Nurse immigration to the United States has tripled since 1994 to close to 15,000 entrants annually. As of 2006, about 8 percent of U.S. registered nurses (RN), numbering around 219,000, are foreign educated. Foreign-educated nurses desired to work in the United States must obtain a work visa. Applicants are required to undergo a review of their education and licensing credentials and pass a nursing certification and English proficiency exam, both conducted by the Commission on Graduates of Foreign Nursing Schools (CGFNS). The commission is an immigration-neutral, nonprofit organization that is recognized internationally as an authority on credentials evaluation in the health care field. Applicants from Australia, Canada (except Quebec), Ireland, New Zealand, and the United Kingdom are exempt from the language proficiency exam. In addition to these national requirements, most States have their own requirements.

As you can see, there is no easy way for foreign medical professionals to prove their skills, knowledge and qualification in the United States. Nevertheless, if you are highly motivated and persistent, you may find that your goal was easier to achieve than you thought. Use this well-known Latin proverb by Seneca the Elder, “Per aspera ad astra" (Through thorns to the stars), as your motto, and hold on hope. You really came to a free country with unlimited opportunities.

Exclusively for MedicalBusinessExchange.com

Valentina Izvekov
Translator and Evaluator
www.USCreditsOnline.com
Evaluation and Translation Services