Guidelines for the Application of a Statement of Need for Postgraduate Medical Training in the United States (USA)

Background

Foreign national physicians who seek entry into US programs of graduate medical education or training must obtain an appropriate visa that permits clinical training activities. One visa commonly used by foreign national physicians is the J-1, a temporary non-immigrant visa reserved for participants in the Exchange Visitor Program (ESVP). The ESVP was established to enhance international exchange and mutual understanding between the people of the US and other nations.

The Educational Commission for Foreign Medical Graduates (ECFMG) is authorised by the US Department of State to sponsor J-1 Exchange Visitor physicians enrolled in accredited programs of graduate medical education or training or advanced research programs (involving primarily observation, consultation, teaching or research). Although many universities and research institutions in the US are authorised to sponsor Exchange Visitors in the categories of student or research scholar, ECFMG is the sole sponsor of J-1 physicians in clinical training programs. ECFMG is responsible in ensuring that all Exchange Visitors and host institutions meet the federal requirements for participation.

To obtain the J-1 Visa to undertake clinical training activities in the US, applicants must, among other requirements, obtain a Statement of Need (SON) from the government of the country of their nationality or last legal permanent residence.

[1] Information extracted from http://www.ecfmg.org/evsp/index.html

Statement of Need (SON)

The SON is an official confirmation from an approving authority that the qualified medical practitioners are needed in Singapore, and that the medical graduates who are pursuing postgraduate medical education in the US intend to return to Singapore and enter the practice of medicine in the specialty sought. It is part of the requirements set by the ECFMG for the issuance of a J-1 Visa.

In Singapore, only the Ministry of Health (MOH) is approved to issue a SON to physicians seeking a J-1 visa. The requirements for obtaining a SON from the Ministry may be subject to change under periodic framework review.

Eligibility criteria:

• Only Singapore Citizens and Singapore Permanent Residents are eligible to apply for a SON.

• All applicants must have a recognised basic medical degree. Please refer to the Singapore Medical Council’s website

• All applicants must also ensure that the postgraduate qualification that they are seeking is recognised by the Singapore Medical Council (SMC) and fulfill Singapore’s needs. As the list of medical qualifications eligible for conditional registration to practise set by the SMC are subject to change, please ensure that you check with SMC on the updated list before applying for postgraduate training in the US.

• All applicants must also be currently employed in a local healthcare institution or has a provisional offer by a healthcare institution in Singapore for employment upon completion of training.

Those who are embarking on HMDP / fellowships after their specialist training must have completed a minimum of 2 years of broad based specialist practice as an Associate Consultant before embarking on HMDP / fellowship.

Applicants with existing service obligations must obtain an approved Suspension of Bond.

Applicants must sign a written assurance that they will return to Singapore upon completion of training in the US and intend to enter the practice of medicine in the specialty being sought. The SON that is given to the physician based on this written assurance does not carry any certainty or guarantee that he/she can be registered as a doctor/specialist in Singapore; be accredited as a Medical Specialist or Family Physician in Singapore; be able to get employment as a physician/specialist in Singapore; or to get resident status in Singapore.

Note: Not every SON application may be successful. Each application is assessed on its own merit, including the national need for such expertise or whether such training can be recognised or accredited for practice in Singapore.

Application Process

Applicants are required to submit the following documents.

• Written Assurance for Statement for Need SON 2024 [PDF, 126 KB]

• Proof of Citizenship or Permanent Residence Status or Nationality (NRIC and Passport). For Permanent Residents, please provide re-entry permit

• Proof of Basic Medical Qualification

• Proof of Postgraduate Medical Qualification (if any)

• Certificate from Specialist Accreditation Board (if applicable)

• Letter of Employment (stating date turned Associate Consultant, if applicable)

• Letter of Provisional Employment or Letter of offer from local healthcare institution in Singapore, if applicable

• Letter of Acceptance from overseas Institution of Study; and

• Proof of Training Placement in the US

  • Letter of Offer or Training Contract from Foreign Institution of Study; or

  • Letter of Offer for a fellowship or a sub-specialty from the clinical training program in the US. The letter must be on the institution's letterhead and should bear your signature of acceptance of the offer; or

  • A Training Contract for a fellowship or a sub-specialty from the clinical training program in the US. The contract should bear your signature indicating your acceptance of the offer.

Applications and supporting documents should be emailed to:

kalaivani_slamazan@moh.gov.sg
dawn_liew@moh.gov.sg

Applicants are responsible in ensuring that all required documents are submitted. Failure to do so may result in a delay in the processing of the application.

Please allow up to seven (7) working days for the processing of the application. Applicants will be informed of the outcome via email. If applicants require approval of a “suspension of bond/service obligation” from MOH, the SON will only be issued after the suspension of bond/service obligation is approved.

The SON bearing the seal of the Ministry of Health Singapore will be sent directly to ECFMG, as required. A softcopy will be sent to the applicant via email for record.

Expiration and Extension of Statement of Need (SON)

The SON will expire at the end of the training program based on the specified end date on the application form. Some exchange visitors with J-1 visa are subject to a two-year home country physical presence requirement. It requires you to return home for at least two years after your exchange visitor programme. This requirement is part of US law in the Immigration and Nationality Act, Section 212(e).

Applicants who have completed their residency training are not eligible for extension, ie continuation into fellowship programmes. They must return to Singapore and re-apply for Fellowship Programmes after meeting similar conditions imposed on doctors who complete local residency programmes, ie all specialist doctors must spend a minimum 2 years as a specialist (i.e. appointed as an Associate Consultant) before embarking on the fellowship.

Suspension of Undergraduate Bond

Suspension of service obligation is applicable to any physician who has graduated or about to graduate from the local medical schools, i.e. Yong Loo Lin School of Medicine, National University of Singapore (YLL-SoM, NUS), Duke-NUS Graduate Medical School (Duke-NUS, GMS) and Lee Kong Chian School of Medicine, Nanyang Technological University (LKC-SoM, NTU), and are currently or about to commence serving their service obligations with the Singapore Government.

Physicians who have existing service obligations must seek approval for a suspension of their obligations for the duration of their overseas training from MOH (for medical students), or from their employers, i.e. MOHH or Public Healthcare Institutions.

Physicians who need to suspend their service obligations must have approval from MOH and MOHH (for PGY1s and medical officers) or cluster employers (for registrars and above) before they apply for SON.

Physicians who already had approval for the suspension of their service obligations for their previous SON application must obtain separate approval from MOH and MOHH (for PGY1s and medical officers) or cluster employers (for registrars and above) before they apply for SON.

For more information regarding suspension of undergraduate service obligations, please contact:

alice_tan@moh.gov.sg
poh_kai_ling@moh.gov.sg

Further Information

• J-1 Visa Exchange Visitor Programme (EVP) : http://j1visa.state.gov/

• Exchange Visitor Visas : http://travel.state.gov/visa/temp/types/types_1267.html

• EVSP Reference Guide :http://www.ecfmg.org/evsp/evsprfgd.pdf

• ECFMG : http://www.ecfmg.org/