Frequently Asked Questions

J-1 Visa Compliance: Conference Attendance and Compensation

Per ECFMG regulations, J-1 physicians are strictly prohibited from engaging in any work or receiving compensation for activities outside of their approved training program.

Key Guidelines for Program Directors:

Prohibited:

• Speaking Engagements: Any payment or honorarium for speaking engagements is classified as "moonlighting" and is strictly prohibited.

Permitted:

• Conference Expenses: Reimbursement for travel and attendance is only permissible if the conference is a required component of the training program necessary for graduation.

  • Compensation Limits: J-1 physicians may only receive compensation for activities required of all trainees in the program. 

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Program Directors are responsible for ensuring all trainee activities align with these federal parameters. For further details, please refer to the official ECFMG Memo.

Legal Determination on 12/29/2025

Regarding the recent ECFMG expansion (2025) allowing for "Supplemental Educational Activities" (SEA) for J-1 physicians, we have determined that this option is currently unavailable at the University of Minnesota due to specific employer-of-record constraints.

The Challenge: Employer Consistency

While the ECFMG now allows for expanded clinical work under J-1 sponsorship, our interpretation of the federal regulations is that this work must be performed for the same employer listed on the physician’s Form DS-2019.

• Eligibility Limit: Only the University of Minnesota, as the official J-1 sponsor/employer, is authorized to compensate the resident.

• Third-Party Restriction: Any supplemental work involving third-party partners or external clinical entities—even if the work occurs at the same physical worksite—is prohibited.

• Payroll Requirements: Because these activities cannot be used to complete an I-9 for a different employer, the University would have to remain the payer of record.

Essentially, since most supplemental and "moonlighting" opportunities involve external medical groups or partner hospitals with separate tax IDs, they do not meet the criteria for J-1 supplemental activities under our current institutional structure.

EVSP Reference Guide (ecfmg.org) 

🛂 Guide: What to Do If You're Sent to Secondary Inspection at U.S. Customs

Why It Happens:

If you've changed your J-1 visa category (e.g., from Research Scholar to Physician), you may be flagged at customs and referred to secondary inspection. This is often routine and does not mean you’ve done anything wrong.

🔎 Common Reasons for Secondary Inspection:

1. Visa Category Change Triggers Scrutiny
   CBP flags any changes in visa category, especially within the J-1 program. The Physician category requires more regulatory checks.

2. High Compliance Threshold for J-1 Physicians
   Officers may verify:

   • Valid ECFMG-sponsored DS-2019

   • Active SEVIS status

   • Compliance with the 212(e) home residency rule
     
     

3. Lack of Familiarity with Clinical Training Paths
   Many CBP officers are unfamiliar with J-1 Physician processes and refer travelers to secondary to double-check documentation.
   
   

4. SEVIS Record Conflicts or Gaps
   If your J-1 Research SEVIS record wasn't properly closed, or there’s overlap between SEVIS IDs, that may raise flags.
   
   

✅ Documents to Carry When Reentering the U.S.:

Bring these with you in your carry-on:

• Original DS-2019 from ECFMG (signed)

• SEVIS fee payment receipt

• Start letter from your GME Office or program

• Proof of ECFMG sponsorship

• Closure confirmation of your old SEVIS record (if applicable)
  
  

🛠 If You Experience Repeated Delays:

You can request a review of your immigration file by filing a DHS Travel Redress Inquiry (TRIP):

🔗 Submit a DHS TRIP Inquiry

This process allows the Department of Homeland Security to review and potentially remove outdated or incorrect flags in your record.

💬 Pro Tip:

Be calm, respectful, and patient during inspection. Secondary inspection is often just a precaution and can be resolved quickly if you have all your documents in order.

Although most of you may be fluent and proficient in English, some may find it challenging to have regular conversations when English is their second language. Here are some resources in case you’d like to explore this:

Resources for Trainees:

• ESL courses in Fall 2021: Please refer to the linked attached flyer which has recommended Academic English courses for trainees. Trainees can ask for more information about a specific course or get a permission number by contacting esl@umn.edu. 

• Self-Service Website: We have a robust website to support multilingual students with their language development and communication skills: esl.umn.edu.  The website includes tips and resources for online learning, self-study materials, practice quizzes, tips, videos, and useful links to provide English language practice. 

Contact:

Minnesota English Language Program (MELP)

University of Minnesota | esl.umn.edu |