Good luck with your endeavours, many people before you have been at the same point in their career and didn't have the advice available on this forum. Be sure to browse through the forum going years back, you will read many stories from people fortunate and less fortunate. It will help you to avoid traps and slings along the way, but it might also scare you at times. Be sure to allways assume that everything will work out well for you, otherwise you will become depressive.
I will try to answer some of your questions:
> i would like some advice regarding what kind of visa i should apply to!!!
Ok, here are my 5 cents on this issue:
- if your 10 year plan is to stay in the US and you are willing to make compromises to achieve this, then go for the H1b.
- if in your 10 year perspective includes the possibility of going back to Peru for 2 years (you don't have to fear persecution, you think you can use your US training for work at home, you are a person who can just 'pack up and go') then a J1 can be an option.
- if you want to get the best possible education regardless of peripheral issues like visas, go for the J1. It will give you enough time to complete your intended training and DURING the training has the least amount of hassle.
Here are the key advantages(+) disadvantages(-) of each visa
H1b
+++++++++++++++++++++ability to stay in the US afterwards (if you find a prospective employer during residency, you can get a GC soon after finishing residency)
-------------limited availability of residencies sponsoring H1b
------expense ($200 for you, $3000 for employer)
------few to no competitive fellowships sponsoring H1b
++--often H1b internists have to put in 2-3 years after residency in a primary care job to get a green-card. after that they can go back for a fellowship which can be difficult after years out of residency (fellowships don't pay well compared with a real job)
---difficult to move from residency to fellowship. Particularly for cardiology, people at times have to put in another year either working as 'chief resident' or as 'hospitalist attending' because the fellowship they want to do won't start until a year later. If you have to put in another year, you run out of H1b time (6 years) in the end.
J1
-----------------------------difficulty to move from residency/fellowship to permanent residency (green card)
-----------------------need to obtain a 'waiver' either through work in an underserved location or for the 'veterans administration'. tremendous paperwork and anxiety infusing process to get from J1 to waiver-H1b.
+++++++++++++++++practically all residencies and most fellowships will take people on J1. If your credentials are good, even good university programs are within reach for foreign graduates
++++----------low expense to get visa in the beginning ($400 for you, $0 for employer). Potentially large expense to get waiver at the end ($200 if you manage to do everything yourself-$10000 if you have attorney do the work)
> i want to be an internist and then get a fellowship in cardiology,
> but i would feel comfortable without the fellowship, too.
You will be in good company. 40% of internists in the US are foreign graduates, most from india.
Cardiology is a competitive fellowship. I know plenty of FMGs who made it into cards fellowships, it does however require training at a good residency program and the ability to connect well with important attendings (in order for people to make phone-calls for your and write good letters of recommendation).
> how hard is to get a waiver????
Depends on the specialty:
Family practice: easy
internist (nonspecialized willing to do primary care): easy
internist/specialist: difficult
> how much time shold i spend trying to get a green card.
If you have family in the US who can hook you and your wife up with a green-card (e.g. by sponsoring you to work in their restaurant as 'specialty cook peruvian'), then you should do that before you come here as a physician.
> my fiancee is in the same situation, so i think it is going to be harder
> to get waiver if it is the case.
There are two scenarios for doc-doc couples who come here together:
#1
Husband gets J1, wife gets J2 + employment authorization
In this case, husband has to get waiver and wife can work during waiver period on her own H1b visa or through an employment authorization paper (if husband is getting sponsored for a 'national interest waiver for physicians' green-card.
#2
Husband gets J1, wife gets own J1
In this case, both have to find 'waiver jobs' and both have to apply for waivers separately.
Good Luck !
