The Department of Homeland Security (DHS) will end the longstanding “duration of status” system for F, J, and I nonimmigrant visas starting September 15, 2026, instituting a fixed maximum period of authorized stay capped at four years. This replaces the previous framework that tied visa duration to the full length of an academic or training program, which DHS described as allowing foreign students to remain in the United States indefinitely through continuous enrollment.
Under the new rule, visa holders in the affected categories may stay for no longer than four years or a shorter period based on their specific program
duration. Students in programs exceeding four years must obtain an Extension of Stay from the United States Citizenship and Immigration Services (USCIS), which involves biometric data collection, background checks, and fraud prevention screenings. This change shifts visa extension oversight from universities to federal agencies.
>Medical Training and Institutional Concerns
Medical educators and healthcare organizations including the Association of American Medical Colleges (AAMC) and the American Hospital Association (AHA) have criticized the policy for ignoring the complexity and longer duration of medical residency and graduate programs. The AAMC stated there is “no compelling need to change the current visa system” and argued the fixed four-year cap
“does not take into account the breadth of complexities” involved in medical and scientific training often lasting beyond four years.
The AHA emphasized the essential contributions of J-1 physicians to U.S. healthcare, particularly in underserved regions, but warned the rule would add administrative burdens and risks disrupting training continuity.
Impact on J-1 Physicians and Healthcare Delivery
Intealth sponsors approximately 17,500 J-1 physicians in residency and fellowship programs at nearly 780 teaching hospitals as of 2025, a 76% increase over the past decade. J-1 physicians represent about 10% of all U.S. physicians in training and are particularly vital in regions like the Upper Midwest, Northern Plains, and Appalachia,
which face critical physician shortages.
Under the existing system, Intealth manages annual visa sponsorship renewals for these physicians. The new DHS rule requires J-1 physicians to apply for extensions through USCIS beyond the four-year cap, exposing them to extended government vetting. Intealth plans to modify one required form to a multi-year cycle but will maintain annual sponsorship renewals. J-1 physicians must still return to their home countries for two years post-training before applying for an H-1B visa, unless they secure a waiver by committing to work in federally designated shortage areas.
Official Statements and Policy Justifications
DHS Secretary Markwayne Mullin stated the previous indefinite duration
system weakened immigration oversight, calling the new regulation a measure to “reclaim proper immigration oversight” by imposing “clear, finite limits” that improve screening and monitoring of foreign students. Mullin added the rule ensures students “remain focused on their primary purpose: completing their studies and returning home.”
The AAMC and AHA both highlighted concerns that the revised policy disregards the complexity of academic and medical training timelines, raising administrative costs and potentially threatening healthcare workforce capacity in underserved parts of the country.
Traveler Impacts and Visa Processing Changes
International students on F, J, and I visas will face a maximum authorized stay of four years starting September
15, 2026. Those in programs exceeding this duration must apply for Extensions of Stay through USCIS, incurring biometric and background screenings previously handled internally by schools. The grace period after program completion for F-1 students is reduced from 60 days to 30 days.
The shift transfers extension authority from educational institutions to federal agencies, introducing new administrative processes and fees for students and sponsors. Medical trainees on J-1 visas risk training interruptions due to longer USCIS processing times, which historically have extended up to 19 months for renewals. Details on restrictions regarding program or college transfers have not been disclosed
by DHS.
As of 2023, about 26,000 international biological and medical sciences graduate students and 11,000 postdoctoral scholars use F and J visas affected by these limits, according to AAMC and National Science Foundation data. The new regulation arrives amid ongoing physician shortages nationwide and increasing competition for international scientific talent.
