The Department of Homeland Security (DHS) has finalized a policy capping the maximum duration of F, J, and I nonimmigrant student visas at four years, effective September 15, 2026. This ends the previous system allowing indefinite stays under the “duration of status” rule.
Policy Ends ‘Duration of Status’ Rule
Under the decades-old “duration of status” framework, international students could remain in the United States while continuously enrolled in academic programs of varying lengths. DHS Secretary Markwayne Mullin described this as a loophole that permitted “forever students,” undermining immigration oversight. The new rule imposes finite limits on student visa validity periods to enhance screening and monitoring of
foreign students within U.S. borders.
Secretary Mullin stated, “This final rule ensures that foreign students remain focused on their primary purpose: completing their studies and returning home.” The policy requires students enrolling in programs longer than four years to apply to U.S. Citizenship and Immigration Services (USCIS) for an Extension of Stay, shifting oversight from university officials to federal authorities.
Impact on Medical Trainees and Residency Programs
The changes pose challenges for medical trainees under J visas, who account for roughly 10% of all physicians in U.S. residency and fellowship programs. J-1 physicians, sponsored mainly by Intealth, historically could renew their sponsorship annually for up to seven
years, allowing flexibility to complete lengthy training. The new four-year cap means these trainees must now secure government approval to extend their stay beyond that period.
The American Hospital Association highlighted the role of J-1 physicians in U.S. healthcare, noting, “J-1 physicians both learn about and contribute significantly to care delivery in the U.S. Their presence reduces wait times, ensures continuity of care and strengthens local health systems.” Disruptions to visa renewals could affect physician training and healthcare delivery, especially in underserved areas.
Visa Numbers and Regional Reliance
In 2025, Intealth sponsored nearly 17,500 J-1 physicians working at almost 780 teaching hospitals, marking a 76%
rise over the past decade. A Health Affairs study for the 2023-2024 academic year reported over 14,000 J-1 physicians in U.S. residency programs. Reliance on these trainees is highest in North Dakota (29% of physicians-in-training), Connecticut (17%) and West Virginia (17%), with strong presence in the Upper Midwest, Northern Plains and Appalachian regions facing physician shortages.
Indian students represented the largest group of international students enrolled in U.S. institutions during the 2024-2025 academic year, with about 360,000 individuals comprising nearly 31% of the 1.1 million international student population.
Extension Process Shifts to Federal Oversight
Students enrolled in extended academic programs must apply for Extension of Stay
approval through USCIS, which will conduct biometric vetting, background checks and fraud screenings as part of the process. This represents a transfer of responsibility from university staff to federal agencies. Historically, visa extension processing times for J-1 physicians have reached up to 19 months, raising concerns about potential delays under the new system.
Additionally, the policy shortens the grace period for F-1 students after program completion from 60 days to 30 days, reducing the time available before leaving the U.S. or changing visa status.
Stakeholder Responses and Institutional Impacts
The Association of American Medical Colleges (AAMC) opposes the policy, stating, “We strongly believe there is
no compelling need to change the current visa system for international students, trainees and postdoctoral scholars.” The AAMC emphasizes that “the final rule does not take into account the breadth of complexities of graduate, postdoctoral, and medical residency programs, many of which often take longer than four years to complete.”
The American Hospital Association, representing care providers, pointed to extensive existing screening conducted by Intealth and warned about administrative burdens from duplicate data collection and the costs of extension applications. These new requirements could affect staffing and continuity of care, especially in high-need specialties and underserved communities.
Intealth announced it
will transition some annual sponsorship documentation to multi-year forms while maintaining annual visa renewals. It plans continued advocacy to engage with government agencies and stakeholders to mitigate impacts on J-1 physicians and training institutions.
Policy Objectives on Security and Visa Fraud
DHS states that ending indefinite stays and implementing clear visa duration limits strengthens immigration oversight, reduces visa fraud, and enhances national security by ensuring foreign students’ presence aligns with their academic objectives. The biometric and background screening processes embedded in extension applications intend to tighten control over nonimmigrant admissions.
