Clinical activities of Visiting Fellows must explicitly be under the direct supervision and control of an NIH employee physician and are limited to the incidental patient contact level.

Special Volunteers may be eligible for incidental patient contact depending on their professional credentials.

Clinical Collaborators may have full patient contact privileges when they are sponsored by another U.S. medical institution and are coming to NIH for clinical research and/or rotation. Non-Clinical Collaborators may have incidental patient contact.

FTE clinical designations must possess both the qualifying credentials and a visa classification that authorize full patient contact privileges.

FTE non-clinical designations may be eligible for incidental patient contact depending on their education history. Consult with the NIH Credentialing Services for more information.

Incidental Patient Contact: Patient contact is limited to "incidental patient contact" where the primary purpose is for research, teaching or observation. After the IC provides a four-point memo, DIS prepares an Incidental Patient Contact statement for review by the designated NIH senior medical official for signature.

Full Patient Contact: J-1 Alien Physicians sponsored by the Educational Commission for Foreign Medical Graduates (ECFMG) are the only J-1 Exchange Visitors authorized to engage in full patient contact. The ECFMG sponsors eligible foreign medical graduates to participate in a clinical residency or fellowship program under the Alien Physician category of the J-1 visa. All applicants for J-1 sponsorship as Alien Physicians must hold a valid ECFMG certificate at the time they enter into a program of graduate medical education. Note: Graduates of U.S. and Canadian medical schools accredited by the Liaison Committee on Medical Education (LCME) are excluded from this requirement. See the “Requirements for Certification” page on the ECFMG website for further information.

Incidental Patient Contact: The alien physician must be coming to the U.S. primarily to teach and/or conduct research. No patient care may be performed except that which is incidental to the physician's teaching or research. Please see the "I-129 Worksheet". DIS requires a four-point memo for approval by the designated NIH senior medical official.

Full Patient Contact: An alien physician may engage in full patient contact as an H-1B Temporary Worker. The alien physician must meet and provide evidence of all of the criteria listed on the "I-129 Worksheet".

Incidental Patient Contact: TN status is available only to Canadian and Mexican citizens. The alien physician must be coming to the U.S. primarily to teach and/or conduct research. No patient contact may be performed, except that which is incidental to the physician's teaching or research. DIS requires a four-point memo for approval by the designated NIH senior medical official.

Full and Incidental Patient Contact: O-1 status is reserved for Aliens of Extraordinary Ability who are among the small percentage of individuals that have risen to the very top of their field of endeavor, and who are coming to the U.S. to continue work in the area of extraordinary ability by engaging in a specific event. The level of patient contact must be described in the O-1 petition filed with USCIS by DIS. Copies of the individual's medical credentials must be included in the petition. If incidental patient contact is requested, DIS also requires a four-point memo for approval by the designated NIH senior medical official.

Individuals holding J-2 status may apply directly to USCIS for an Employment Authorization Document (EAD). This EAD allows for unrestricted employment, including full patient contact privileges.

Dependents holding A-1, A-2, G-1, G-3, or G-4 status may apply through their sponsoring international organization or diplomatic post and the Protocol Office of the Department of State under certain circumstances for each status. Dependents in A & G status should consult their sponsoring organization for more information. A & G status holders are given neither explicit patient contact permission by visa status, nor are they prohibited from having full or incidental patient contact by their visa status. The only requirement is that the individual be qualified to practice medicine in the United States.

Patient contact is not permitted. But, see information below on "medical clerkships":

Medical clerkship: An individual who is studying at a foreign medical school and enters the U.S. temporarily in order to take an "elective clerkship" at a U.S. medical school's hospital without remuneration from that hospital. An "elective clerkship" affords practical experience and instruction in the various disciplines of medicine under the supervision and direction of faculty physicians at a U.S. medical school's hospital as an approved part of the individual's foreign medical school education.