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DIS Title Divider Administrative Staff Title Divider Incidental Patient Contact
Administrative Staff​
Patient Contact, Incidental

How to Apply for Incidental Patient Contact for NIH-Sponsored
Foreign Scientists Holding a J-1 Visa

I. APPLYING FOR INCIDENTAL PATIENT CONTACT AS PART OF A NEW or RENEWAL REQUEST.

BASIC RULE No. 1: Apply for incidental patient contact (IPC) to be effective at the start of the award / appointment / assignment period.

BASIC RULE No. 2: When in doubt about whether IPC will be needed to fulfill a foreign scientist's research program, apply for it.

BASIC RULE No. 3: Do not invite a foreign medical graduate to NIH with the intent to request a change from no to incidental patient contact at a later date.

(a) Department of State regulations governing the Exchange Visitor (J-1) Program require that there be no change in program objective (e.g., change in patient contact status) during the course of an appointment period.

(b) A change from no patient contact to IPC may not be effected during the course of an award/appointment/assignment (i.e., during the period of stay specified in a foreign scientist's Form DS-2019.

(c) A change from no patient contact to IPC is possible at the time of renewal (see Section II. below).

THEREFORE:

(d) Apply for IPC as part of the initial award/appointment/assignment package or when submitting a renewal request for a foreign scientist who is already at NIH and whose stay in the U.S. is expiring.

REQUIREMENTS:

(a) "Four-Point" Memorandum

(b) Clear explanation of the need for IPC in the "Description of Proposed Research Program" block of Form NIH 829-1 (Visiting Scientists), Form NIH 829-2 (Visiting Fellows), Form 829-7 (Post-doctoral Supplemental Visiting Fellows only), or the "Brief Description of the Work to be Performed" block of Form NIH 590 (Special Volunteers only).

(c) Copy of Educational Commission for Foreign Medical Graduates (ECFMG) certification. 

II. CHANGING FROM NO PATIENT CONTACT TO INCIDENTAL PATIENT CONTACT ATTHE TIME OF RENEWAL.

BASIC RULE: There should be no change in an Exchange Visitor's purpose after arrival in the United States. However, should incidental patient contact become necessary, it may be applied for during the request for extension of stay (renewal) of the foreign scientist.

REQUIREMENTS:

(a) "Four-Point" Memorandum

(b) Clear explanation of the need for IPC in the "Description of Proposed Research Program" block of Form NIH 829-1 (Visiting Scientists), Form NIH 829-2 (Visiting Fellows), Form NIH 829-7 (Post-doctoral Supplemental Visiting Fellows only), or the "Brief Description of the Work to be Performed" block of Form NIH 590 (Special Volunteers only).

(c) Cover memorandum from the sponsor through the IC's Clinical Director explaining the changed research program which now makes IPC essential and why it had not been foreseen originally.

(d) Copy of Educational Commission for Foreign Medical Graduates (ECFMG) certification.

"CERTIFICATE 3" FOR INCIDENTAL PATIENT CONTACT
(Four-point Memorandum)

INSTRUCTIONS

As required by the Department of State, a "Certificate 3" is prepared for each foreign medical graduate (FMG) sponsored under NIH's Exchange Visitor Program (J-1) visa (Research Scholar category) who will have incidental patient contact as a part of his/her research program.

At the time of submitting a request for award, appointment, or assignment, the IC must supply the DIS with the following:

1. Form NIH 829-1 (for Visiting Scientists), NIH 829-2 (for Visiting Fellows), NIH 829-7 (for Post-doctoral Supplemental Visiting Fellows only), or NIH 590 (for Special Volunteers only);

2. A copy of the FMG's ECFMG certificate, even if the certificate has expired. FMGs who have not taken the ECFMG examination, must submit proof, through their curricula vitae or other documentary evidence, of significant medical experience in the home country;

3. A memorandum from the sponsor, called the "4-point memo", through the IC Clinical Director, to the designated NIH senior medical official, outlining the participant's clinical duties. The memorandum must include(a) the name of the foreign scientist to whom it refers; (b) the name of the NIH physician who will be responsible for the FMG's patient contact; and (c) address the following four points:

    (a) that the program in which the foreign physician will participate is predominately involved with observation, consultation, teaching, or research;

    (b) that the individual's research program necessitates clinical contact with patients involved in the research -- describe contact;

    (c) the clinical privileges which are essential to carry out the research; and

    (d) that the foreign physician (1) will not be given supervisory responsibilities nor final responsibility for the treatment or diagnosis of any patients, (2) that he or she will be supervised by a U.S. citizen or permanent resident who is licensed to practice medicine in the state of (or has a PHS waiver of that requirement), and (3) that he or she will receive no credit towards medical specialty certification.

Note: A new "4-point memo" is not required for renewal of appointment if there is no change in the program or supervisor. If this is the case, specifically state so on the NIH 829-1, NIH 829-2, NIH 829-7, or NIH 590.

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