I am an H-1B physician, and I will be completing my residency program in June. I will subsequently be employed by a for-profit physician group, and therefore, I cannot start working until October 1st. What can I do during the summer?

This problem comes about with some degree of frequency for H-1B physicians, because there is no standard way for these physicians to bridge the gap between the end of their typically cap exempt graduate medical program and the beginning of their often cap subject employment. Stay informed on the comprehensive immigration reform debate, as its passage could bring with it an excellent "cap gap" measure that would solve this problem once and for all. Until then, here are some thoughts:

1. Cap exemption

Perhaps you have already thought about cap exemption, but you believed it could not apply, because your employer is neither a university nor a non-profit organization. However, does the same hold true for all of your work locations? If your employer will compensate you to perform job duties at a cap exempt institution that directly and predominately further the objectives of the cap exempt institution, you may be able to qualify for cap exemption anyway.  Alternatively, the cap exempt organization could file an H-1B petition for you, and your employer could file a concurrent H-1B to benefit from the cap exemption of the first petition.

2. Derivative status through a spouse

If your spouse has any status or pending status (such as a pending green card case), you may be able to qualify for a derivative status. Some of these types of status will confer work authorization on you, and others will not. However, all such statuses will allow you to remain in the U.S. for a period of time.

3. Vacation/Locum Tenens

The summer could present an excellent opportunity for you to take a vacation after the long hours of your residency or fellowship program. Alternatively, if you want to work during your summer, there are several locum tenens (essentially temporary) doctor positions for which you may qualify. Locum positions are available all over the world, so you may be able to combine vacation and work.

There are other possible strategies, but many of them introduce an element of risk. Hopefully, comprehensive immigration reform will pass, and this issue will simply evaporate!