New ACGME recognition for non-standard training of J-1 exchange visitor physicians International medical graduates who seek entry into U.S. programs of graduate medical education (GME) or training must obtain an appropriate visa that permits clinical training activities. The most commonly used visa to participate in U.S. GME programs is the J-1, a temporary nonimmigrant visa. The Educational Commission for Foreign Medical Graduates (ECFMG) is authorized by the U.S. Department of State (DOS) to sponsor J-1 foreign national physicians in clinical training programs. ECFMG clinical training sponsorships All clinical training must be provided within an Accreditation Council for Graduate Medical Education (ACGME)-accredited Sponsoring Institution.