Exchange Visitor Sponsorship Program (EVSP)
Applying for Sponsorship
General Requirements
Statement of Need
U.S. Public Law 94-484, effective January 10, 1978, requires that J-1 physician applicants provide a letter of need from the Ministry of Health of the country of most recent legal permanent residence. Such a letter must provide written assurance, satisfactory to the Secretary of the United States Department of Health and Human Services, that there is a need in that country for persons with the skills the alien physician seeks to acquire.
If the applicant is a permanent resident of a country other than that of citizenship, the Statement of Need (SoN) must come from the Ministry of Health of the country of most recent legal permanent residence.
In cases in which a new or updated SoN is required, an original, official SoN issued directly from the Ministry of Health in the country of most recent legal permanent residence must be submitted directly to ECFMG. SoN letters can be submitted EITHER by mail/courier service OR electronically as described below.
Regardless of submission method, per the U.S. Code of Federal Regulations (CFR), all SoNs must:
- Be issued by the federal/central office of the applicant’s country of most recent legal permanent residence
- Be issued on official Ministry of Health letterhead and addressed to ECFMG
- Exactly follow prescribed wording outlined in the CFR §62.27 (see Statement of Need Instructions for Ministry of Health Officials)
- Specify a need that exactly matches the name of the training specialty/subspecialty being pursued
- Contain the official stamp or seal of the issuing government and dated signature of issuing official on the SoN
- Be issued in English; if not issued in English, a certified word-for-word English translation is required (again, please note that the SoN and any translation must follow regulatory prescribed language)
Requirements for Submitting an SoN by Mail/Courier Service
- To be accepted by ECFMG, the original SoN must be received in the original, sealed envelope of the Ministry of Health. In addition, the Ministry of Health official issuing the letter must place it in a Ministry of Health envelope and stamp the outside flap with the issuing government seal.
- SoNs in sealed Ministry of Health envelopes must be mailed directly to ECFMG either by the Ministry of Health or the applicant. If sent by an applicant, the applicant must place the sealed envelope containing the SoN in an envelope. The document should be forwarded directly to ECFMG; if the sealed envelope is opened, ECFMG will not accept the SoN. In all cases, use of a courier service is recommended. The mailing address is: EVSP/ECFMG, 3624 Market Street, Philadelphia, PA 19104 USA.
Requirements for Submitting an SoN Electronically
- To be accepted by ECFMG, the electronic SoN must be submitted as a PDF file from an official and recognized Ministry of Health e-mail address, to ECFMG at [email protected]. The electronic SoN must be a scanned version of the original SoN, which has been fully executed with a hand signature and official stamp or seal. Electronic SoNs must meet all other specifications of a qualifying SoN as listed above, like signatory, letterhead, and text requirements.
- Do not send the original physical copy by mail if an electronic SoN is submitted.
Any SoN that does not meet all of the above-specified requirements will not be accepted. If the original SoN is not issued in English, the Ministry of Health may provide a copy of the SoN to the applicant for the purpose of obtaining an English translation. The certified English translation may either be submitted in the sealed envelope with the original SoN, electronically by e-mail to [email protected], or it may be submitted to ECFMG separately. Both the original SoN and a certified English translation, if applicable, are required as part of the application.
Statement of Need Instructions for Ministry of Health Officials

