Medical Physicist Visa Sponsorship: The CAMPEP Residency Bottleneck and Who Can Sponsor You

Health/Medical Physics is CIP 51.2205, which sits on the DHS STEM list and buys you 36 months of OPT. The hard part is the residency. In the 2026 MedPhys Match there were 199 positions for 430 registered applicants.

You are in the second year of a CAMPEP-accredited medical physics program, the MedPhys Match opens in the autumn, and you have just realised that nobody in your department can tell you whether the residency programs you are about to spend money applying to will take someone on an F-1 visa.

That is the actual bottleneck. Not the degree, not the board exams, not the job market at the end. The residency.

Three facts to anchor the rest of this page.

Your degree is on the STEM list. Health/Medical Physics is CIP 51.2205, and it appears on the DHS STEM Designated Degree Program List. So do all the other codes medical physics programs get filed under. That means 12 months of OPT plus a 24-month extension — 36 months of work authorization, which is longer than a residency.

The residency is genuinely competitive, and the numbers are public. In the 2026 MedPhys Match, 430 applicants registered against 199 positions offered. Only four positions went unfilled.

The best sponsorship news in this field is structural. A large share of CAMPEP residencies and staff physicist jobs sit at university-affiliated academic medical centers — precisely the category of employer that can file H-1B petitions outside the annual lottery.

This page covers the CIP question, the residency bottleneck, who actually sponsors, the alternate ABR pathway if you never match, and state licensing. It is procedure, not legal advice.

Your degree is on the STEM list — check the CIP code, not the title

The DHS STEM Designated Degree Program List (last updated July 22, 2024, and still the most recent published version as of this writing) determines whether you get the 24-month STEM OPT extension. Medical physics is on it, and so is essentially every adjacent coding:

This is unusually good news, and it is worth understanding why it matters. Medical physics programs are administratively homeless — some live in a physics department, some in a school of medicine, some in radiation oncology, some in nuclear engineering. Depending on which, your school may have reported any of the codes above. All of them qualify.

What still gets people is the gap between the degree name and the reported code. The number that controls your STEM OPT eligibility is the CIP code printed on your Form I-20, not the one on the department's website and not the one a professor remembers. Look at it now. If it is wrong or unexpected, only your DSO can address it, and only their record controls. For the mechanics of reading the list, see the full DHS STEM designated degree list and how to read your CIP code.

The 36-month runway, and why it fits a residency almost exactly

Post-completion OPT gives you 12 months. The STEM extension adds 24. Total: 36 months of work authorization on your F-1 record.

A CAMPEP therapy or imaging residency is typically 24 months. CAMPEP flags some programs as running longer than 24 months, often because they include a research component, and those are marked on its published list.

Line those up and the arithmetic is favourable: OPT plus the STEM extension can cover a standard two-year residency end to end, with roughly a year left over for the transition into a staff position. That is the single most useful thing to know when you talk to a program. You are frequently not asking a residency to sponsor anything. You are asking them to employ someone who already holds work authorization and whose employer obligations are a Form I-983 training plan and E-Verify enrollment.

Two constraints on that plan.

The unemployment clock. You may not accrue more than an aggregate of 90 days of unemployment during post-completion OPT, or more than 150 days aggregate across the total OPT period once the STEM extension is counted. Residencies start on a fixed calendar — most around July 1 — and if you graduate in May and do not match, that gap eats your allowance fast. The 90-day unemployment clock explains how the count works and what to do while it runs.

The STEM extension has employer conditions. Your residency employer must be enrolled in E-Verify, must hold an IRS-issued EIN, and must sign a Form I-983 training plan. A large hospital system will almost always be enrolled; a small private physics practice may not be, and may not know what you are asking. If your search returns nothing when you check, read what a blank E-Verify employer search actually means before you panic — four of the five causes are database artifacts.

The residency bottleneck, in numbers

The MedPhys Match is run by National Matching Services for the AAPM, and it publishes a full statistical summary every year. Here is the 2026 cycle:

Read those last two rows together. Nearly every position filled, and 148 applicants who went all the way to a rank order list did not match. This is a supply-constrained market, and the shortage is positions, not candidates.

Two more numbers from the same report tell you how to behave. Applicants submitted an average of 25.3 applications each — the entire pool sent 10,203 applications. And interviews are what separate matched from unmatched: matched applicants averaged 4.3 residency interviews, unmatched applicants averaged 2.4.

Important caveat, stated plainly: these figures describe the whole applicant pool, not international applicants specifically. NMS does not publish a citizenship breakdown, so nobody — including us — can tell you an international-specific match rate. What the numbers do establish is that the base rate is demanding before visa status enters the picture, and that the answer to "how many programs should I apply to?" is "more than you think."

One structural note worth knowing: residencies do not have to be CAMPEP-accredited to participate in the Match. The NMS rules say so directly and require programs to disclose their accreditation status, "since it may affect their eligibility for future Board certification." Check accreditation on the CAMPEP list yourself rather than trusting the Match listing alone. A non-accredited residency can cost you ABR eligibility, which is the whole point of doing one.

Who actually sponsors, and why cap-exempt is the headline

This is where medical physics is better positioned than most fields, and where most candidates undersell themselves.

The cap-exempt categories

H-1B petitions are exempt from the annual numerical cap when the petitioner or the worksite is:

1. An institution of higher education
2. A nonprofit entity related to or affiliated with an institution of higher education
3. A nonprofit research organization
4. A governmental research organization

USCIS's own description of category 2 names the relevant institutions outright — a related or affiliated nonprofit entity is one "including but not limited to hospitals and medical or research institutions" that is connected to an institution of higher education through shared ownership or control, operation by the institution, or attachment to it as a member. The nonprofit must also be organized under section 501(c)(3), (c)(4) or (c)(6) and approved by the IRS as tax-exempt for research or educational purposes.

Cap-exempt means no lottery and no March filing season. A petition can be filed at any point in the year and, if approved, you start. For a field where the training pipeline runs on a fixed July calendar and the lottery odds are what they are, that is not a marginal advantage — it can be the entire difference between a career in the US and a return ticket.

Look at where CAMPEP residencies actually sit and the pattern is obvious. The accredited list is full of university medical centers, medical school programs, and university-affiliated cancer centers. Our guide to cap-exempt hospitals and university health systems covers how to identify them, and cap-exempt employers who petition outside the lottery covers the wider category.

⚠️ Cap-exempt status is the employer's determination, not yours. Do not infer it from a hospital's name, its academic affiliation on a website, or the fact that residents rotate through a medical school. The employer and their immigration counsel decide whether they qualify and must establish it in the petition. Ask the question directly — does your institution file cap-exempt H-1B petitions? — and accept the HR answer. Guessing wrong costs you a lottery cycle you cannot get back. This is also the reason not to assume the opposite: plenty of candidates rule out an academic medical center because they assume the March lottery applies, when it does not.

The employers that are not cap-exempt

The CAMPEP residency list also includes private physics practices and consulting groups — organisations like independent medical physics companies serving multiple clinics — and for-profit hospital systems. These are legitimate training environments and some are excellent. They are simply cap-subject, which means an H-1B for one of them goes into the March lottery like any software engineer's.

That does not make them a bad choice. It makes them a different choice, one where your OPT and STEM OPT runway matters more, and where you should be honest with yourself about the timeline.

How to check a specific employer

Do not rely on a recruiter's assurance or on a lifetime H-1B count from an aggregator. Two primary sources:

• The USCIS H-1B Employer Data Hub, read for the most recent fiscal year rather than cumulative totals.
• DOL OFLC disclosure data, which shows actual Labor Condition Applications with job titles, worksites and wage levels.

One classification note. The BLS Standard Occupational Classification system has no separate code for medical physicists — the occupation sits within the broader physicist classification, SOC 19-2012. Employers file LCAs under a range of codes depending on how the role is written, so if you are checking prevailing wage levels, look at the actual LCA rather than searching for a "medical physicist" occupation that does not exist as a discrete SOC. Our five-method checklist for confirming H-1B sponsorship covers the full search method.

The ABR ladder, and where visa status intersects it

Board certification is what makes you employable as an independent clinical physicist, and the American Board of Radiology sets the sequence. It matters here because each rung has a training or employment requirement, and every training or employment requirement is a work-authorization question.

Part 1 Qualifying Exam. You can sit it if you are enrolled in or have graduated from a CAMPEP-accredited graduate, certificate or DMP program; or are enrolled in or have completed a CAMPEP-accredited residency; or are in an ABR-approved Structured Mentorship program. Once approved, you have five years to pass it.

The credential evaluation trap. The ABR states that if all of your degrees are from outside the US or Canada and you are enrolled in or have completed a CAMPEP certificate or residency program, you must have a NACES credential evaluation sent directly to the ABR, requesting a "general" or "document" review. This surprises people late, and it takes time. Start it early.

Part 2 Qualifying Exam. Requires that you have passed Part 1, and that you have completed or are on track to complete a CAMPEP-accredited residency or DMP program by August 31 of the exam year. You must also have started residency training within 10 years of passing Part 1. If you are in a three- or four-year program, you must finish the entire program regardless of how it is structured.

Board eligibility window. You have six full calendar years from completion of residency or Part 2 approval, whichever comes first, to obtain initial certification.

Part 3 Oral Certifying Exam. Requires passing Part 1 (both General and Clinical) and Part 2.

The visa reading of that ladder is simple. Part 2 is gated on a residency you have to be legally employed to complete, and the board-eligibility window is a clock that runs while you are also managing OPT expiry, an H-1B filing, or both. Sequence them together on one page, with your DSO, before your final year.

If you never match: the IMPG Structured Mentorship Pathway

For readers who trained abroad, or who have exhausted the Match, the ABR runs an International Medical Physics Graduate (IMPG) Structured Mentorship Program Pathway. It is a genuine alternative and it is worth knowing precisely, because it is often described inaccurately.

Prerequisites:

• You completed training in a non-US, non-Canadian country
• Transcripts showing you completed the equivalent of a master's degree in medical physics from a CAMPEP-accredited program
• Documentation verifying your ability to practise medical physics independently in your country — certification, registration or a similar credential
• Documentation of at least one year of clinical employment as a medical physicist in your country

Eligibility requirements:

• Secure a clinical training site in the US that has a CAMPEP-accredited residency program, with a supervisor who is an ABR-certified medical physicist
• Be employed in the US as a medical physicist — a junior physicist or medical physics assistant position is acceptable
• Complete two years of clinical training within four years of your start date, preferably at one institution. A maximum of two institutions may be used, and you must complete at least 18 months at the institution where you finish

Note what the second bullet really says. "Be employed in the US" is a work-authorization requirement wearing different clothes. This pathway does not route around the visa problem; it relocates it. You need an employer willing to hire you into a junior physicist or assistant role and support your status, at an institution that happens to host a CAMPEP residency. The upside is that the same cap-exempt logic applies — if that institution is a university-affiliated academic medical center, the H-1B is not a lottery question.

The ABR also requires structured rotations across diagnostic, nuclear and therapeutic medical physics, coverage of the six ABMS/ABR competencies, an annual progress statement to your supervisor, and a documented portfolio that the ABR may audit.

State licensure is a separate gate

Board certification and state licensure are different things, and the second one is easy to miss until it blocks a start date.

Licensing is set state by state, and only some states license medical physicists at all. Texas is the clearest example and worth studying even if you are not going there, because it shows what the requirement looks like in practice. Under Texas Occupations Code Chapter 602, the Texas Medical Board licenses medical physicists in four specialties — diagnostic radiological physics, therapeutic radiological physics, medical nuclear physics, and medical health physics.

Texas also issues a temporary medical physicist license, valid for one year, for work performed under the supervision of a licensed medical physicist holding a license in that specialty. That is the instrument a resident or a mentorship-pathway trainee would typically be working under.

Two rules to carry:

1. Check the licensing board of the state where the job actually is, not the state where your school is. Requirements and whether licensure exists at all vary.
2. Ask about licensure timing before you accept an offer, because a licence application that takes months can collide with an OPT start date or an H-1B validity period.

We are not listing other states here. Licensing statutes change, and a stale list in a blog post is worse than no list — go to the state board.

What to do, and when

Two years before graduation. Confirm the CIP code on your I-20. Confirm your program's CAMPEP accreditation status. Start building the research or clinical record that will make you interview-competitive, because interviews are the variable that separates matched from unmatched.

Twelve to fifteen months out. Build your program list from the CAMPEP accredited list, not from the Match list alone. For each program, email the GME or HR office — not only the program director — and ask two questions: does the institution employ residents who hold OPT or STEM OPT work authorization, and does the institution file cap-exempt H-1B petitions. Record the answers. Apply broadly; the pool average was 25 applications.

Nine months out. File your I-765 for post-completion OPT within the window your DSO confirms, and pick a start date that does not strand you between graduation and a July residency start. Begin any NACES credential evaluation you will need.

During residency. Get your employer's E-Verify and I-983 obligations settled in month one, not month twelve. Track unemployment days if there is any gap. Map your ABR exam sequence against your OPT expiry on a single calendar.

Final year of residency. Talk to your employer about H-1B timing. If they are cap-exempt, there is no March deadline and the conversation is easier than you expect. If they are not, you need the lottery calendar and a fallback.

Where this stops and someone else starts

This page describes structures. It cannot describe your case.

Your DSO owns your SEVIS record and is the only person who can confirm your CIP code, recommend the STEM extension, or tell you how many unemployment days you have accrued. Anything touching status maintenance goes to them first.

An immigration attorney owns the strategy questions: whether a particular employer qualifies as cap-exempt, whether your record supports O-1A or an EB-2 national interest waiver, how a residency at one institution and a staff job at another sequence together, and anything involving a prior status issue. The H-1B versus O-1 comparison for researchers is a starting frame, not an assessment.

The employer's HR and counsel decide cap-exempt eligibility and licensure support. Ask them plainly and in writing.

And one thing no one else will tell you: a residency program that will not answer a straightforward question about work authorization in writing has told you something useful about how the next two years will go. Ask early, ask the right office, and keep the reply.

Frequently asked questions

Is a medical physics degree eligible for the 24-month STEM OPT extension?

Yes. CIP 51.2205 Health/Medical Physics appears on the DHS STEM Designated Degree Program List, and so does every other code a medical physics program is commonly filed under, including 40.0801 Physics General, 40.0806 Nuclear Physics, 40.0899 Physics Other, 14.2301 Nuclear Engineering, 14.0501 Bioengineering and Biomedical Engineering, and 26.0203 Biophysics. That gives you 12 months of post-completion OPT plus a 24-month extension, or 36 months total. Check the CIP code printed on your Form I-20 rather than assuming from your degree title, because the code your school reported is the only one that counts.

How competitive is a CAMPEP residency for an international applicant?

The National Matching Services summary for the 2026 MedPhys Match reports 430 applicants registered and 199 positions offered across 122 registered residencies. Of the 343 applicants who submitted rank order lists, 195 matched and 148 did not. Only 4 positions went unfilled. Those numbers describe the whole applicant pool, not international applicants specifically, and they do not capture the additional filter of whether a given program will sponsor. Assume the search is harder than the headline ratio suggests and apply broadly.

Do CAMPEP residency programs sponsor visas?

Some do and some do not, and there is no central list. Residency programs sit at academic medical centers, community hospital systems, cancer centers, and private physics practices, and each institution sets its own policy on hiring a resident who needs work authorization. Many international residents use post-completion OPT and the STEM extension to cover the two-year training period, which avoids asking the program to file anything. Ask each program directly and early, before you spend an application fee, and get the answer from the graduate medical education or HR office rather than from the program director alone.

Can a hospital file a cap-exempt H-1B for a medical physicist?

It can if the hospital fits one of the statutory categories. H-1B petitions filed by an institution of higher education, by a nonprofit entity related to or affiliated with an institution of higher education, or by a nonprofit or governmental research organization are not counted against the annual cap. USCIS names hospitals and medical institutions explicitly in its description of related or affiliated nonprofit entities. Many university-affiliated academic medical centers therefore petition outside the lottery, while a for-profit hospital chain or a private physics practice generally does not. Whether a specific employer qualifies is a determination for the employer and their counsel, not something you can infer from the name.

What happens if I never match into a CAMPEP residency?

You do not automatically lose the career, but the standard route to ABR certification closes. The ABR requires a completed or in-progress CAMPEP-accredited residency or DMP program for Part 2 eligibility. The alternate route is the International Medical Physics Graduate Structured Mentorship Program Pathway, which requires that you trained outside the US and Canada, can document at least one year of clinical employment as a medical physicist in your country, secure a US clinical training site that has a CAMPEP-accredited residency program and an ABR-certified supervisor, and be employed in the US as a medical physicist, where a junior physicist or medical physics assistant position is acceptable. That employment requirement is a work authorization requirement in disguise, so the visa question does not go away on this path.

Do I need a state license to work as a medical physicist?

In some states, yes, and it is separate from ABR board certification. Texas is the clearest example. Under Texas Occupations Code Chapter 602 the Texas Medical Board licenses medical physicists in diagnostic radiological physics, therapeutic radiological physics, medical nuclear physics, and medical health physics, and it issues a temporary medical physicist license valid for one year for work supervised by a licensed medical physicist in that specialty. Licensing rules are set state by state and change, so check the licensing board of the state where the job actually is before you accept an offer.

Should I consider O-1A or EB-2 NIW rather than waiting on the H-1B lottery?

They are real options for some medical physicists, particularly researchers with a substantial publication and citation record from a PhD, but they are evidence-intensive and neither is automatic. If your training path runs through a cap-exempt academic medical center, the lottery may never be your binding constraint in the first place, which changes the calculation entirely. Whether your actual record supports either classification is a judgement for an immigration attorney who has read your CV, not a self-assessment against a criteria list.

Medical physics is one of the few clinical-adjacent fields where the degree is STEM-designated, the training period fits inside the OPT runway, and a large share of employers can petition outside the H-1B lottery. The bottleneck is the residency, and the way through it is applying widely and asking the sponsorship question in writing before you apply. F1Jobs works with international students and clinicians through the sponsorship side of the search, from a first residency application to a cap-exempt offer. This article is general information, not legal advice.