J1 visa denial 214(b).

I’m a Non-US IMG from bangladesh and recently matched into a U.S. Internal Medicine residency. I’m preparing for my second J-1 visa interview and would really appreciate advice from anyone who has dealt with a similar situation.

Here is my timeline:

• May 4, 2025: I was diagnosed with gastric ulcer on endoscopy and started treatment.
• May 9, 2025: I traveled to the U.S. on a B1/B2 visa. During my visa interview, I had stated that my purpose was to take USMLE Step 3.
• At the time of travel, I had a Step 3 scheduling permit, with an eligibility period of September–November 2025, although I had not booked a specific exam date.
• I also had an 8-week observership arranged in Detroit.
• I stayed in the U.S. for approximately 7 weeks. I continued my ulcer treatment and carried my medications with me.
• Unfortunately, my symptoms worsened during my stay, so I decided to return back on June 30, 2025, before my Step 3 eligibility period began.
• I ultimately did not take Step 3.

Fast-forward to 2026: I matched into an Internal Medicine residency and applied for a J-1 visa.

At my first J-1 interview, the officer asked me for my Step 3 report. I explained that I had not taken Step 3 and that I had returned back because my ulcer symptoms worsened. He then asked how long I had stayed in the U.S. When I said approximately 7 weeks, he said something along the lines of “Things are not making sense. You said you did an observership, but you had the ulcer before going and you didn't take Step 3.”

officer was unknown about my step 3 timeline.

I explained that the observership had been arranged before my trip, that I was already under treatment for the ulcer, and that my symptoms worsened later, leading me to return home.

He gave me a pink slip requesting my USMLE transcript and evidence of the ulcer. I submitted my USMLE transcript and the endoscopy report I had from before my trip. I did not submit the prescription/medical treatment records or the repeat endoscopy I had after returning back, which also showed a ulcer with gastroduodenitis.

I received a 214(b) refusal after submitting the documents.

This was my only visa refusal.

I now have another J-1 interview coming up soon. I’m concerned that the officer may still have doubts about my previous B1/B2 trip and why I did not take Step 3.

Also my previous visa was single entry of 6 months.

What would you recommend I do differently this time?