Foreign doctors in the United States on a J-1 visa are generally required to depart the country upon the completion of their program. But, a J-1 visa waiver for physicians can help you stay and work in the United States. Physicians must fulfill the two-year home-country physical presence requirement. However, if the physician receives a job offer to work in Health Professional Shortage Areas (HPSAs), Medically Underserved Areas (MUAs) or the Department of Veterans Affairs (VA) for three or more years, these requirements can be waived.
There are quite a few programs for which J-1 visa physicians could opt, and they include the following:
- Conrad 30 Waiver Program
- Health and Human Services Waiver (HHS)
- Appalachian Regional Commission (ARC)
- Delta Regional Authority (DRA)
- Veterans Administration (VA)
- Hardship or Persecution Waiver
Let’s take a look at each of the programs and waivers.
Conrad 30 Waiver Program
The Conrad 30 program is in place for J-1 physicians who wish to work as a medical professional in underserved areas. The physician can apply to waive the two-year home residency requirement upon the completion of their J-1 program.
According to the United States Citizenship and Immigration Services (USCIS) website, J-1 physicians must meet each of the following requirements:
- Entered the U.S. under section 101(a)(15)(J) of the Immigration Nationality Act (INA) to receive graduate medical training
- Agree to full-time employment for at least three years with an H-1B visa status, at a designated health care facility, especially in an area designated by U.S. Department of Health and Human Services (HHS) as an HPSA, MUA, or MUP, or serve patients who reside in HPSA, MUA or MUP areas
- Provide an employment contract pertaining to the full-time work
- Provide a “no objection” letter from his or her home country if the J-1 visa exchange program was funded by the physician’s home government
- Agree to start employment within 90 days of receiving the waiver
Another important component to the Conrad 30 process is supplying proof of non-immigrant intent. Meaning,the foreign physician must demonstrate concrete plans of returning to his or her country of origin upon the completion or fulfillment of their employment tenure.
Such documents include, but are not limited to the following:
- Proof of property ownership
- Evidence of familial ties in their homeland
- Memberships in certain organizations
To apply for the Conrad 30, applications must be submitted to the state’s healthcare agency. Though each state has its own deadlines, the time frames are usually between August and January.
The Conrad 30 program is state specific, wherein each state is authorized to accept up to 30 medical students each year.
Health and Human Services Waiver
HHS waivers are in place for primary care physicians only. Furthermore, the medical facility must have an HPSA score of 7. Unlike the Conrad 30 waiver, there is no limit on HHS applications per year. Additional information about clinical care waiver requirements, physician and program eligibility, as well as information for employers can be found on the HHS website.
Appalachian Regional Commission
The Appalachian region spans across 13 states, from Mississippi to New York. If the foreign physician lives/serves in the below states, there is a high probability he or she can apply for the ARC. The states are as follows:
- New York
- North Carolina
- South Carolina
- West Virginia
Delta Regional Authority
There are eight DRA states, comprised mostly of Southern States. Each of which has its own unique landscape and is complete with diversity, culture and history. Equally as important is the opportunity boasted in each of these states. They are the following:
More information about opportunities according to state can be found on the DRA website.
Similarly, The U.S. Department of Veteran Affairs is also authorized to request home residency waivers for foreign physicians - with the caveat that the VA facility must be able to demonstrate an overwhelming need for healthcare providers.
Unlike many other programs, physicians working in a VA facility are not required to work in medically underserved areas.
Waivers Requested for Physicians
An alternative could also be either of the following scenarios:
- A U.S. government agency wishes to request a waiver for the physician because he or she is substantially and actively involved in an activity or program sponsored by the agency, or the physician and their profession is of interest to the agency
- A state's Department of Public Health (DPH) or an equivalent state agency wishes to request a waiver on behalf of the physician
Hardship or Persecution Waivers
Lastly, J-1 waivers for home-country residence requirements for physicians can be based on a foreseeable, sustained hardship or persecution.
- The physician’s U.S. or lawful permanent resident spouse or child would suffer an exceptional hardship if the physician were to depart the U.S. and return home
- The physician would face persecution based on his or her race, political opinion or religion if he or she were forced to return to their home country
Conclusion of J-1 Visa Waiver for Physicians
Physicians with J-1 visas who have moved to the U.S. to participate in clinical training programs are responsible for satisfying all of the J-1 Exchange Visitor agreements. This includes leaving the U.S. promptly upon program completion. So as to remain and continue working in the medical profession, doctors can petition for a J-1 visa waiver.
These waivers are specifically for the home residency requirement J-1 visa holders must typically satisfy after their training ends. There are many opportunities in medically underserved and shortage areas, which gives international medical graduates a chance to stay and work in their profession, in the United States.
It is important to note that these waivers are usually sponsored by interested government agencies, which include state Conrad 30 programs or United States federal agencies.
The following list are the programs, agencies or options J-1 physicians may consider:
- Conrad 30 Waiver Program
- Health and Human Services Waiver
- Appalachian Regional Commission
- Delta Regional Authority
- Veterans Administration
- U.S. government agency or Department of Public Health
- Hardship or Persecution Waivers
Frequently Asked Questions About J-1 Visa Waiver for Physicians (FAQs)
I’m planning on establishing my medical practice. Can I do this and receive a J-1 waiver?
Unfortunately the majority of J-1 waiver programs do not give waivers to employers. Though it is not entirely impossible.
How do I know if I am required to satisfy the two-year home-country physical presence requirement?
J-1 program sponsors typically inform J-1 visa holders. However, the physician will most likely have this requirement if he or she is in a government-funded exchange program, has a specialized knowledge or skill, or is a graduate student in medical training/education.
Is the health profession position required to be in a medically underserved, shortage area or VA to get the J-1 waiver for physicians?
No. Out of the 30 J-1 waiver slots, each state health department can use up to five of them for non-medically underserved areas. The condition is that the patients living in MUAs must be treated by the J-1 physician.
Is it possible to change my F-1 or J-1 status to an H-1B after reaching an H-1B cap?
No. J-1 physicians cannot be granted this type of grace period.