However, a doctor may request a waiver of this requirement on several different grounds: (1) anticipated prosecution; (2) exceptional hardship to a U.S citizen or permanent resident spouse or child: (3)a recommendation from an Interested Government Agency (IGA).
Conrad 30 Waiver
However, the most sought way for J-1 waiver in most cases is based upon clinical are to medically underserved communities. Through the community-based waivers, the J-1 physicians can get J-1 waiver. Those who receive community-based waiver must work a minimum of 40 hours per week for three years in H-1B status pursuant to the terms of their waiver agreement prior to gaining eligibility for permanent resident status. Conrad 30 waivers usually target primary care physicians who have completed a U.S. residency training program in one of the following specialties: Family Medicine, General Obstetrics, General Pediatrics, General Internal Medicine and General Psychiatry.
Each state has specific requirements regarding whether your specialty will qualify for their Conrad J1 waiver program. On December 4, 2004, Congress enacted legislation that affords states the right to substitute five of their 30 slots with licensed and contracted specialty physicians.
Guan, Washington D.c, and 49 U.S states participates in the Conrad 30 Waiver Program, with Idaho as the only current abstainer. Conrad state waiver programs share the following characteristics:
1) The J1 physicians must work full-time for three years in H-1B status for a facility in a HPSA or MUA/MUP;
2) The J1 physicians must agree to begin work at the facility within 90 days of obtaining a waiver from USCIS.
3) The Physician must obtain a no objection statement from the home government if the physician is contractually obligated to the home government.
Requirements for a J1 Conrad 30 Waiver
- The physician must work for three years and 40 hours per week providing primary care services.
- The employer must offer the physician a salary that is comparable to other physicians with the same level of experience and training in the clinic’s geographical area.
- The physician must provide evidence and work in a Medically Underserved Area (“MUA”) or in a Health Professional Shortage Area designated by the Department of Health and Human Services (“HHS”).
- The physician must submit Form DS 3035.
- A letter from the facility that wishes to hire physicians must be submitted.
- A letter from the State health department’ s designated official (designated by the state governor) which provides that it is in the “public interest” that the exchange visitor physician remain in the U.S.
Each state also has unique Conrad 30 requirements which may include the following:
- The hospital may need to demonstrate its recruitment efforts to show that it was not possible to obtain a legal permanent resident or US citizen doctor.
- The doctor must be employed at a hospital that accepts Medicaid/Medicare eligible patients.
- The doctor must meet licensure requirements of the state.
- Applications must include the I-94 for the physician and copies of all IAP-66 forms.
There are certain caveats of which the applicant must be aware. First, if the physician’s J1 program was funded by the foreign government, the physician will need to obtain a no-objection letter as part of the Conrad 30 waiver. Second, if the physician does not fulfill the 3-year commitment under the terms as described in the Conrad 30 waiver, the physician will be subject to the two-year home residency requirement.
J1 waiver regulations are complex, and complying with the law is paramount to obtaining 1 of 30 allotted J1 waiver recommendations. Timing is also very important when applying for a J1 Conrad 30 Waiver, as they are granted on a “first come first serve” basis. If you submit a well-prepared application as soon as the filing date becomes available, you will have a higher likelihood of obtaining your J1 Conrad 30 Waiver. Therefore, it is imperative that you find out the MUA and HHS designated areas and the filing deadlines so you can successfully apply for a J1 waiver.
Federal Interested Government Agency Waiver vs. Conrad 30
1) Primary care only issue
2) Noncompetition clause issue
3) Medicare- or Medicated-eligible patients and indigents uninsured patients issue
4) Statement confirming that no other waiver request is pending or will be filed during the pendency of their waiver request
5) Evidence of unsuccessful recruitment of qualified U.S workers.
J1 Waiver Hardship
J1 visa holders who can demonstrate that their departure for two years would cause “exceptional hardship” to their United States citizen or lawful permanent resident spouse or child (“qualifying relatives”) may obtain a waiver of the two-year foreign residence requirement.
Requirements for a J1 Hardship Waiver
Typical hardships include medical hardship, psychological hardship, political and social conditions in the home country, and economic and career disruption which would impact the qualifying relative(s). Length of marriage, number of children, original nationality of the qualifying relative, and any past separation between the applicant and the qualifying relatives are also taken into consideration.
Mere separation and the attendant sadness that this involves is not enough to outweigh the public policy objectives of the J1 program.
Because the hardship waiver is not easy to obtain and is highly fact based and subject to discretionary considerations by adjudicating officers, waivers should not be submitted without careful preparation. An experienced immigration attorney can help you determine whether your waiver has a reasonable possibility of success.
Veterans Affair J1 Waivers for Physicians
The Department of Veterans Affairs (VA) is authorized to request waiver of the two-year home residency requirements for J1 foreign medical graduates (FMG) when a VA facility can demonstrate overwhelming need.
This particular waiver option is appealing to J1 FMGs with specialized training, as a sponsoring VA facility may request a waiver for the J1 FMG to be employed in patient care, research or teaching. Moreover, physicians are not required to work in a medically underserved area.
Sponsor Requirements – The sponsoring facility must demonstrate that there is no US citizen or lawful permanent resident physician able and willing to assume this position.
Other Requirements – The physician must also sign a written agreement, confirming that upon approval of the waiver, he or she will begin employment within 90 days and will work for the VA facility for at least 3 years.
The VA has very specific eligibility requirements and application procedures for J1 waivers. As such, it is advisable that the physician and the prospective sponsor coordinate efforts through an Immigration Attorney from the outset to ensure that all requirements have been satisfied and that the application is proper submitted.
J-1 Delta Regional Commission Waiver
Delta Regional Authority (DRA) J1 Visa Waiver for Doctors
Delta Regional Authority (DRA) may recommend to the U.S. Department of State (DOS) that the two year J1 visa home residency requirements be waived for foreign doctors in J1 status if they meet the Delta Doctors program’ s requirements. This program is designed to serve 240 counties and 8 states in the Mississippi Delta Region that have a demonstrated need for physicians.
The following states are included in the 240 county program but not every county in these states are included in the DRA ’s jurisdiction.
Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, Tennessee
Physician Specialists are eligible for a DRA J1 visa waiver recommendation
The DRA waiver program is one of the few waiver programs that will recommend a waiver for specialists. Generally, the various waiver programs are only available for J1 doctors who will engage in:
1) general or family practice;
2) general internal medicine;
4) obstetrics/gynecology; or
The DRA waiver program, however, includes specialists if the J1 doctors meet additional requirements, as outlined below.
Requirements for obtaining a J1 waiver recommendation from DRA include
1) The J1 doctor must work three years in a rural DRA area with a minimum of 40 hours per week in primary medical care or a specialty (per the specification below).
2) The area must be identified by the U.S. Public Health Service as a Health Professional Shortage Area (HPSA); Mental Health Professional Shortage Area (MHPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP), and be within the congressionally defined DRA service area. HPSA areas change and it is imperative that you confirm that you will be working in a HPSA area prior to filing your DRA application.
3) The J1 doctor must be licensed in the DRA state where he or she will be practicing medicine. He or she must be licensed before starting employment with the DRA sponsor.
4) The J1 physician must not have been out of status for more than 180 days.
5) The J1 physician must sign and notarize an affidavit of agreement (J1 Visa Waiver Program Affidavit and Agreement).
5) A personal statement must be submitted by the J1 physician explaining why he or she does not wish to fulfill the two year home country residence requirement per Section 212(e) of the Immigration and Nationality Act.
The DRA ’s application guidelines for its Delta Doctors program are very detailed. To ensure that all documentary and eligibility requirements are met, it may be advisable to seek the assistance of counsel.
J-1 (ARC) Appalachian Regional Commission Waiver
Appalachian Regional Commission (ARC) J1 Visa Waiver for Doctors
The Appalachian Regional Commission (ARC) will recommend to the U.S. Department of State (DOS) that the two year home residency requirement be waived for foreign doctors in J1 status if certain criteria are met. The program is designed to serve 400 counties and 13 states that have a demonstrated need for physicians. The J1 visa waiver request must be sponsored by one of these states.
States that are included in the J1 Waiver ARC program
The following states are included in the 400 county program. However, not every county in these states participate in ARC.