For Healthcare Professionals
For Healthcare Professionals
The Conrad 30 J-1 Visa Waiver Program
Why is a J-1 Waiver Needed?
J-1 visa status authorizes an International Medical Graduate (IMG) to do Graduate Medical Education (GME) in the United States.
All J-1 clinical physicians – no exceptions – need to return for two years to their home countries following conclusion of GME.
Unless the two-year home residence obligation is waived, a J-1 physician is ineligible for an H-1B visa and/or permanent residence
Therefore, it is necessary to get a waiver of the two-year home residence obligation in order to get H-1B eligibility which, in turn, is the visa status that will enable an IMG to work as a physician in the United States.
The Conrad 30 Program
States can sponsor waivers in order to get physicians into hard-to-fill placements where they will be serving the medically undeserved. There has to be an element of expanding the safety net.
There are 30 waivers per year for each state. The waivers become available October 1. Some states fill all 30 slots very quickly (a few hours); others never fill all 30 slots.
See how many waivers states have used in the past here
If states fill quickly – you need to start this process with the goal of filing waiver early in waiver cycle (i.e., in or shortly after October)
Consult with the Primary Care Office (PCO) to determine the likely drawdown of J-1 waiver numbers– how many states fill their slots in 2014.
Consult with PCO to determine how the state processes J-1 waivers (i.e., merit based; first in/first out; set application periods)
Up to 10 waiver numbers can be used for non-medically underserved placements (Flex waivers). The balance can only be used for placements in medically designated areas.
Whether the waiver is a Flex or normal waiver, the underlying goal is to show that the IMG will provide safety-net clinical services – i.e., serve the indigent and medically underserved and fill gaps in the medical delivery system.
If the J-1 waiver is granted, an IMG has a minimum three-year service obligation that needs to be fulfilled in H-1B status (could be more by state).
How States Determine Areas of Need
Medically Underserved Areas are defined as Health Professional Shortage Areas (HPSA) or Medically Underserved Areas/Populations (MUA/P).
to determine if a practice site is located in a designated shortage area.
Potential State Variations in the J-1 Visa Waiver Program
Primary care vs. specialty care – some states reserve their spots only for primary care; others allow some specialty care spots.
Application periods and filing deadlines
Non-compete clauses – some states mandate that there CANNOT be a non-compete clause in a contract for a physician seeking a J-1 waiver
Liquidated damages – if the physician departs prior to fulfilling their time commitment – they agree to a set sum that the physician has to pay
Mandatory period of service
Eligible employer requirements – a state could add to the federal requirements that outline which employers are eligible
Other Agencies that Offer Waivers
Appalachian Regional Commission (ARC)
J-1 Visa Waivers
Delta Regional Authority (DRA)
Delta Doctors Program
United States Department of Health and Human Services (US DHHS)
US Exchange Visitor Program