J-1 Waiver for Foreign Medical Graduates
The majority of international medical graduates who come to the United States for residency or fellowship training do so on a J-1 visa. A J-1 visa is issued for the duration of the physician's training in the U.S., for a maximum of 7 years, with limited exceptions. At the conclusion of training, the J-1 physician is required to return to his or her home country for two years before the physician can return to the U.S. This obligation is often referred to as the J-1 foreign residence requirement.
A physician may be eligible for a waiver of the J-1 foreign residence requirement to stay in the U.S. after completing training. Waivers are available based on hardship or persecution or based on sponsorship by a federal government agency or state department of health. Federal government agency waiver programs for physicians who will engage in patient care are available through the Department of Veteran Affairs, the Department of Health and Human Services, the Delta Regional Authority and the Appalachian Regional Commission. In addition to the federal agencies, each state is also authorized to sponsor 30 J-1 waivers per fiscal year. This is known as the Conrad 30 J-1 waiver program. While each program has its own requirement, all require at a minimum that the physician have a three-year employment contract to provide full-time medical care to patients.
Because the J-1 waiver request to the government agency or state department of health is submitted by the employer on behalf of the physician, the physician must first locate qualifying employment before the J-1 waiver application can be submitted. We are available to consult with you if you are considering a J-1 waiver through the Conrad 30 program or federal government agency J-1 waiver programs.
Obtaining the H-1B Visa Status
After receiving a J-1 waiver, the next step is to obtain work authorization. To do so, the physician’s employer must file an H-1B visa petition with the U.S. Citizenship and Immigration Services to obtain H-1B visa status for the physician.
The H-1B visa is designed for employers who wish to temporarily employ foreign nationals in specialty occupations. H-1B visas are available for physicians who come to the United States to perform direct patient care, provided that the physician possesses a valid medical license from the state of intended employment and has successfully completed all parts of the Federation Licensing Examination (FLEX) or the United States Medical Licensing Examination (USMLE). The H-1B visa is issued for an initial period of up to three years with a maximum stay of six years. The H-1B visa limits the physician to working only for the H-1B petitioner employer.
The H-1B visa category is the only visa category available for a physician who has obtained a J-1 waiver through employment in a medically underserved area. Physicians must work for three years in H-1B visa status to comply with the terms of the J-1 waiver. Failure to complete three years of employment in H-1B status will result in the physician once again becoming subject to the two-year foreign residence requirement unless the U.S. Citizenship and Immigration Services approves a transfer to another employer in a qualifying medically underserved area. Because there are several government agencies involved in the J-1 waiver and H-1B visa process, it is important to plan ahead and begin the process at least six months before the date the physician intends to begin employment.
