International physicians who are in J-1 status in the United States become subject to 2 years home residency requirement. Physicians wishing to remain in the United States may be eligible to apply for a J-1 Visa Waiver if an Interested Government Agency agrees to recommend them for the waiver. Through this waiver, a physician may remain in the U.S. under a commitment to work for at least 3 years in a medically underserved area or the Veterans Administration. J-1 Waiver is a prerequisite for foreign physicians to begin their path to permanent residency as without the waiver they would be inadmissible.
Physicians will work with the U.S. Department of State, USCIS, and their local health agency in order to request the J-1 Waiver. The U.S. State Department permits any US government agency to request a waiver. Some agencies have special programs to sponsor doctors. In many cases, this agency will be a state health department. Agencies sponsoring applicants for J-1 Waivers are known as Interested Government Agencies (IGA).
Of the major governmental agencies that sponsor J-1 Waivers, the Delta Regional Authority (DRA) is recognized as independent, and is unlimited in number of physicians they can recommend to receive waivers. By contrast, the Conrad State 30 Waiver Program (administered in Illinois by the Center for Rural Health – Illinois Department of Public Health) recommends only 30 physicians per year to receive waivers.
The Delta Regional Authority sponsors both primary care physicians (including “general or family practice, general internal medicine, pediatrics, obstetrics/gynecology, and psychiatry) and specialty medicine physicians. (For specialty medicine physicians, DRA requires additional documentation.) It serves communities in the Delta Region of the U.S., spanning Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee. In Illinois, the DRA serves 16 counties in the state’s southern region.
Through the Delta Doctors Program, the DRA places physicians in Health Professional Shortage Areas, Medically Underserved Populations/Medically Underserved Areas, and Mental Health Professional Shortage Areas which are located within its service counties. However, the DRA will consider applications for J-1 waiver placements if the employer can prove that the communities of a location outside of the established service areas will be better served.
Full-time, primary care physicians in rural clinics in this region are eligible for J-1 Waiver requests by the Delta Doctors Program. The DRA provides comprehensive information of the process on their website . It is advisable to read the J-1 Visa Waiver Program Guidelines, found above, in its entirety. Applicants must follow all specified guidelines and submit the packet, in duplicate, to the DRA. The non-refundable filing fee for the J-1 Waiver application is $3,000.00. If an application is withdrawn within 20 days after it is received by the DRA, the applicant will be issued a 50% refund.
Once the DRA receives the packet, they communicate to the local state agency (often the state’s Department of Health) the date they received the application, and information about the physician. Provided that state agency has no compelling reason to reject the application, the DRA then begins reviewing the application. The State agency has 45 days from the process start date to issue comments or objections to the DRA. The DRA adjudicates J-1 Waiver applications within 60 days. Once approved, the application is forwarded to the U.S. Department of State. If the waiver is granted, the physician must complete the DRA’s “Physician Employment Verification Form” within their first week of employment to submit to the State agency.
Unlike other government agencies that sponsor J-1 Waivers, the DRA requires the physician’s employers to make a recruiting effort for 60 days prior to submitting the application. This is to prove that the foreign physician’s employment will not displace U.S.-born workers. Recruitment is done at three levels: national, in-state, and with state medical schools. The DRA website lists specific criteria of which advertising platforms are acceptable and which are not.
Additionally, in order to be considered for J-1 Waiver recommendation, the contract between a physician and their intended employer must include specific criteria: an employment term of at least three years; full-time employment (40 hours) for both primary care and specialty physicians; placement of the physician and a HPSA, MUA, or MHPSA (along with the ID number); and the contract must not contain a non-compete clause. Thus, it is imperative that the physician and intended employer work coordinate carefully to make sure all of the DRA’s requirements are met in the contract.
Obtaining a J-1 Visa Waiver is a combined effort of the foreign physician, the employer, and governmental agencies. The immigration attorneys at Zneimer & Zneimer can help ensure it is done successfully. Call our office at 773-516-4100 to schedule a consultation to begin requesting your J-1 Waiver.