The Doctor Job Presents: Demystifying The J - 1 Visa Waiver Process For Physicians

The Doctor Job Presents: Demystifying The J - 1 Visa Waiver Process For Physicians

Demystifying the J - 1 Visa Waiver Process
If you are a foreign medical school graduate ( FMG ) who is not a U. S. Citizen, and you are seeking further medical training in the U. S., a J - 1 Visa ( Education Exchange Visa ) will enable you to pursue that training. While a J - 1 Visa is fairly easy to attain, the drawback to this visa is that it requires you to return to your home country at the end of your training for at primary two years before being eligible to come back to the U. S. and promote for immigrant station.
If you do NOT want to fulfill the two - year home condo requirement, you do have the option of pursuing a J - 1 Waiver ( also known as a J Waiver ), allowing you to remain in the U. S. Taking a J1 Waiver, however, is excessively competitive and requires fierceness, patience, and sometimes a bit of luck.
STEP ONE: EVALUATE YOUR J - 1 WAIVER OPTIONS
Let’s start by outlining the three methods by which an FMG with a J - 1 Visa may obtain a waiver.
1. The Hardship Waiver
If returning to your home country would impose “exceptional hardship” on you, your spouse ( who must be a U. S. Citizen or Lasting Dweller ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” cover: an FMG whose immediate family would be forced to separate as a result of the home box requirement, an FMG who would have to return to a war - torn country, or an FMG with a family member suffering from a disease for which treatment is not available in the home country.
2. The Asylum Waiver
Your foreign stomping grounds requirement may be waived by the INS if it is tenacious that you cannot return to your home country thanks to of persecution you would be likely to encounter, based on pursuit, religion or political presumption.
3. The Absorbed Government Agency ( IGA ) Waiver
This is by far the most common J1 waiver obtained by FMGs, and it is also easier to procure than the hardship or asylum waiver. But that doesn’t mean it’s easy. To attain an IGA waiver, an agency of the U. S. Government must formulate to the USIA ( United States Information Agency ) requesting a waiver of the foreign home requirement in exchange for the FMG committing to work in a medically underserved area full - time for three years. If the USIA and the INS okay with the agency’s advising ( which they typically do ), the J1 waiver will be affirmative.
* * Note: it is possible to bestow for a hardship / asylum waiver and an keen government agency waiver at the twin time. If you buy you may be eligible for either a hardship or asylum waiver, this may be advisable in order to increase your odds.
There are currently 4 government agencies that act as IGAs to sponsor J - 1 Waivers:
The Appalachian Regional Commission ( ARC )
The Delta Regional Authority ( DRA )
The Department of Health and Human Services ( DHH )
The Veterans Administration ( VA )
In addition, individual states are official to act as an IGA and sponsor up to 30 physicians each year through a program called the Conrad 30.
DEFINING A MEDICALLY UNDERSERVED AREA
If you have decided to pursue a J1 waiver through an Taken Government Agency, it is important for you to realize what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health know stuff shortage area ).
As you get going researching the requirements of IGAs, you will find that some warrant that a physician with a J - 1 Visa work in an HPSA, others depend upon a physician with a J - 1 Visa to work in an MUA, and still others will sponsor physicians working in either an MUA or HPSA.
HPSA, MUA, MUP: What’s the Peculiarity?
Health Expert Shortage Areas ( HPSA ) may have shortages of primary medical care, dental or mental health providers and may be urban or rural areas, population groups or medical or other public facilities.
Medically Underserved Areas ( MUA ) may be a whole sovereignty or a group of contiguous counties, a group of country or civil divisions or a group of urban census tracts in which residents have a shortage of personal health services.
Medically Underserved Populations ( MUP ) may entail groups of persons who face economic, cultural or linguistic barriers to health care.
Determining how a particular region and / or healthcare facility is categorized can be a complicated task. Earnest an MUA involves application of the Brochure of Medical Underservice ( IMU ) to data on a service area to attain a score for the area. The IMU scale is from 0 to 100, where 0 represents completely underserved and 100 represents best served or leading underserved. Under the popular criteria, each service area raise to have an IMU of 62. 0 or less qualifies for denomination as an MUA.
Is your head spinning yet? Luckily, there are some collectible resources in position to help you distinguish which areas fall below MUA or HSPA matronymic.
The U. S. Department of Health & Human Services has a website ( http: / / hpsafind. hrsa. gov / HPSASearch. aspx ) that enables you to search for HPSAs nationwide.
Many states list MUA - marked counties on their government websites.
3Rnet ( www. 3rnet. org ) also contains information regarding underserved communities.
Once you have decided which state you will be applying to work in, and which agency you will be applying through, you can turn to these sites to help bias where to profit by for J1 Waiver positions.
STEP TWO: FAMILIARIZE YOURSELF WITH IGA OPTIONS
Since the IGA waiver is the most common for physicians with J1 Visas, the remainder of this article will discuss the process for receipt an IGA waiver and adjustment employment in an MUA or HPSA.
Here is a brief summary of the agencies that currently sponsor J Waivers.
The Appalachian Regional Commission ( www. arc. gov )
Physicians taking these J waivers must practice for at leading three years in rural Appalachian areas that are limited as Health Ace Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see primary for information regarding Health Well-qualified Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have fini dump training in a primary care field, which is often uncommon as internal medicine, family practice, general practice, pediatrics, general psychiatry or obstetrics and gynecology.
Requests for J waivers unbefitting the ARC J - 1 Visa Program must be sponsored by a state within the Appalachian Region, which includes all of West Virginia and parts of 12 other states: Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, and Virginia. All inquiries should be made to state contacts. This means that you use through the state health department fairly than away to the ARC.
Delta Regional Authority ( www. dra. gov )
The Delta Region comprises counties from eight states: Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee. Eligible physicians with J - 1 Visas who have ended a pied-a-terre in Family Practice, General Pediatrics, Obstetrics, or Internal Medicine are eligible for a J Waiver. Candidates can work in an area with either HPSA, MUA, or MUP autograph.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must yield out - patient primary care ( family practice, general internal medicine, general pediatrics, or obstetrics / gynecology ) or general psychiatric services. HHS will only process an application for a J1 waiver from a facility in or with a health crack shortage area ( HPSA ) score of 14 or higher.
The Veterans Administration ( www. va. gov )
The VA sponsors physicians for J waivers, but only when they are straightaway on duty by VA facilities. Positions at VA facilities are not subject to MUA or HPSA heading requirements. The VA waiver is often the J1 waiver of choice for scientific physicians, since most other waiver programs are available only to primary care or psychiatric physicians.
State Departments of Health ( through the Conrad State 30 Program )
Each individual state can sponsor up to 30 J - 1 Waiver applicants per year to work in an underserved area. Most states grant information on their J waiver application and requirements online; however, some states have yet to contraption a formal waiver application process. Below you will find links to each state’s website where you can research whether the state you are caught in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies supreme ).
J - 1 Waivers offered through the Conrad 30 are provided on a first - come, first - served basis, so it is a good idea to profit by early. A new set of 30 waivers becomes available at the first of each new monetary year, which begins October 1st in most states ( although some states found on else date ). In states that heavily forward the Conrad 30 program, all of the waivers might be taken within the first four or five months of the cash year. In other states, there may be waivers by oneself over at the end of the year.
An important thing to note about the Conrad 30 is that the program is administered differently from state to state. For that instigation, it is important that physicians with J - 1 visas carefully research the state or states they’re partial in practicing in before embarking on the J - 1 waiver application process.
STEP THREE: RESEARCH & SELECT A STATE
Common sense would tell you that the more happy you are to relocate anywhere in the U. S., the greater the chance you will have of getting a J - 1 waiver position. However, inured the complexity of the J Waiver application process, it would be time consuming, frustrating, and conclusively gainsaying to cast a wide net.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states generate their new budgetary year beginning in October, while others lead in August or January. Depending on when you can tender your application, this can strikingly affect your odds of receipt a waiver.
Some states do not sponsor waivers for technical physician J - 1 Visa holders, while others sponsor anywhere from 5 to 15.
Some states / agencies have need that you complete your habitation or union program monk to submitting your application, while others only crave that you be enrolled at the time you resort to. In a consubstantial vein, some states have need that your license application just be submitted, while others crave that it be fully refined.
Some states may have a fairly streamlined application process, while other states are new participants in the J - 1 Waiver program and hence may not have set procedures in home.
Some states / agencies only recall HPSA denomination while others only realize MUA matronymic. Some states recognize both.
Some states / agencies desire a personal statement.
Some states / agencies need several learning of endorsement.
These are just a few of the discrepancies you will find. Due to the rules are so disparate between states, you need to picayune down your options to one or two states and become an expert in those states’ waiver regulations.
Some things to consider when choosing a state to handle for a J - 1 Visa Waiver:
How many underserved areas are in that state? Some states have more MUAs or HPSAs than others.
Does the state have opportunities for specialists or only primary care physicians? If they do sponsor specialists, what is the maximum number of specialists they will sponsor in any inured year?
When can you profit by? Do you have to be licensed first? Can you appropriate during your lean-to or only after it’s buttoned up?
Is there more than one way to gain a J1 waiver for that state? For example, some states ( corresponding as Alabama ), have regions that fall below the trade name of the ARC, DRA, and VA, as well as the Conrad 30. Having all of these options for sponsorship might increase your odds of taking a waiver.
How experienced is the state in processing J Waiver applications? A quick phone call to the state health department might help you to impel whether they are accustomed to employment waiver applications or whether the state is ill - informed about the proper procedures.
Below are links to individual state websites, which will help you with your research. In addition to state websites, there are some other estimable online resources that can help you find the best state. For instance, 3rnet ( http: / / www. 3rnet. org ) provides up to date information on how many waiver openings are available in several states. Although this information might not be instanter useful if you will be applying during a later budgetary year, it can still give you a sense of the level of competition in certain states.
Conrad 30 Netting Sites:
Alabama - http: / / www. adph. org / OPCRH /
Alaska - http: / / www. chems. alaska. gov / PCRH / workforce_search_ak_exp. htm
Arizona - http: / / www. azdhs. gov / hsd / visa_waiver. htm
Arkansas - http: / / www. healthyarkansas. com /
California - http: / / www. prh. dhs. ca. gov / Programs / CalSORH / J1Visa. htm
Colorado - http: / / www. cdphe. state. co. us / pp / primarycare / J1. html
Connecticut ( PDF ) - http: / / www. dph. state. ct. us / Licensure / apps / j1info. pdf
Delaware - http: / / www. dhss. delaware. gov / dhss / main / sp. htm
District of Columbia - http: / / doh. dc. gov / doh / site / default. asp
Florida - http: / / www. doh. state. fl. us / workforce / recruit1 / J1lforms. html
Georgia - http: / / gain. mercer. edu / rhic / employ. html
Guam - http: / / www. cehn. org / cehn / resourceguide / gdphss. html
Hawaii - http: / / www. state. hi. us / doh / rural - health / j1visa. htm
Idaho - http: / / www. healthandwelfare. idaho. gov
Illinois - http: / / www. idph. state. il. us / about / rural_health / rural_shortage. htm
Indiana - http: / / www. in. gov / isdh / publications / llo / waivers. htm
Iowa - http: / / www. idph. state. ia. us /
Kansas - http: / / www. kdheks. gov / olrh / j - 1visa_waiver. html
Kentucky - http: / / chfs. ky. gov / #Section2
Louisiana - http: / / www. dhh. state. la. us / aegis /? ID=88
Maine ( DOC ) - ftp: / / ftp. state. me. us / pub / sos / cec / rcn / apa / 10 / 144 / 144c513. doc
Maryland - http: / / www. fha. state. md. us / orhpcs / pco / html / mdj1visawaiverprog. html
Massachusetts - http: / / www. mass. gov / dph / dphhome. htm
Michigan - http: / / www. mimom. org / page. cfm / 41 /
Minnesota - http: / / www. health. state. mn. us / divs / chs / j1main. htm
Mississippi - http: / / www. health. ms. gov / inventory. htm
Missouri - http: / / www. dhss. mo. gov / j1visa /
Montana - http: / / www. dphhs. mt. gov / PHSD / Primary - Care / primary - care - j - 1info. shtml
Nebraska - http: / / www. hhs. state. ne. us / orh / j1. htm
Nevada ( PDF ) - http: / / health2k. state. nv. us / primary / JP - 1. pdf
New Hampshire - http: / / www. dhhs. nh. gov / DHHS / RHPC / default. htm
New Jumper - http: / / www. state. nj. us / health / j - 1 /
New Mexico - http: / / www. nmhr. org / nmj1. html
New York - http: / / www. health. state. ny. us / nysdoh / dpprd / j - 1a. htm
North Carolina - http: / / www. ncruralhealth. org / j1. html
North Dakota - http: / / www. med. und. nodak. edu / depts / rural / rhw / j1 /
Ohio - http: / / www. odh. ohio. gov / odhPrograms / chss / visa / visa1. aspx
Oklahoma - http: / / www. health. state. ok. us /
Oregon - http: / / oregon. gov / DHS / ph / hsp / conrad / guide. shtml
Pennsylvania - http: / / www. dsf. health. state. pa. us / health / cwp / view. asp? a=169&q=204585
Rhode Island - http: / / www. healthri. org / hsr / professions / visa / j1visa. php
South Carolina - http: / / www. scdhec. collar /
South Dakota - http: / / www. state. sd. us / doh / rural / J1waiver. htm
Tennessee - http: / / www2. state. tn. us / health / rural / j1visa0. html
Texas - http: / / www. dshs. state. tx. us / chpr / j1info. shtm
Utah - http: / / health. utah. gov / primarycare / employment. html
Vermont - http: / / www. healthyvermonters. info / hi / ruralhealth / ruralhome. shtml
Virginia - http: / / www. vdh. state. va. us / primcare / center / j1 / info. asp
Washington - http: / / www. doh. wa. gov / hsqa / ocrh / r&r / j1. htm
West Virginia - http: / / www. wvochs. org / dr / j - 1. aspx
Wisconsin - http: / / dhfs. wisconsin. gov / localhealth / J_1VISA /
Wyoming - http: / / wdh. state. wy. us / main / inventory. asp
STEP FOUR: HIRE AN IMMIGRATION ATTORNEY
Given the doubtful score of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have strong-willed the state you want to work in, contact an attorney in that state. He / babe can confirm that no stone goes unturned, and help clarify inconceivable aspects of the application process. The attorney can also work with your coming gaffer to make positive they stand together with various regulations.
Do some research to find an attorney who is up to date on recent developments affecting the J Waiver process. You also want an attorney who demonstrates that he / chick is truly committed to fragment you remain in the U. S.
Once you’ve hired an attorney, your work isn’t done. Not only will you need to aggressively pursue your job search, you will need to be proactive in making unambiguous that you are involved in the application process. While an attorney should always have your best interests at heart, occasionally immigration attorneys become overwhelmed and some of their clients may fall through the cracks.
In one case, a J - 1 Visa physician obtained a contract with an approved healthcare facility in a HPSA, only to find that there were no more waivers available in her state for that year. This could have been avoided if her attorney had been paying closer attention to her case.
STEP FIVE: Undertake YOUR JOB SEARCH
Once you have start up the state ( s ) that best matches your needs, it’s time motivate looking for a J - 1 Visa Waiver position. Thanks to your research, you should know whether you will be required to find employment in an MUA ( medically underserved area ), HPSA ( health acknowledged shortage area ), or MUP ( medically underserved population ) in your state.
By searching online or calling the state health department, you should be able to discover the counties or areas in your state that have the true name ( see HPSA / MUA section better for links to websites ).
From there, you can create seeking out health care facilities in those areas. If you do not have the time to research health care facilities on your own, a service not unlike as The Doctor Job can dig up hiring contacts for you. In that The Doctor Job has the ability to search for contacts by zing code, they will be able to find all ultimate employers within a chief MUA, HPSA, or MUP.
Contacting Near Employers
Since the J Waiver process is approximating a mingled one, the best thing you can do to increase your chances of success is yield eventual employers with detailed information about what it means to occupy a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may unobtrusive away from the process neatly now it is hidden. By persuasive them that you are an expert on the J - 1 waiver process, you will glut many of their concerns.
When contacting fated employers, you should make it crystal that you are a J - 1 visa bail and that you are looking to adjust a need in a medically underserved area. You should also roll out that you have a full understanding of the procedures needed to obtain a J Waiver, and that you would be happy to demonstrate these procedures in an tarriance setting.
In a typical job search, the physician candidate is focused on reunion the needs of a eventual boss. While this is inanimate true in a J - 1 Visa holder’s job search, it is equally important that your unfolding administrator meet a number of criteria. The website of the IGA or state you will be applying to should have this criteria markedly listed. At the time you write down to looked toward employers, you might consider including a printout of these requirements along with your CV and cover letter. This way, employers will have an understanding of what will be needed of them religious to contacting you for an stay. As a outgrowth, you can spend your visitation discussing the ways in which you can help the practice, quite than discussing the logistics of the waiver power process.
While this again will vary from state to state and agency to agency, here are some of the most common criteria that your administrator must meet:
If the manager decides to employ you, you both must a concede encumbrance for no less than three years indicating that you will be working 40 hours a week.
The director must practice in a geographic area or areas particular by the Secretary of Health and Human Services as a Health Licensed Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on normal agency requirements ).
The health care facility must believe Medicaid / Medicare eligible patients, as well as medically reduced patients.
The health care facility must define concerted recruitment / retention efforts for an American physician. It must be clearly demonstrated that a non - visa physician could not be get going.
The health care facility must consign that it will not walk through the process of acquiring surviving residence for the physician until he / butterfly has been on duty in harmony with these requirements for at head two years.
The health care facility must employ a discounted / sliding payment schedule and procure a copy of their public consideration of the availability of this discounted / sliding charge calendar.
Note: Whereas the health care facility has to have attempted to hire an American physician before they can hire an FMG, it’s possible that a practice may not be able to offer you a contract right away, but would potentially be really into in hiring you after their period of recruitment for an American physician has passed. For this actuation, it is a good idea to approach practices as promptly as possible. A service homologous The Doctor Job can own you to make contact with many employers simultaneously to assure that you find a J - 1 waiver job as juicy as possible.
When You Receive an Vacation
If you did not embody information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make forcible to ghost out this information and take it with you to your holiday. Plan on giving this to budgeted employers so that they can see whether or not their facility is eligible, and gain an understanding of what they will need to do on their end if they decide to hire you. If you have hired an attorney, let the boss know that you will have assistance in completing the J - 1 waiver application.
Again, fanfare that you are an expert in the J1 waiver process will show unfolding employers that you have done your homework, and it will make you a more attractive candidate. In addition, it will prevent a post where an offer is accustomed and then rescinded successive when the supervisor finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make factual you really sell yourself in the tarriance! Although the waiver process is chicken, at the root of the process is the truth that there are many underserved health care facilities in the U. S. that are in desperate need of quality physicians. Do not be afraid to talk about your strengths and convince ultimate employers of the price you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Rank
Once you have avowed an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to crawl where the particular healthcare facility has certified MUA or HPSA patronymic.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Nickname Branch.
Please note that even when a website indicates an area is medically underserved, you should contend the criteria closely before accepting a position there. Since the information is only updated every few years for the purpose of disseminating it publicly, it’s possible that a location’s level has changed since it was savvy online.
The timeline of your job search can be a lily-livered one. Normally when someone applies for a job, he / virgin begins working within a few weeks to a few months after accepting the offer. In the case of J Waiver candidates, however, it might be a year or more from the time you weekend for a position to the time you actually set about working.
The time frame to earn a J waiver recurrently ranges from six to nine months, from the first contact with the Primary Care Office until final countdown from the BCIS. But also factored into this timeline is the detail that you may have to wait until you’ve fully nailed down your crash pad and obtained your license before applying.
In addition, physicians must set to commence employment within ninety ( 90 ) days of corroboration of the waiver. Inasmuch as, the filing of the application should be timed with this requirement in mind. Make decided you don’t exploit so early that you are still completing your stomping grounds or union training at the time you are supposed to set about working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to ultimate the best time advance. Also, make genuine you have stirring expectations regarding the timeline, and that you are able to financially support yourself during any period where you may not be working.
The Doctor Job normally recommends that you actualize searching for a J - 1 waiver position around 12 - 20 months before you plan on maiden work.
WHAT A WAIVER WILL COST YOU
The estimated cost for applying for a J - 1 Waiver, including attorney’s fees is between $4000 and $5000. In most states the application remuneration ( approx. $2000 ) will be utterly or partially refunded in the wonder that the waiver is not approved. The DRA, however, charges a $3000 application fee, which is nonrefundable.
AFTER GETTING APPROVED
Once you’ve successfully obtained a waiver ( congratulations! ), your manager must charge an H - 1B desire with the INS. The recourse must be accompanied by various documents, including a Labor Affirmation Application accepted by the Labor Department. Upon prelim of both the J waiver and the H - 1B invitation, you will be allowed to remain and practice in the United States following the production of your three - year MUA / HPSA charge.
MATCHES CAN BE MADE!
While the process of receipt a J Waiver can be extreme, retain that this can also be a fulfilling experience for both the physician and the gaffer. There are many areas in the U. S. that are in desperate need of good physicians. Unfortunately, government bureaucracy makes the match between a in rags facility and a good FMG insoluble to make at times. But with persistence and urgency, these stories can have happy endings.
Call The Doctor Job at 1 - 800 - 591 - 4842 or visit us online to get free career advice on ruling a J - 1 Waiver position. We specialize in piece J - 1 Waiver physicians find jobs with employers who will NOT below - pay you or take advantage of you!