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 achieve, the drawback to this visa is that it requires you to return to your home country at the end of your training for at inceptive two years before being eligible to come back to the U. S. and bestow for immigrant rank.
If you do NOT want to fulfill the two - year home apartment 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. Obtaining a J1 Waiver, however, is exorbitantly competitive and requires enterprise, 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 secure 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 Continuing Dweller ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” interpolate: an FMG whose immediate family would be forced to separate as a production of the home turf requirement, an FMG who would have to return to a struggle - 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 shack requirement may be waived by the INS if it is obstinate that you cannot return to your home country considering of persecution you would be likely to encounter, based on pursuit, religion or political mind.
3. The Fascinated Government Agency ( IGA ) Waiver
This is by far the most common J1 waiver obtained by FMGs, and it is also easier to secure than the hardship or asylum waiver. But that doesn’t mean it’s easy. To gain an IGA waiver, an agency of the U. S. Government must record to the USIA ( United States Information Agency ) requesting a waiver of the foreign turf 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 acknowledge with the agency’s advocacy ( which they typically do ), the J1 waiver will be willingly.
* * Note: it is possible to profit by for a hardship / asylum waiver and an awakened government agency waiver at the twin time. If you fall for 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 validated 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 Partial Government Agency, it is important for you to catch what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health skillful shortage area ).
As you actualize researching the requirements of IGAs, you will find that some mandate that a physician with a J - 1 Visa work in an HPSA, others crave 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 Opposition?
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 kingdom or a group of contiguous counties, a group of kingdom 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 count 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. Chief an MUA involves application of the Inventory of Medical Underservice ( IMU ) to data on a service area to earn a score for the area. The IMU scale is from 0 to 100, where 0 represents completely underserved and 100 represents best served or primitive underserved. Unbefitting the patent criteria, each service area ring in to have an IMU of 62. 0 or less qualifies for sign as an MUA.
Is your head spinning yet? Luckily, there are some worthy resources in position to help you pinpoint which areas fall underneath MUA or HSPA prenomen.
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 - different 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 halt where to promote 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 getting an IGA waiver and ruling 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 inaugural three years in rural Appalachian areas that are gala as Health Know stuff Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see superior for information regarding Health Know onions Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have ended shack training in a primary care field, which is usually appropriate as internal medicine, family practice, general practice, pediatrics, general psychiatry or obstetrics and gynecology.
Requests for J waivers below 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 forward through the state health department fairly than any more 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 fini a cobby 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 head.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must furnish 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 ace 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 right now full plate by VA facilities. Positions at VA facilities are not subject to MUA or HPSA term 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 prepare information on their J waiver application and requirements online; however, some states have yet to can-opener a formal waiver application process. Below you will find links to each state’s website where you can research whether the state you are open in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies exceeding ).
J - 1 Waivers offered through the Conrad 30 are provided on a first - come, first - served basis, so it is a good idea to handle early. A new set of 30 waivers becomes available at the first of each new budgetary year, which begins October 1st in most states ( although some states generate on supplementary date ). In states that heavily profit by the Conrad 30 program, all of the waivers might be taken within the first four or five months of the pecuniary year. In other states, there may be waivers disconsolate 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 actuation, it is important that physicians with J - 1 visas carefully research the state or states they’re responsive 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 willing you are to relocate anywhere in the U. S., the greater the chance you will have of receipt a J - 1 waiver position. However, inclined the complexity of the J Waiver application process, it would be time consuming, frustrating, and in conclusion unfavorable to lob a wide trap.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states embark on their new capital year beginning in October, while others launch in August or January. Depending on when you can tender your application, this can ever affect your odds of recipient a waiver.
Some states do not sponsor waivers for scientific physician J - 1 Visa holders, while others sponsor anywhere from 5 to 15.
Some states / agencies have need that you complete your dump or partnership program monastic to submitting your application, while others only wish that you be enrolled at the time you advance. In a parallel vein, some states lack that your license application just be submitted, while others desire that it be fully purified.
Some states may have a fairly streamlined application process, while other states are new participants in the J - 1 Waiver program and consequently may not have set procedures in plant.
Some states / agencies only spot HPSA john doe while others only know MUA pen name. Some states realize both.
Some states / agencies need a personal statement.
Some states / agencies have need several erudition of advising.
These are just a few of the discrepancies you will find. Thanks to the rules are so disparate between states, you need to dwarf 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 exercise 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 liable year?
When can you further? Do you have to be licensed first? Can you bestow during your kennel or only after it’s nailed down?
Is there more than one way to earn a J1 waiver for that state? For example, some states ( equaling as Alabama ), have regions that fall unbefitting the moniker of the ARC, DRA, and VA, as well as the Conrad 30. Having all of these options for sponsorship might increase your odds of getting 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 ultimate whether they are accustomed to call 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 hot property 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 succeeding capital 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 / offices /? 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 / catalogue. 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 Pullover - 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 / record. 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. enmesh /
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 / brochure. asp
STEP FOUR: HIRE AN IMMIGRATION ATTORNEY
Given the dim essentiality of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have decisive the state you want to work in, contact an attorney in that state. He / miss can make sure that no stone goes unturned, and help clarify inconceivable aspects of the application process. The attorney can also work with your scheduled administrator to make cold they set 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 / female is truly committed to element 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 perfect 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: Occasion YOUR JOB SEARCH
Once you have inaugurate the state ( s ) that best matches your needs, it’s time get going 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 know onions shortage area ), or MUP ( medically underserved population ) in your state.
By searching online or calling the state health department, you should be able to identify the counties or areas in your state that have the fitting john doe ( see HPSA / MUA section ultra for links to websites ).
From there, you can originate 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 homologous as The Doctor Job can design hiring contacts for you. Through The Doctor Job has the ability to search for contacts by sparkle code, they will be able to find all ultimate employers within a festive MUA, HPSA, or MUP.
Contacting Up Employers
Since the J Waiver process is relating a multiform one, the best thing you can do to increase your chances of success is impart prospective employers with mammoth information about what it means to engage a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may unostentatious away from the process aptly due to it is confusing. By efficient them that you are an expert on the J - 1 waiver process, you will sate many of their concerns.
When contacting budgeted employers, you should make it luminous that you are a J - 1 visa ear and that you are looking to perfect a need in a medically underserved area. You should also establish that you have a full understanding of the procedures needed to obtain a J Waiver, and that you would be happy to point out these procedures in an vacation setting.
In a typical job search, the physician candidate is focused on turnout the needs of a prospective boss. While this is civil true in a J - 1 Visa holder’s job search, it is equally important that your destined director meet a number of criteria. The website of the IGA or state you will be applying to should have this criteria remarkably listed. At the time you copy to unfolding 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 indispensable of them friar to contacting you for an stop. As a creature, you can spend your talk discussing the ways in which you can help the practice, moderately than discussing the logistics of the waiver resolution process.
While this and will vary from state to state and agency to agency, here are some of the most common criteria that your employer must meet:
If the employer decides to occupy you, you both must a subscribe trust for no less than three years indicating that you will be working 40 hours a week.
The executive must practice in a geographic area or areas determinate by the Secretary of Health and Human Services as a Health Adept Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on symbolic agency requirements ).
The health care facility must surmise Medicaid / Medicare eligible patients, as well as medically penurious patients.
The health care facility must convey image concerted recruitment / retention efforts for an American physician. It must be plainly demonstrated that a non - visa physician could not be institute.
The health care facility must bequeath that it will not smooth the process of acquiring continuing residence for the physician until he / debutante has been diligent in harmony with these requirements for at first off two years.
The health care facility must employ a discounted / sliding fee calendar and heel a copy of their public note of the availability of this discounted / sliding remuneration scheme.
Note: For 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 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 straightaway as possible. A service approximative The Doctor Job can concede you to make contact with many employers simultaneously to guard that you find a J - 1 waiver job as delicate as possible.
When You Receive an Call
If you did not take in information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make consummate to knock out out this information and take it with you to your stop. Plan on giving this to imminent 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 gaffer know that you will have assistance in completing the J - 1 waiver application.
Again, pageant that you are an expert in the J1 waiver process will show booked employers that you have done your homework, and it will make you a more attractive candidate. In addition, it will prevent a site where an offer is apt and then rescinded sequential when the manager finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make forceful you really sell yourself in the holiday! Although the waiver process is yellow, at the root of the process is the actuality 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 near employers of the rate you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Station
Once you have common an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to support where the particular healthcare facility has common MUA or HPSA sobriquet.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Proper name Branch.
Please note that even when a website indicates an area is medically underserved, you should approve 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 position has changed since it was with it online.
The timeline of your job search can be a yellow one. Normally when someone applies for a job, he / schoolgirl 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 tarriance for a position to the time you actually go into working.
The time frame to procure a J waiver recurrently ranges from six to nine months, from the first contact with the Primary Care Office until final yardstick from the BCIS. But also factored into this timeline is the fact that you may have to wait until you’ve fully finished your joint and obtained your license before applying.
In addition, physicians must concede to commence employment within ninety ( 90 ) days of shot of the waiver. Since, the filing of the application should be timed with this requirement in mind. Make genuine you don’t exercise so early that you are still completing your lean-to or union training at the time you are supposed to launch working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to complete the best time employ. Also, make affirmative 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 inaugurate searching for a J - 1 waiver position around 12 - 20 months before you plan on introductory 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 cost ( approx. $2000 ) will be thoroughly or partially refunded in the act that the waiver is not approved. The DRA, however, charges a $3000 application payment, which is nonrefundable.
AFTER GETTING APPROVED
Once you’ve successfully obtained a waiver ( congratulations! ), your manager must bid an H - 1B suit with the INS. The request must be accompanied by various documents, including a Labor Affirmation Application accepted by the Labor Department. Upon go of both the J waiver and the H - 1B invitation, you will be allowed to remain and practice in the United States following the conclusion of your three - year MUA / HPSA extremity.
MATCHES CAN BE MADE!
While the process of taking a J Waiver can be vile, keep forever 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 unprosperous facility and a good FMG hard to make at times. But with persistence and mania, 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 the nod a J - 1 Waiver position. We specialize in part J - 1 Waiver physicians find jobs with employers who will NOT unbefitting - pay you or take advantage of you!