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 get, the drawback to this visa is that it requires you to return to your home country at the end of your training for at first off two years before being eligible to come back to the U. S. and handle for immigrant station.
If you do NOT want to fulfill the two - year home kennel 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 terrifically competitive and requires yen, 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 Lifelong Occupier ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” build in: an FMG whose immediate family would be forced to separate as a product of the home joint requirement, an FMG who would have to return to a hostility - 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 apartment requirement may be waived by the INS if it is firm that you cannot return to your home country as of persecution you would be likely to encounter, based on contest, religion or political conception.
3. The Occupied Government Agency ( IGA ) Waiver
This is by far the most common J1 waiver obtained by FMGs, and it is also easier to gain than the hardship or asylum waiver. But that doesn’t mean it’s easy. To secure an IGA waiver, an agency of the U. S. Government must bang out to the USIA ( United States Information Agency ) requesting a waiver of the foreign roost 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 buy into with the agency’s urging ( which they typically do ), the J1 waiver will be certainly.
* * Note: it is possible to promote for a hardship / asylum waiver and an awakened government agency waiver at the equivalent time. If you affirm 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 Drawn Government Agency, it is important for you to distinguish what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health well-qualified shortage area ).
As you introduce researching the requirements of IGAs, you will find that some authority that a physician with a J - 1 Visa work in an HPSA, others hurting for 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 Aberration?
Health Skillful 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 domain or a group of contiguous counties, a group of throne 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 allow for 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. Foremost 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 inaugural underserved. Subservient the popular criteria, each service area initiate to have an IMU of 62. 0 or less qualifies for rubric as an MUA.
Is your head spinning yet? Luckily, there are some respected resources in area to help you identify which areas fall below MUA or HSPA appellation.
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 - rare 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 resolve 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 reconciliation 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 obtaining these J waivers must practice for at headmost three years in rural Appalachian areas that are uncommon as Health Proficient Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see uppermost for information regarding Health Polished Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have buttoned up cubbyhole training in a primary care field, which is often definite as internal medicine, family practice, general practice, pediatrics, general psychiatry or obstetrics and gynecology.
Requests for J waivers underneath 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 employ through the state health department fairly than double time 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 complete a shack 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 agnomen.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must grant 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 learned 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 at once swamped by VA facilities. Positions at VA facilities are not subject to MUA or HPSA cognomen requirements. The VA waiver is often the J1 waiver of choice for technical 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 cater information on their J waiver application and requirements online; however, some states have yet to appliance a formal waiver application process. Below you will find links to each state’s website where you can research whether the state you are prejudiced in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies chief ).
J - 1 Waivers offered through the Conrad 30 are provided on a first - come, first - served basis, so it is a good idea to utilize early. A new set of 30 waivers becomes available at the first of each new financial year, which begins October 1st in most states ( although some states open on new date ). In states that heavily handle the Conrad 30 program, all of the waivers might be taken within the first four or five months of the capital year. In other states, there may be waivers uncherished 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 basis, it is important that physicians with J - 1 visas carefully research the state or states they’re sympathetic 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 receiving a J - 1 waiver position. However, obsessed the complexity of the J Waiver application process, it would be time consuming, frustrating, and fundamentally negative to fling a wide catch.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states enter on their new financial year beginning in October, while others make active in August or January. Depending on when you can charge your application, this can utterly affect your odds of obtaining 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 depend upon that you complete your kennel or collaboration program brother to submitting your application, while others only lack that you be enrolled at the time you forward. In a akin vein, some states hurting for that your license application just be submitted, while others require that it be fully clear.
Some states may have a fairly streamlined application process, while other states are new participants in the J - 1 Waiver program and and so may not have set procedures in locality.
Some states / agencies only identify HPSA nomen while others only recall MUA label. Some states recognize both.
Some states / agencies hurting for a personal statement.
Some states / agencies need several enlightenment of recommendation.
These are just a few of the discrepancies you will find. For the rules are so disparate between states, you need to scrubby 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 use 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 bestow? Do you have to be licensed first? Can you promote during your pied-a-terre or only after it’s concluded?
Is there more than one way to obtain a J1 waiver for that state? For example, some states ( approximative as Alabama ), have regions that fall below the place 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 recipient 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 drive whether they are accustomed to kick 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 cherished 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 now useful if you will be applying during a subsequent budgetary year, it can still give you a sense of the level of competition in certain states.
Conrad 30 Lacework 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 / assistance /? 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 Woolly - 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. 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 / brochure. asp
STEP FOUR: HIRE AN IMMIGRATION ATTORNEY
Given the occult stuff of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have dogged the state you want to work in, contact an attorney in that state. He / baby doll can ensure that no stone goes unturned, and help clarify complicated aspects of the application process. The attorney can also work with your booked manager to make hard they concede 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 / virgin is truly committed to side 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 genuine 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: Initiate YOUR JOB SEARCH
Once you have initiate the state ( s ) that best matches your needs, it’s time make 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 adept shortage area ), or MUP ( medically underserved population ) in your state.
By searching online or calling the state health department, you should be able to spot the counties or areas in your state that have the useful term ( see HPSA / MUA section sizable for links to websites ).
From there, you can make active 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 close as The Doctor Job can discover hiring contacts for you. Due to The Doctor Job has the ability to search for contacts by liveliness code, they will be able to find all likely employers within a definite MUA, HPSA, or MUP.
Contacting Fated Employers
Since the J Waiver process is allied a mixed one, the best thing you can do to increase your chances of success is indulge to come employers with forever information about what it means to employ a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may biddable away from the process plainly because it is dark. By practical them that you are an expert on the J - 1 waiver process, you will slake many of their concerns.
When contacting imminent employers, you should make it clarion that you are a J - 1 visa shaft and that you are looking to negotiate a need in a medically underserved area. You should also manifest that you have a full understanding of the procedures needed to gain a J Waiver, and that you would be happy to analyze these procedures in an visit setting.
In a typical job search, the physician candidate is focused on cattle call the needs of a subsequent director. While this is low-key true in a J - 1 Visa holder’s job search, it is equally important that your budgeted manager meet a number of criteria. The website of the IGA or state you will be applying to should have this criteria decidedly listed. At the time you letter to prospective 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 requisite of them brother to contacting you for an talk. As a sequence, you can spend your stop discussing the ways in which you can help the practice, quite than discussing the logistics of the waiver whack process.
While this and 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 administrator decides to enrol you, you both must a okay amenability 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 unusual by the Secretary of Health and Human Services as a Health Polished Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on differentiating agency requirements ).
The health care facility must presume Medicaid / Medicare eligible patients, as well as medically strapped patients.
The health care facility must make vivid concerted recruitment / retention efforts for an American physician. It must be plainly demonstrated that a non - visa physician could not be launch.
The health care facility must consign that it will not smooth the process of acquiring abiding residence for the physician until he / coed has been buried in harmony with these requirements for at maiden two years.
The health care facility must employ a discounted / sliding price schedule and store a copy of their public concern of the availability of this discounted / sliding remuneration diary.
Note: Considering 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 awakened in hiring you after their period of recruitment for an American physician has passed. For this reason, it is a good idea to approach practices as these days as possible. A service agnate The Doctor Job can acquiesce you to make contact with many employers simultaneously to lock up that you find a J - 1 waiver job as delicate as possible.
When You Receive an Talk
If you did not receive information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make unmistakable to reproduce out this information and take it with you to your vacation. 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 director know that you will have assistance in completing the J - 1 waiver application.
Again, pomp 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 situation where an offer is apt and then rescinded succeeding when the gaffer finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make assured you really sell yourself in the tarriance! Although the waiver process is gutless, 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 impending employers of the equivalent you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Class
Once you have down pat an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to substantiate where the particular healthcare facility has well-known MUA or HPSA stage name.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Pseudonym Branch.
Please note that even when a website indicates an area is medically underserved, you should answer for 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 stratum has changed since it was apprised online.
The timeline of your job search can be a pusillanimous one. Normally when someone applies for a job, he / nymphet 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 holiday for a position to the time you actually make working.
The time frame to attain a J waiver repeatedly ranges from six to nine months, from the first contact with the Primary Care Office until final corroboration from the BCIS. But also factored into this timeline is the fact that you may have to wait until you’ve fully complete your commorancy and obtained your license before applying.
In addition, physicians must sign to commence employment within ninety ( 90 ) days of experiment of the waiver. So, the filing of the application should be timed with this requirement in mind. Make thoroughgoing you don’t exploit so early that you are still completing your mansion or association training at the time you are supposed to enter upon working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to incline the best time promote. Also, make downright you have powerful 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 drive searching for a J - 1 waiver position around 12 - 20 months before you plan on elementary 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 payment ( approx. $2000 ) will be fully or partially refunded in the phenomenon that the waiver is not approved. The DRA, however, charges a $3000 application charge, which is nonrefundable.
AFTER GETTING APPROVED
Once you’ve successfully obtained a waiver ( congratulations! ), your administrator must propose an H - 1B suit with the INS. The begging must be accompanied by various documents, including a Labor Parameter Application accepted by the Labor Department. Upon crack of both the J waiver and the H - 1B begging, you will be allowed to remain and practice in the United States following the backwash of your three - year MUA / HPSA charge.
MATCHES CAN BE MADE!
While the process of receiving a J Waiver can be awe-inspiring, cite that this can also be a fulfilling experience for both the physician and the executive. There are many areas in the U. S. that are in desperate need of good physicians. Unfortunately, government bureaucracy makes the match between a suffering facility and a good FMG oppressive to make at times. But with persistence and perseverance, 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 outcome a J - 1 Waiver position. We specialize in sector J - 1 Waiver physicians find jobs with employers who will NOT below - pay you or take advantage of you!