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 secure, the drawback to this visa is that it requires you to return to your home country at the end of your training for at head two years before being eligible to come back to the U. S. and handle for immigrant rank.
If you do NOT want to fulfill the two - year home residence 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. Receipt a J1 Waiver, however, is quite competitive and requires vehemence, 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 get 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 Renter ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” embrace: an FMG whose immediate family would be forced to separate as a conclusion of the home rack requirement, an FMG who would have to return to a battle - 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 roost requirement may be waived by the INS if it is persevering that you cannot return to your home country in that of persecution you would be likely to encounter, based on chase, religion or political inclination.
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 obtain 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 reproduce to the USIA ( United States Information Agency ) requesting a waiver of the foreign house 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 recognize with the agency’s counselling ( which they typically do ), the J1 waiver will be very well.
* * Note: it is possible to advance for a hardship / asylum waiver and an stirred government agency waiver at the identical time. If you believe 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 Excited Government Agency, it is important for you to learn what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health finished shortage area ).
As you enter on researching the requirements of IGAs, you will find that some direction that a physician with a J - 1 Visa work in an HPSA, others need 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 Variation?
Health Learned 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 crown or a group of contiguous counties, a group of province 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 teem with 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. Essential an MUA involves application of the Inventory of Medical Underservice ( IMU ) to data on a service area to gain 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. Underneath the admitted criteria, each service area initiate to have an IMU of 62. 0 or less qualifies for flag as an MUA.
Is your head spinning yet? Luckily, there are some collectible resources in hamlet to help you locate which areas fall unbefitting MUA or HSPA rubric.
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 - individual 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 nail down where to use 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 acceptance an IGA waiver and showdown 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 receipt these J waivers must practice for at smallest three years in rural Appalachian areas that are definite as Health Proficient Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see primary for information regarding Health Licensed Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have fini domicile training in a primary care field, which is regularly choice 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 handle through the state health department quite than pronto 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 concluded a building 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 handle.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must keep 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 finished 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 forthwith on duty by VA facilities. Positions at VA facilities are not subject to MUA or HPSA proper name requirements. The VA waiver is often the J1 waiver of choice for practical 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 produce information on their J waiver application and requirements online; however, some states have yet to instrument a formal waiver application process. Below you will find links to each state’s website where you can research whether the state you are concerned in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies larger ).
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 financial year, which begins October 1st in most states ( although some states effect on innumerable date ). In states that heavily resort to 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 comfortless 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 motive, it is important that physicians with J - 1 visas carefully research the state or states they’re absorbed 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 taking a J - 1 waiver position. However, inclined the complexity of the J Waiver application process, it would be time consuming, frustrating, and somewhere nullifying to fling a wide entangle.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states introduce their new monetary year beginning in October, while others enter upon in August or January. Depending on when you can tender your application, this can awfully 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 crave that you complete your roof or association program friar to submitting your application, while others only miss that you be enrolled at the time you bestow. In a congruent vein, some states miss that your license application just be submitted, while others desire that it be fully distilled.
Some states may have a fairly streamlined application process, while other states are new participants in the J - 1 Waiver program and wherefore may not have set procedures in situation.
Some states / agencies only know HPSA nomen while others only recall MUA sign. Some states identify both.
Some states / agencies depend upon a personal statement.
Some states / agencies desire several scholarship of endorsement.
These are just a few of the discrepancies you will find. In that the rules are so disparate between states, you need to shrimp 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 obsessed year?
When can you resort to? Do you have to be licensed first? Can you profit by during your building or only after it’s over?
Is there more than one way to earn a J1 waiver for that state? For example, some states ( jibing as Alabama ), have regions that fall below the nomen 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 halt 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 precious 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 right now useful if you will be applying during a sequential capital year, it can still give you a sense of the level of competition in certain states.
Conrad 30 Lattice 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 / 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 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. catch /
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 indeterminate score of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have earnest the state you want to work in, contact an attorney in that state. He / deb can confirm that no stone goes unturned, and help clarify incomprehensible aspects of the application process. The attorney can also work with your scheduled executive to make convinced they accede 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 / miss is truly committed to ration 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 thorough 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: Go ahead YOUR JOB SEARCH
Once you have organize the state ( s ) that best matches your needs, it’s time go ahead 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 able shortage area ), or MUP ( medically underserved population ) in your state.
By searching online or calling the state health department, you should be able to distinguish the counties or areas in your state that have the pertinent signature ( see HPSA / MUA section most for links to websites ).
From there, you can bring about 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 uniform as The Doctor Job can explore hiring contacts for you. For The Doctor Job has the ability to search for contacts by gusto code, they will be able to find all destined employers within a personal MUA, HPSA, or MUP.
Contacting Destined Employers
Since the J Waiver process is analogous a circuitous one, the best thing you can do to increase your chances of success is feather inevitable employers with voluminous information about what it means to retain a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may polite away from the process simply due to it is vague. By wicked them that you are an expert on the J - 1 waiver process, you will quench many of their concerns.
When contacting looked toward employers, you should make it sunshiny that you are a J - 1 visa handgrip and that you are looking to enact a need in a medically underserved area. You should also authenticate that you have a full understanding of the procedures needed to procure a J Waiver, and that you would be happy to define these procedures in an weekend setting.
In a typical job search, the physician candidate is focused on gig the needs of a imminent executive. While this is bland true in a J - 1 Visa holder’s job search, it is equally important that your looked toward executive 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 reproduce to approaching 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 leading of them prior to contacting you for an talk. As a outcropping, you can spend your stopover discussing the ways in which you can help the practice, tolerably than discussing the logistics of the waiver fling process.
While this further will vary from state to state and agency to agency, here are some of the most common criteria that your manager must meet:
If the manager decides to enrol you, you both must a comply rap for no less than three years indicating that you will be working 40 hours a week.
The supervisor must practice in a geographic area or areas significant by the Secretary of Health and Human Services as a Health Know onions Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on differentiating agency requirements ).
The health care facility must credit Medicaid / Medicare eligible patients, as well as medically needy patients.
The health care facility must limn concerted recruitment / retention efforts for an American physician. It must be distinctly demonstrated that a non - visa physician could not be organize.
The health care facility must leave that it will not speed the process of acquiring permanent residence for the physician until he / bird has been busy in agreement with these requirements for at introductory two years.
The health care facility must employ a discounted / sliding remuneration schedule and maintain a copy of their public apprehension of the availability of this discounted / sliding payment timetable.
Note: Being 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 inspired 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 like now as possible. A service compatible The Doctor Job can allow you to make contact with many employers simultaneously to make sure that you find a J - 1 waiver job as tender as possible.
When You Receive an Evening
If you did not carry information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make forcible to write up out this information and take it with you to your tarriance. Plan on giving this to impending 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 manager know that you will have assistance in completing the J - 1 waiver application.
Again, view that you are an expert in the J1 waiver process will show coming employers that you have done your homework, and it will make you a more attractive candidate. In addition, it will prevent a spot where an offer is apt and then rescinded next when the executive finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make convinced you really sell yourself in the talk! Although the waiver process is gutless, at the root of the process is the detail 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 assessment you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Level
Once you have popular an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to brief where the particular healthcare facility has manifest MUA or HPSA appellation.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Term Branch.
Please note that even when a website indicates an area is medically underserved, you should excuse 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 understanding online.
The timeline of your job search can be a offensive one. Normally when someone applies for a job, he / nymph 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 call for a position to the time you actually do working.
The time frame to obtain a J waiver oftentimes ranges from six to nine months, from the first contact with the Primary Care Office until final quiz from the BCIS. But also factored into this timeline is the gospel that you may have to wait until you’ve fully on ice your setup and obtained your license before applying.
In addition, physicians must grant to commence employment within ninety ( 90 ) days of dry run of the waiver. Therefrom, the filing of the application should be timed with this requirement in mind. Make concrete you don’t bestow so early that you are still completing your crib or union training at the time you are supposed to inaugurate working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to regulate the best time profit by. Also, make concrete 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 activate searching for a J - 1 waiver position around 12 - 20 months before you plan on initial 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 fee ( approx. $2000 ) will be utterly or partially refunded in the mistake that the waiver is not approved. The DRA, however, charges a $3000 application remuneration, which is nonrefundable.
AFTER GETTING APPROVED
Once you’ve successfully obtained a waiver ( congratulations! ), your manager must charge an H - 1B recourse with the INS. The call must be accompanied by various documents, including a Labor Essence Application accepted by the Labor Department. Upon verification of both the J waiver and the H - 1B desire, you will be allowed to remain and practice in the United States following the outcome of your three - year MUA / HPSA desideratum.
MATCHES CAN BE MADE!
While the process of getting a J Waiver can be appalling, revive that this can also be a fulfilling experience for both the physician and the boss. There are many areas in the U. S. that are in desperate need of good physicians. Unfortunately, government bureaucracy makes the match between a insolvent facility and a good FMG oppressive to make at times. But with persistence and readiness, 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 accord a J - 1 Waiver position. We specialize in cut J - 1 Waiver physicians find jobs with employers who will NOT below - pay you or take advantage of you!