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 gain, 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 two years before being eligible to come back to the U. S. and resort to for immigrant class.
If you do NOT want to fulfill the two - year home domicile 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 over competitive and requires perseverance, 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 Lessee ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” incorporate: an FMG whose immediate family would be forced to separate as a completion of the home residence 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 bullpen requirement may be waived by the INS if it is decided that you cannot return to your home country as of persecution you would be likely to encounter, based on chase, religion or political impression.
3. The Sold 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 secure an IGA waiver, an agency of the U. S. Government must transcribe to the USIA ( United States Information Agency ) requesting a waiver of the foreign edifice 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 consent with the agency’s endorsement ( which they typically do ), the J1 waiver will be yea.
* * Note: it is possible to exercise for a hardship / asylum waiver and an drawn government agency waiver at the identical time. If you understand 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 Roused Government Agency, it is important for you to catch on what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health known shortage area ).
As you eventuate researching the requirements of IGAs, you will find that some instruction 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 Characteristic?
Health Ace 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 nation or a group of contiguous counties, a group of nation 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 enter 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. Great an MUA involves application of the Record of Medical Underservice ( IMU ) to data on a service area to procure a score for the area. The IMU scale is from 0 to 100, where 0 represents completely underserved and 100 represents best served or premier underserved. Beneath the hackneyed criteria, each service area get going 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 whereabouts to help you discover which areas fall underneath MUA or HSPA alias.
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 - especial 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 predispose where to utilize 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 judgment 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 recipient these J waivers must practice for at smallest three years in rural Appalachian areas that are special as Health Efficient Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see considerable for information regarding Health Licensed Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have concluded den training in a primary care field, which is often significant 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 utilize through the state health department fairly than immediately 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 over a den 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 pet name.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must replenish 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 professional 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 immediately busy 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 produce information on their J waiver application and requirements online; however, some states have yet to apparatus a formal waiver application process. Below you will find links to each state’s website where you can research whether the state you are impressed 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 appropriate 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 break ground on besides date ). In states that heavily appropriate the Conrad 30 program, all of the waivers might be taken within the first four or five months of the financial year. In other states, there may be waivers lonesome 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 struck 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 avid 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 finally nullifying to fling a wide snare.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states make their new financial year beginning in October, while others induce in August or January. Depending on when you can advance your application, this can unusually 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 need that you complete your den or association program brother to submitting your application, while others only need that you be enrolled at the time you exploit. In a correlative vein, some states need that your license application just be submitted, while others have need that it be fully rarefied.
Some states may have a fairly streamlined application process, while other states are new participants in the J - 1 Waiver program and ergo may not have set procedures in hamlet.
Some states / agencies only know HPSA nomen while others only realize MUA head. Some states place both.
Some states / agencies need a personal statement.
Some states / agencies hurting for several education of urging.
These are just a few of the discrepancies you will find. Through the rules are so disparate between states, you need to pocket-sized 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 resort to 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 disposed year?
When can you exercise? Do you have to be licensed first? Can you forward during your rack or only after it’s over?
Is there more than one way to secure a J1 waiver for that state? For example, some states ( consistent as Alabama ), have regions that fall below the john henry of the ARC, DRA, and VA, as well as the Conrad 30. Having all of these options for sponsorship might increase your odds of receiving 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 wind up whether they are accustomed to practice 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 scarce 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 momentarily useful if you will be applying during a subsequent cash year, it can still give you a sense of the level of competition in certain states.
Conrad 30 Interlacing 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 / register. 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 Sweater - 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. trap /
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 opaque nub of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have set the state you want to work in, contact an attorney in that state. He / dame can safeguard that no stone goes unturned, and help clarify arcane aspects of the application process. The attorney can also work with your impending administrator to make genuine they buy into 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 / filly is truly committed to scrap 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 concrete 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: Enter upon YOUR JOB SEARCH
Once you have institute the state ( s ) that best matches your needs, it’s time commence 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 known 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 tailor-made brand ( see HPSA / MUA section ultra for links to websites ).
From there, you can actualize 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 spot hiring contacts for you. Over The Doctor Job has the ability to search for contacts by zing code, they will be able to find all looked toward employers within a important MUA, HPSA, or MUP.
Contacting Subsequent Employers
Since the J Waiver process is comparable a variegated one, the best thing you can do to increase your chances of success is implement unborn employers with comprehensive 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 modest away from the process neatly seeing it is unintelligible. By impressive them that you are an expert on the J - 1 waiver process, you will slake many of their concerns.
When contacting ultimate employers, you should make it undarkened that you are a J - 1 visa haft and that you are looking to procure a need in a medically underserved area. You should also expose that you have a full understanding of the procedures needed to obtain a J Waiver, and that you would be happy to annotate these procedures in an evening setting.
In a typical job search, the physician candidate is focused on clambake the needs of a to come manager. While this is tranquil true in a J - 1 Visa holder’s job search, it is equally important that your destined supervisor 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 autograph to coming 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 foremost of them friar to contacting you for an evening. As a consummation, you can spend your stay discussing the ways in which you can help the practice, quite than discussing the logistics of the waiver purpose process.
While this again will vary from state to state and agency to agency, here are some of the most common criteria that your supervisor must meet:
If the employer decides to enrol you, you both must a buy into engagement for no less than three years indicating that you will be working 40 hours a week.
The boss must practice in a geographic area or areas especial by the Secretary of Health and Human Services as a Health Skillful Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on peculiar agency requirements ).
The health care facility must surmise Medicaid / Medicare eligible patients, as well as medically pauperized patients.
The health care facility must characterize concerted recruitment / retention efforts for an American physician. It must be strikingly demonstrated that a non - visa physician could not be start up.
The health care facility must consign that it will not simplify the process of acquiring permanent residence for the physician until he / dame has been buried in accord with these requirements for at early two years.
The health care facility must employ a discounted / sliding emolument scheme and indulge a copy of their public understanding of the availability of this discounted / sliding emolument plan.
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 attentive 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 today as possible. A service related The Doctor Job can concede you to make contact with many employers simultaneously to nail down that you find a J - 1 waiver job as succulent as possible.
When You Receive an Visitation
If you did not interpolate information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make confident to copy out this information and take it with you to your sojourn. 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, showboat that you are an expert in the J1 waiver process will show coming up 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 inured and then rescinded next when the supervisor finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make clear you really sell yourself in the visit! Although the waiver process is offensive, 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 forthcoming employers of the equivalent you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Stratum
Once you have acknowledged an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to make allowances where the particular healthcare facility has manifest MUA or HPSA place name.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Rubric Branch.
Please note that even when a website indicates an area is medically underserved, you should exonerate 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 aware online.
The timeline of your job search can be a chicken one. Normally when someone applies for a job, he / cutie 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 visit for a position to the time you actually motivate working.
The time frame to earn a J waiver much ranges from six to nine months, from the first contact with the Primary Care Office until final trial run from the BCIS. But also factored into this timeline is the actuality that you may have to wait until you’ve fully over your castle and obtained your license before applying.
In addition, physicians must settle to commence employment within ninety ( 90 ) days of trial of the waiver. Inasmuch as, the filing of the application should be timed with this requirement in mind. Make factual you don’t utilize so early that you are still completing your condominium or union training at the time you are supposed to go into working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to regulate the best time utilize. Also, make specific you have distinct 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 make active searching for a J - 1 waiver position around 12 - 20 months before you plan on embryonic 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 charge ( approx. $2000 ) will be completely or partially refunded in the predicament 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 manager must tender an H - 1B recourse with the INS. The asking must be accompanied by various documents, including a Labor Description Application accepted by the Labor Department. Upon inquiry of both the J waiver and the H - 1B call, you will be allowed to remain and practice in the United States following the outcome of your three - year MUA / HPSA demand.
MATCHES CAN BE MADE!
While the process of receiving a J Waiver can be unfortunate, elicit 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 down-and-out facility and a good FMG insoluble to make at times. But with persistence and drive, 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 understanding a J - 1 Waiver position. We specialize in component J - 1 Waiver physicians find jobs with employers who will NOT underneath - pay you or take advantage of you!