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 fundamental two years before being eligible to come back to the U. S. and appropriate for immigrant rank.
If you do NOT want to fulfill the two - year home house 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. Recipient a J1 Waiver, however, is awfully competitive and requires dispatch, 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 Continuing Renter ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” take in: an FMG whose immediate family would be forced to separate as a returns of the home home plate 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 turf requirement may be waived by the INS if it is serious that you cannot return to your home country due to of persecution you would be likely to encounter, based on relay, religion or political idea.
3. The Predisposed Government Agency ( IGA ) Waiver
This is by far the most common J1 waiver obtained by FMGs, and it is also easier to procure than the hardship or asylum waiver. But that doesn’t mean it’s easy. To procure an IGA waiver, an agency of the U. S. Government must chalk to the USIA ( United States Information Agency ) requesting a waiver of the foreign shanty 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 subscribe with the agency’s advocacy ( which they typically do ), the J1 waiver will be without fail.
* * Note: it is possible to handle for a hardship / asylum waiver and an fascinated government agency waiver at the corresponding time. If you hold 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 Fascinated Government Agency, it is important for you to understand 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 actualize researching the requirements of IGAs, you will find that some direction 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 Idiosyncrasy?
Health Licensed 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 principality 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 subsume 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. Influential an MUA involves application of the Index of Medical Underservice ( IMU ) to data on a service area to achieve a score for the area. The IMU scale is from 0 to 100, where 0 represents completely underserved and 100 represents best served or aboriginal underserved. Under the accepted criteria, each service area organize to have an IMU of 62. 0 or less qualifies for pet name as an MUA.
Is your head spinning yet? Luckily, there are some treasured resources in vicinity to help you identify which areas fall below MUA or HSPA denomination.
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 - distinctive 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 decide where to bestow 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 receiving an IGA waiver and verdict 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 pioneer three years in rural Appalachian areas that are smashing as Health Trained Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see most for information regarding Health Known Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have down habitation training in a primary care field, which is regularly special as internal medicine, family practice, general practice, pediatrics, general psychiatry or obstetrics and gynecology.
Requests for J waivers unbefitting the ARC J - 1 Visa Program must be sponsored by a state within the Appalachian Region, which includes all of West Virginia and parts of 12 other states: Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, and Virginia. All inquiries should be made to state contacts. This means that you employ through the state health department reasonably than promptly 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 finished 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 cognomen.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must arrange 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 efficient 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 soon swamped by VA facilities. Positions at VA facilities are not subject to MUA or HPSA monogram 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 fix up information on their J waiver application and requirements online; however, some states have yet to machine a formal waiver application process. Below you will find links to each state’s website where you can research whether the state you are inspired in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies big ).
J - 1 Waivers offered through the Conrad 30 are provided on a first - come, first - served basis, so it is a good idea to advance early. A new set of 30 waivers becomes available at the first of each new pecuniary year, which begins October 1st in most states ( although some states go ahead on enhanced 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 monetary year. In other states, there may be waivers estranged over at the end of the year.
An important thing to note about the Conrad 30 is that the program is administered differently from state to state. For that instigation, it is important that physicians with J - 1 visas carefully research the state or states they’re obsessed 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 recipient a J - 1 waiver position. However, inclined the complexity of the J Waiver application process, it would be time consuming, frustrating, and someday privative to fling a wide trap.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states go into their new pecuniary year beginning in October, while others create in August or January. Depending on when you can tender your application, this can severely affect your odds of getting 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 hurting for that you complete your shanty or collaboration program monastic to submitting your application, while others only have need that you be enrolled at the time you advance. In a akin vein, some states hurting for that your license application just be submitted, while others depend upon 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 for may not have set procedures in point.
Some states / agencies only recall HPSA head while others only recall MUA john doe. Some states know both.
Some states / agencies miss a personal statement.
Some states / agencies hurting for several erudition of counselling.
These are just a few of the discrepancies you will find. Seeing 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 profit by 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 apt year?
When can you exploit? Do you have to be licensed first? Can you exploit during your rack or only after it’s ended?
Is there more than one way to secure a J1 waiver for that state? For example, some states ( identical as Alabama ), have regions that fall unbefitting the agnomen 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 pin down whether they are accustomed to hang-up 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 collectible 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 subsequent pecuniary year, it can still give you a sense of the level of competition in certain states.
Conrad 30 Web 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 / record. 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 Jersey - 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 / guide. asp
STEP FOUR: HIRE AN IMMIGRATION ATTORNEY
Given the indeterminate disposition of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have brick wall the state you want to work in, contact an attorney in that state. He / nymph can ice that no stone goes unturned, and help clarify hazy aspects of the application process. The attorney can also work with your future administrator to make categorical they allow 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 / nymphet is truly committed to part 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 incontrovertible 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: Trigger YOUR JOB SEARCH
Once you have institute the state ( s ) that best matches your needs, it’s time initiate 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 competent 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 belonging moniker ( see HPSA / MUA section supreme for links to websites ).
From there, you can found 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 akin as The Doctor Job can learn hiring contacts for you. Now The Doctor Job has the ability to search for contacts by vigor code, they will be able to find all coming up employers within a characteristic MUA, HPSA, or MUP.
Contacting Scheduled Employers
Since the J Waiver process is homologous a labyrinthine one, the best thing you can do to increase your chances of success is contribute inevitable employers with whopping information about what it means to enrol a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may timorous away from the process cleverly as it is dark. By active them that you are an expert on the J - 1 waiver process, you will lighten many of their concerns.
When contacting booked employers, you should make it luminous that you are a J - 1 visa haft and that you are looking to earn a need in a medically underserved area. You should also make out that you have a full understanding of the procedures needed to attain a J Waiver, and that you would be happy to explicate these procedures in an holiday setting.
In a typical job search, the physician candidate is focused on rally the needs of a likely manager. While this is placid true in a J - 1 Visa holder’s job search, it is equally important that your prospective administrator meet a number of criteria. The website of the IGA or state you will be applying to should have this criteria distinctly listed. At the time you record to forthcoming 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 essential of them brother to contacting you for an interview. As a backwash, you can spend your call discussing the ways in which you can help the practice, fairly than discussing the logistics of the waiver achievement process.
While this further will vary from state to state and agency to agency, here are some of the most common criteria that your boss must meet:
If the administrator decides to enrol you, you both must a acquiesce blame 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 definite by the Secretary of Health and Human Services as a Health Qualified Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on regular agency requirements ).
The health care facility must credit Medicaid / Medicare eligible patients, as well as medically stone broke patients.
The health care facility must narrate concerted recruitment / retention efforts for an American physician. It must be markedly demonstrated that a non - visa physician could not be father.
The health care facility must leave that it will not make easy the process of acquiring lifelong residence for the physician until he / queen has been unavailable in harmony with these requirements for at primary two years.
The health care facility must employ a discounted / sliding price diary and equip a copy of their public thought of the availability of this discounted / sliding emolument scheme.
Note: In that 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 occupied 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 double time as possible. A service twin The Doctor Job can let on you to make contact with many employers simultaneously to ensure that you find a J - 1 waiver job as tender as possible.
When You Receive an Talk
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 pencil out this information and take it with you to your tarriance. Plan on giving this to ulterior 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, pageantry that you are an expert in the J1 waiver process will show impending employers that you have done your homework, and it will make you a more attractive candidate. In addition, it will prevent a stage where an offer is habituated and then rescinded later when the executive finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make specific you really sell yourself in the evening! Although the waiver process is unethical, at the root of the process is the truth that there are many underserved health care facilities in the U. S. that are in desperate need of quality physicians. Do not be afraid to talk about your strengths and convince unborn employers of the charge you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Position
Once you have familiar an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to validate where the particular healthcare facility has admitted MUA or HPSA denomination.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Denomination Branch.
Please note that even when a website indicates an area is medically underserved, you should sustain 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 rank has changed since it was learned online.
The timeline of your job search can be a treacherous one. Normally when someone applies for a job, he / minx 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 talk for a position to the time you actually prepare working.
The time frame to obtain a J waiver much ranges from six to nine months, from the first contact with the Primary Care Office until final catechism from the BCIS. But also factored into this timeline is the detail that you may have to wait until you’ve fully finished your edifice and obtained your license before applying.
In addition, physicians must permit to commence employment within ninety ( 90 ) days of go of the waiver. Inasmuch as, the filing of the application should be timed with this requirement in mind. Make concrete you don’t handle so early that you are still completing your dwelling or cooperation training at the time you are supposed to induce working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to drive the best time utilize. Also, make explicit you have expressive 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 occasion searching for a J - 1 waiver position around 12 - 20 months before you plan on opening 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 business that the waiver is not approved. The DRA, however, charges a $3000 application cost, which is nonrefundable.
AFTER GETTING APPROVED
Once you’ve successfully obtained a waiver ( congratulations! ), your boss must proffer an H - 1B desire with the INS. The appeal must be accompanied by various documents, including a Labor Description Application accepted by the Labor Department. Upon corroboration of both the J waiver and the H - 1B suit, you will be allowed to remain and practice in the United States following the proceeds of your three - year MUA / HPSA occasion.
MATCHES CAN BE MADE!
While the process of recipient a J Waiver can be awful, recollect that this can also be a fulfilling experience for both the physician and the administrator. There are many areas in the U. S. that are in desperate need of good physicians. Unfortunately, government bureaucracy makes the match between a tapped facility and a good FMG insoluble to make at times. But with persistence and gusto, 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 end a J - 1 Waiver position. We specialize in parcel J - 1 Waiver physicians find jobs with employers who will NOT underneath - pay you or take advantage of you!