J-1 Visa Waivers for Physicians to Work in Medically Underserved Areas

A J-1 exchange visa holder who received graduate medical education or training in the U.S. (a J-1 medical doctor) is generally ineligible to apply for a Green Card or nonimmigrant visa unless he or she resides in his or her home country for at least two years upon completion of the J-1 exchange visitor program.  This requirement of returning to home country (to be more precise, the country of last permanent residence at the time of obtaining the J-1 classification/visa) is referred to as “Home Residency Requirement,” (“HRR,”) and is also known as the 212(e) requirement, based upon the section of the law that contains it.

This two-year HRR can be waived through four methods [three for Foreign Medical Graduates (“FMG’s”)].  We are highlighting here the most commonly used waiver options used by FMG’s. 

The most commonly used waiver options rely upon an FMG’s undertaking to serve a certain amount of time in a designated medical facility or area.  Information on each state’s programs is below.

Here is general information about the J-1 Visa program:

http://www.immigration.com/visa/j-1-visa/j-1j-2-visa

The applying physician must begin the process with the U.S. Department of State and obtain a case number.  Here is the website for beginning the process and obtaining a case number:

https://j1visawaiverrecommendation.state.gov/

The applying physician needs to have employment lined up to participate in the program and agree to begin employment at the health care facility within 90 days of receipt of the waiver, not the date his or her J-1 visa expires.  The employment offer needs to be for full-time employment in H-1B nonimmigrant status at a health care facility located in an area designated by U.S. Department of Health and Human Services (HHS) as a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP). 

The U.S. Department of Health and Human Services maintains a database of openings in shortage areas:

http://bhpr.hrsa.gov/shortage/shortageareas/index.html

In addition, there is another national database of available placements for this and similar programs, the 3RNet website, from which those interested should choose "Search Opportunities," then check “Search Only Health Professional Shortage Areas – HPSAs” in order to search rural areas that are eligible for the program:

https://www.3rnet.org/

The applicant must obtain a “no objection” letter from his or her home country if the home government funded his or her exchange program.

The four most commonly used programs are as follows:

1)     The largest program is the Conrad-30 J-1 Waiver program.  Each state is entitled to 30 waivers per year.  Below are links to each state’s Conrad-30 program. 

2)     The U.S. Department of Health and Human Services (HHS) manages health the research and clinical care portion of the U.S. Exchange Visitor Program.  This program accepts applications for two types of waivers--research performed in an area of priority or significant interest to the agency, and

health care services needed in a Health Professional Shortage Area (HPSA) in the United States.  Here is more information about this program:

http://www.globalhealth.gov/global-programs-and-initiatives/exchange-visitor-program/index.html

3)     The Appalachian Regional Commission (ARC) is administered in the 13 states in the Appalachian region.  The ARC 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.  The links below for each state provide information about that state’s program.  Here is general information:

http://www.arc.gov/j1visawaiver

4)     The Delta Doctors program is administered in parts of eight states:  Alabama Arkansas Illinois Kentucky Louisiana Mississippi Missouri and Tennessee  Information about most of these state programs is in the links below.  Click here is general information about the Delta Doctors program.

Below is a link for each state, including individual state contact information.  In addition, the U.S. State Department maintains a list of state contacts.  Should the state website not be clear about the contact person for that state, you may wish to consult this list:

http://travel.state.gov/visa/temp/info/info_1292.html

STATE BY STATE SUMMARY OF J-1 Waiver Programs

Alabama

Alabama has two main J-1 Waiver programs, the Conrad State 30 program and the Appalachian Regional Commission.  Here is information on these programs:

http://adph.org/ruralhealth/index.asp?id=882 

Alabama also participates in the Delta Doctor program through the Delta Regional Authority:

http://www.dra.gov/about-us/eight-state-map.aspx

Alaska

Here is information on Alaska’s Conrad-30 program:

http://www.hss.state.ak.us/dhcs/Healthplanning/workforce/assets/akPandP.pdf

Arizona

Here is information on Arizona’s Conrad-30 program:

http://azdhs.gov/hsd/visa_waiver.htm

Arkansas

Here is information on the Arkansas Conrad-30 program:

http://www.healthy.arkansas.gov/programsServices/hsLicensingRegulation/HealthFacilityServices/Pages/J-1WaiverProgram.aspx  

Arkansas also participates in the Delta Doctors Program of the Delta Regional Authority:

http://www.dra.gov/delta-doctors/default.aspx

California

Here is information on California's Conrad-30 program:

http://www.dhcs.ca.gov/services/rural/Pages/J-1VisaWaiver.aspx

Colorado

Here is information on Colorado's Conrad-30 program:

http://www.colorado.gov/cs/Satellite/CDPHE-PSD/CBON/1251631636597

Connecticut

Here is information on Connecticut's Conrad-30 program:

http://www.ct.gov/dph/cwp/view.asp?a=3121&q=453806

Delaware

Here is information on Delaware’s Conrad-30 program:

http://dhss.delaware.gov/dhss/dph/hsm/j1visahome.html

Florida

Here is information on Florida’s Conrad-30 program:

http://www.doh.state.fl.us/Workforce/recruit1/Waivers.html

Georgia

Georgia’s administers two programs, the Conrad-30 and the Appalachian Regional Commission programs.  Both receive applications year-round.  Here is information:

http://dch.georgia.gov/georgias-j-1-visa-waiver-program

Hawaii

Here is information about Hawaii’s Conrad-30 program:

http://hawaii.gov/health/family-child-health/rural-health/j1visa.html

Idaho

Here is information on Idaho’s Conrad-30 program:

http://www.healthandwelfare.idaho.gov/Health/RuralHealthandPrimaryCare/J1VisaWaiverNationalInterestWaiver/tabid/413/Default.aspx

Illinois

Here is information on the Illinois Conrad-30 program:

http://www.idph.state.il.us/about/rural_health/rural_home.htm

Illinois also participates in the Delta Doctor program through the Delta Regional Authority:

http://www.dra.gov/delta-doctors/

Indiana

Here is information on Indiana's Conrad-30 program:

http://www.indianapca.org/programs/j1waiver.html

Iowa

Here is information on Iowa's Conrad-30 program:

http://www.idph.state.ia.us/OHDS/RuralHealthPrimaryCare.aspx?prog=RHPC&pg=PCO

Kansas

Here is information on the Kansas Conrad-30 program:

http://www.kdheks.gov/olrh/j-1visa_waiver_overview.htm

Kentucky

Kentucky participates in three programs—the Conrad-30, the Appalachian Regional Commission, and the Delta Regional Authority programs.  Here is information on the Conrad-30 and ARC programs:

http://chfs.ky.gov/dph/info/dpqi/ky+j1+visa+waiver+program.htm

Here is information on the Delta Doctor program through the Delta Regional Authority:

http://www.dra.gov/delta-doctors/

Louisiana

Here is information on Louisiana's Conrad-30 program:

http://new.dhh.louisiana.gov/index.cfm/page/792

Louisiana also participates in the Delta Doctor program through the Delta Regional Authority:

http://www.dra.gov/delta-doctors/

Maine

Here is information on Maine’s Conrad-30 program:

http://www.maine.gov/dhhs/mecdc/local-public-health/orhpc/j1.shtml

Maryland

Below is information on Maryland's Conrad-30 program.  Maryland also participates in the Appalachian Regional Commission (ARC) program.

http://fha.dhmh.maryland.gov/ohpp/SitePages/pco-j1visa.aspx

Massachusetts

Here is information on the Massachusetts program:

http://www.mass.gov/eohhs/provider/guidelines-resources/services-planning/workforce-development/workforce-help/j1/

Michigan

Here is information on Michigan's Conrad-30 program:

http://www.mimom.org/mi_conrad_30.php

Minnesota

Here is information on Minnesota’s Conrad-30 program:

http://www.health.state.mn.us/divs/orhpc/workforce/j1/index.html

Mississippi

Mississippi has a Conrad-30 program, an Appalachian Regional Commission program, and a Delta Regional Authority program.  Here is information about the Conrad-30 and ARC programs:

http://www.msdh.state.ms.us/msdhsite/_static/44,0,112,181.html

Here is information about the Delta Doctor program through the Delta Regional Authority:

http://www.dra.gov/delta-doctors/

Missouri

Here is information on Missouri’s Conrad-30 program:

http://health.mo.gov/living/families/primarycare/j1visa/index.php

Missouri is also a member of the Delta Regional Authority, which administers the Delta Doctor program:

http://www.dra.gov/delta-doctors/

Montana

Here is information on Montana’s Conrad 30 program:

http://www.dphhs.mt.gov/publichealth/primarycare/

Nebraska

Here is information on Nebraska’s Conrad 30 program:

http://dhhs.ne.gov/publichealth/Pages/hew_orh_j1.aspx

Nevada

Here is information on Nevada’s Conrad 30 program:

http://health.nv.gov/PrimaryCare_Conrad_J-1.htm

New Hampshire

Here is information on New Hampshire’s Conrad 30 program:

http://www.dhhs.nh.gov/dphs/bchs/rhpc/visa.htm

New Jersey

Here is information about New Jersey’s Conrad 30 program:

http://www.state.nj.us/health/fhs/j1/index.shtml

New Mexico

Here is information about New Mexico’s Conrad 30 program:

http://nmhealth.org/PHD/OPRH.shtml

New York

Here is information on New York’s Conrad 30 program:

http://www.health.ny.gov/professionals/j-1_visa_waivers/

North Carolina

For information about North Carolina’s Conrad 30 and Appalachian Regional Commission (ARC) programs, contact the N.C. Department of Health and Human Services.  Here is contact information:

http://www.ncdhhs.gov/orhcc/recruitment/medical.htm

North Dakota

Here is information about North Dakota’s Conrad 30 program:

http://www.ndhealth.gov/pco/

Ohio

Here is information on Ohio’s Conrad-30 and Appalachian Regional Commission (ARC) programs:

http://www.odh.ohio.gov/odhPrograms/chss/PCRH_Programs/recruitment/jvisa.aspx

Oklahoma

Here is Oklahoma’s Conrad 30 program contact:

http://www.ok.gov/health/Community_Health/Community_Development_Service/Primary_Care_&_Rural_Health_Development/Oklahoma_Volunteer_Charitable_Healthcare_Provider_Program/index.html

Here is Oklahoma’s Conrad 30 application:

http://www.oumedicine.com/docs/college-of-medicine-workfiles/com-visa_waiver_request.pdf?sfvrsn=2

Oregon

Here is information about Oregon’s Conrad 30 program:

http://www.oregon.gov/OHA/OHPR/PCO/index.shtml#Physician_Visa_Waiver_Program

Pennsylvania

For information on Pennsylvania’s Conrad-30 and Appalachian Regional Commission (ARC) programs, click here.

Rhode Island

Here is information on Rhode Island’s Conrad-30 program:

http://www.health.ri.gov/programs/physicianvisawaiver/index.php

South Carolina

Below is information on South Carolina’s Conrad-30 program.  South Carolina also participates in the Appalachian Regional Commission (ARC) program.

http://www.dhec.sc.gov/health/opc/j1.htm

South Dakota

Here is information on South Dakota’s Conrad-30 program:

http://doh.sd.gov/RuralHealth/J1.aspx  

Tennessee

Below is information on Tennessee’s Conrad-30 program.  Tennessee also participates in the Appalachian Regional Commission (ARC) program.

http://health.state.tn.us/rural/j1visa0.html

Texas

Here is information on the Texas Conrad-30 program:

http://www.dshs.state.tx.us/chpr/j1info.shtm

Utah

Here is information on Utah’s Conrad-30 program:

http://health.utah.gov/primarycare/employment.html

Vermont

Here is information on Vermont’s Conrad-30 program:

http://healthvermont.gov/rural/visa.aspx

Virginia

Below is information on Virginia’s Conrad-30 program.  Virginia also participates in the Appalachian Regional Commission (ARC) program.

http://www.vdh.state.va.us/healthpolicy/primarycare/incentives/j1visa/index.htm

Washington

Here is information on the State of Washington's Conrad-30 program:

http://www.doh.wa.gov/PublicHealthandHealthcareProviders/RuralHealth/HealthProfessionalSupportPrograms/J1VisaWaiverProgram.aspx

West Virginia

West Virginia participates in the Conrad-30 and Appalachian Regional Commission programs.  Here is information:

http://www.wvochs.org/dr/j-1.aspx

Wisconsin

Here is information on Wisconsin’s Conrad-30 program:

http://www.dhs.wisconsin.gov/health/PrimaryCare/J-1Visa/description.htm

Wyoming

Here is information on Wyoming’s Conrad-30 program:

http://www.health.wyo.gov/rfhd/rural/Primary_Care_Office.html