J-1 Waivers

Physicians who enter the U.S. on a J-1 for Graduate Medical Education are subject to Section 212(e) of the Immigration Nationality Act, or the “Foreign Residency Requirement.” Unless you receive and fulfill a J-1 Waiver, you must return to your home country for 2 years before you can obtain an H-1B Visa or green card and work in the United States. There are multiple ways to obtain a waiver of this requirement. Most J-1 physicians we assist choose an employment-based J-1 waiver, in which case they commit to working in a medical shortage area or at a Veterans Affairs hospital for 3 years.

We prepare and file various types of J-1 waivers, including (but not limited to): Conrad 30 (all U.S. states), HHS Clinical, HHS Research, ARC, Delta Regional Authority/Delta Doctors, Exceptional Hardship to U.S. Citizen, No Objection, and Persecution.

Conrad 30 Waiver

The Conrad 30 waiver allows states to support  30 J-1 waivers per year for physicians who will be working in underserved areas in their state. In this program, the physician is required to work full-time with a temporary U.S. work visa (H-1B) in a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP) for 3 years. Priority is given to primary care physicians and physicians working in more severe shortage areas. Some states require primary care physicians working in a facility with a HPSA score of 7 or higher to apply for an HHS waiver instead.

HHS Clinical Waiver

The HHS waiver is a good option for physicians practicing in either primary care or general psychiatry who will be working in an area with an HPSA score of at least 7. The physician must have completed a primary care or psychiatry residency no more than 12 months before the contract start date. Unlike the Conrad 30 waiver, there is no limit on how many HHS waivers can be granted per year and the application can be completed at any time.

VA Waiver

The VA waiver applies to physicians working full-time in a Veterans Affairs medical facility for 3 years. This waiver does not require the applicant to work in a medical shortage area, but there is a screening process where the VA facility must verify there are no U.S. physicians who are qualified and able to work in the facility. The application can be completed at any time and the VA will handle the entire J-1 waiver process and the H-1B Visa.

Location-Specific Waivers

Waivers like ARC, SCRC, DRA, and more require a physician to work in one of the organization’s designated areas for 3 years. The ARC waiver is designated to counties in 13 states, including Ohio, Georgia, and Maryland. The SCRC waiver includes counties in 8 states including Florida, South Carolina, and Alabama. The DRA waiver includes counties in 8 states including Arkansas, Illinois, and Missouri. In addition to being in the appropriate area, the facility you work at must be in a designated HPSA, MHPSA, MUA, or MUP, with some waivers only accepting HPSAs. Each organization has their own application process and requirements.

Exceptional Hardship to U.S. Citizen Waiver

To receive this J-1 waiver, the applicant must prove that fulfilling the Foreign Residency Requirement would cause exceptional hardship to the applicant’s spouse or child who is a U.S. citizen or Lawful Permanent Resident. This applies to situations where the qualifying family members would experience exceptional hardship from being separated from the applicant and where the qualifying family member would experience exceptional hardship from relocating with the applicant. You will be required to submit evidence that the hardship is greater than expected from a typical relocation, whether this be from anxiety and loneliness, medical conditions, the conditions of the home country, or another kind of evidence. This waiver is only applicable if there will be exceptional hardship to a U.S. citizen or LPR, evidence of exceptional hardship to the J-1 holder is not considered!

Persecution Waiver

Lastly, a person subject to the J-1 return home requirement may be eligible for the Persecution J-1 waiver if there is a well-founded fear of persecution upon returning to their home country. This fear of persecution can be based on your race, religion, or political opinion. Applicants for this waiver are required to provide proof that there is a well-founded fear of persecution upon return, whether it be from the government of their home country or a group the government is unable to control. This waiver is based on the threat of persecution to the J-1 holder, not their family members.

The most important factors that go into selecting a J-1 waiver are the type of medicine you will be practicing, which waivers are available for your location, and the time frame in which you will be applying. Sherman Immigration is here to assist with the process and help you determine which J-1 waiver is the best for you.