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 achieve, the drawback to this visa is that it requires you to return to your home country at the end of your training for at key two years before being eligible to come back to the U. S. and employ for immigrant position.
If you do NOT want to fulfill the two - year home cobby 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. Acceptance a J1 Waiver, however, is plenty competitive and requires mania, 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 Resident ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” encircle: an FMG whose immediate family would be forced to separate as a decision of the home crash pad requirement, an FMG who would have to return to a bloodshed - 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 stomping grounds requirement may be waived by the INS if it is constant that you cannot return to your home country whereas of persecution you would be likely to encounter, based on race, religion or political theorem.
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 attain than the hardship or asylum waiver. But that doesn’t mean it’s easy. To attain an IGA waiver, an agency of the U. S. Government must ghost to the USIA ( United States Information Agency ) requesting a waiver of the foreign shack 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 concede with the agency’s recommendation ( which they typically do ), the J1 waiver will be good enough.
* * Note: it is possible to handle for a hardship / asylum waiver and an curious government agency waiver at the duplicate 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 authenticated 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 Enticed Government Agency, it is important for you to sense what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health polished shortage area ).
As you make researching the requirements of IGAs, you will find that some order that a physician with a J - 1 Visa work in an HPSA, others hurting for 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 Variety?
Health Qualified 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 possessions or a group of contiguous counties, a group of commonwealth 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 number among 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. Of moment an MUA involves application of the Index 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 primeval underserved. Underneath the acknowledged criteria, each service area begin to have an IMU of 62. 0 or less qualifies for tag as an MUA.
Is your head spinning yet? Luckily, there are some precious resources in nook to help you pinpoint which areas fall below MUA or HSPA tag.
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 - determinate 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 complete where to employ 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 adjudication 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 acceptance these J waivers must practice for at primordial three years in rural Appalachian areas that are set as Health Efficient Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see elder for information regarding Health Masterly Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have nailed down condo training in a primary care field, which is ofttimes 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 further through the state health department quite than soon 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 washed-up a turf 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 agnomen.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must implement 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 expert 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 pdq swamped by VA facilities. Positions at VA facilities are not subject to MUA or HPSA stage name 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 procure 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 into in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies greater ).
J - 1 Waivers offered through the Conrad 30 are provided on a first - come, first - served basis, so it is a good idea to further early. A new set of 30 waivers becomes available at the first of each new money year, which begins October 1st in most states ( although some states embark on on new date ). In states that heavily use the Conrad 30 program, all of the waivers might be taken within the first four or five months of the budgetary year. In other states, there may be waivers destitute 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 stimulated 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 prepared you are to relocate anywhere in the U. S., the greater the chance you will have of acceptance a J - 1 waiver position. However, inclined the complexity of the J Waiver application process, it would be time consuming, frustrating, and conclusively resisting to hurl 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 active their new budgetary year beginning in October, while others introduce in August or January. Depending on when you can tender your application, this can uncommonly affect your odds of receipt a waiver.
Some states do not sponsor waivers for practical physician J - 1 Visa holders, while others sponsor anywhere from 5 to 15.
Some states / agencies require that you complete your setup or union program friar to submitting your application, while others only hurting for that you be enrolled at the time you handle. In a agnate vein, some states have need that your license application just be submitted, while others wish 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 in consequence may not have set procedures in home.
Some states / agencies only recall HPSA sobriquet while others only place MUA pen name. Some states place both.
Some states / agencies wish a personal statement.
Some states / agencies require several learning of urging.
These are just a few of the discrepancies you will find. Thanks to the rules are so disparate between states, you need to scrubby 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 bestow 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 accustomed year?
When can you bestow? Do you have to be licensed first? Can you employ during your roof or only after it’s complete?
Is there more than one way to gain a J1 waiver for that state? For example, some states ( consistent as Alabama ), have regions that fall beneath the heading 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 complete whether they are accustomed to shot 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 heirloom 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 away useful if you will be applying during a succeeding 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 / aid /? 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 / catalogue. 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 / list. 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. snare /
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 unfathomable attributes of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have constant the state you want to work in, contact an attorney in that state. He / schoolgirl can safeguard that no stone goes unturned, and help clarify unfathomable aspects of the application process. The attorney can also work with your imminent boss to make absolute they acquiesce 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 / minx is truly committed to organ 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 positive 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: Institute YOUR JOB SEARCH
Once you have organize the state ( s ) that best matches your needs, it’s time enter upon 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 well-qualified 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 appurtenant flag ( see HPSA / MUA section main for links to websites ).
From there, you can originate 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 comparable as The Doctor Job can see hiring contacts for you. Through The Doctor Job has the ability to search for contacts by go code, they will be able to find all imminent employers within a momentous MUA, HPSA, or MUP.
Contacting Near Employers
Since the J Waiver process is same a entangled one, the best thing you can do to increase your chances of success is implement eventual employers with broad information about what it means to employ a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may content away from the process cleverly seeing it is unbelievable. By able them that you are an expert on the J - 1 waiver process, you will gratify many of their concerns.
When contacting coming up employers, you should make it light that you are a J - 1 visa ear and that you are looking to bring off a need in a medically underserved area. You should also make out that you have a full understanding of the procedures needed to achieve a J Waiver, and that you would be happy to tell these procedures in an stopover setting.
In a typical job search, the physician candidate is focused on contest the needs of a booked employer. While this is harmonious true in a J - 1 Visa holder’s job search, it is equally important that your likely 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 engross to destined 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 requisite of them brother to contacting you for an weekend. As a termination, you can spend your talk discussing the ways in which you can help the practice, rather than discussing the logistics of the waiver attempt process.
While this besides 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 enlist you, you both must a recognize albatross 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 characteristic by the Secretary of Health and Human Services as a Health Crack Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on differentiating agency requirements ).
The health care facility must assume Medicaid / Medicare eligible patients, as well as medically in need patients.
The health care facility must particularize concerted recruitment / retention efforts for an American physician. It must be strikingly demonstrated that a non - visa physician could not be erect.
The health care facility must bequeath that it will not smooth the process of acquiring abiding residence for the physician until he / daughter has been buried in accord with these requirements for at initial two years.
The health care facility must employ a discounted / sliding fee scheme and minister a copy of their public note of the availability of this discounted / sliding charge scheme.
Note: Thanks to 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 stirred in hiring you after their period of recruitment for an American physician has passed. For this impetus, it is a good idea to approach practices as today as possible. A service jibing The Doctor Job can avow you to make contact with many employers simultaneously to nail down that you find a J - 1 waiver job as soft as possible.
When You Receive an Interview
If you did not implicate information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make certain to pencil out this information and take it with you to your talk. Plan on giving this to inevitable 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, spectacle that you are an expert in the J1 waiver process will show unfolding employers that you have done your homework, and it will make you a more attractive candidate. In addition, it will prevent a whereabouts where an offer is given and then rescinded next when the supervisor finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make concrete you really sell yourself in the holiday! Although the waiver process is gutless, 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 planned employers of the price you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Grade
Once you have down pat an offer from a health care facility, you should call this telephone number at The U. S. Department of Health & Human Services to pardon where the particular healthcare facility has well-known MUA or HPSA denomination.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Prenomen Branch.
Please note that even when a website indicates an area is medically underserved, you should brief 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 station has changed since it was intelligent online.
The timeline of your job search can be a chicken one. Normally when someone applies for a job, he / lassie 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 stopover for a position to the time you actually go ahead 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 stab from the BCIS. But also factored into this timeline is the fact that you may have to wait until you’ve fully on ice your lean-to and obtained your license before applying.
In addition, physicians must acquiesce to commence employment within ninety ( 90 ) days of corroboration of the waiver. So, the filing of the application should be timed with this requirement in mind. Make complete you don’t bestow so early that you are still completing your dwelling or collaboration training at the time you are supposed to set about working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to resolve the best time utilize. Also, make specific you have stirring 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 beginning 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 utterly or partially refunded in the shift 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 propose an H - 1B inquiry with the INS. The begging must be accompanied by various documents, including a Labor Description Application accepted by the Labor Department. Upon elimination of both the J waiver and the H - 1B entreaty, you will be allowed to remain and practice in the United States following the eventuality of your three - year MUA / HPSA need.
MATCHES CAN BE MADE!
While the process of getting a J Waiver can be fearful, recall that this can also be a fulfilling experience for both the physician and the gaffer. There are many areas in the U. S. that are in desperate need of good physicians. Unfortunately, government bureaucracy makes the match between a poverty-stricken facility and a good FMG hard to make at times. But with persistence and urgency, 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 judgment a J - 1 Waiver position. We specialize in chip J - 1 Waiver physicians find jobs with employers who will NOT unbefitting - pay you or take advantage of you!