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 procure, the drawback to this visa is that it requires you to return to your home country at the end of your training for at leading 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 co-op 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. Receipt a J1 Waiver, however, is notably competitive and requires hop, 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 gain 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 Abiding Dweller ) or your children, you may be eligible for a hardship waiver. Examples of situations that might qualify as “hardship scenarios” enter: an FMG whose immediate family would be forced to separate as a eventuality of the home flat requirement, an FMG who would have to return to a combat - 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 abode requirement may be waived by the INS if it is resolved that you cannot return to your home country over of persecution you would be likely to encounter, based on chase, religion or political presumption.
3. The Attracted 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 earn an IGA waiver, an agency of the U. S. Government must sign to the USIA ( United States Information Agency ) requesting a waiver of the foreign home plate 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 shake hands with the agency’s advocacy ( which they typically do ), the J1 waiver will be gladly.
* * Note: it is possible to handle for a hardship / asylum waiver and an inspired government agency waiver at the equivalent time. If you conclude 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 accredited 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 Buying it Government Agency, it is important for you to identify with what constitutes a medically underserved area. There are two terms that crop up frequently: MUA ( medically underserved area ) and HPSA ( health crack shortage area ).
As you embark on researching the requirements of IGAs, you will find that some authority 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 Contrariness?
Health Adept 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 sphere or a group of contiguous counties, a group of rule 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 allow for 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. Significant an MUA involves application of the List of Medical Underservice ( IMU ) to data on a service area to get a score for the area. The IMU scale is from 0 to 100, where 0 represents completely underserved and 100 represents best served or primordial underserved. Underneath the conscious criteria, each service area fix to have an IMU of 62. 0 or less qualifies for label as an MUA.
Is your head spinning yet? Luckily, there are some treasured resources in joint to help you identify which areas fall below MUA or HSPA term.
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 - chief 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 cinch where to profit by 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 compromise 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 elementary three years in rural Appalachian areas that are extraordinary as Health Well-qualified Shortage Areas ( HPSA ) by the U. S. Public Health Service ( see better for information regarding Health Trained Shortage Areas vs. Medically Underserved Areas ). The ARC program is limited to physicians who have ended edifice training in a primary care field, which is much individual as internal medicine, family practice, general practice, pediatrics, general psychiatry or obstetrics and gynecology.
Requests for J waivers underneath 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 appropriate through the state health department fairly than like now 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 wrapped up a crash pad 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 heading.
The Department of Health and Human Services ( www. hhs. gov )
The DHHS serves as the IGA for underserved communities outside of Appalachia. Physicians must fit 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 polished 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 assiduous by VA facilities. Positions at VA facilities are not subject to MUA or HPSA denomination 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 heel 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 moved in participates in the Conrad 30 ( if not, you may still be able to work in that state through one of the other agencies over ).
J - 1 Waivers offered through the Conrad 30 are provided on a first - come, first - served basis, so it is a good idea to exercise early. A new set of 30 waivers becomes available at the first of each new budgetary year, which begins October 1st in most states ( although some states actualize on and 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 money year. In other states, there may be waivers friendless 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 ground, it is important that physicians with J - 1 visas carefully research the state or states they’re moved 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 recipient a J - 1 waiver position. However, obsessed the complexity of the J Waiver application process, it would be time consuming, frustrating, and in consummation contrary to toss a wide trap.
Here a just a few examples of the differences between states with regard to J Waiver rules and regulations:
Some states effect their new pecuniary year beginning in October, while others motivate in August or January. Depending on when you can tender your application, this can hugely 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 domicile or collaboration program monastic to submitting your application, while others only have need that you be enrolled at the time you use. In a complementary vein, some states depend upon that your license application just be submitted, while others hurting for that it be fully pure.
Some states may have a fairly streamlined application process, while other states are new participants in the J - 1 Waiver program and forasmuch as may not have set procedures in spot.
Some states / agencies only place HPSA prenomen while others only know MUA name. Some states know both.
Some states / agencies hurting for a personal statement.
Some states / agencies have need several erudition of endorsement.
These are just a few of the discrepancies you will find. Seeing the rules are so disparate between states, you need to toy 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 advance 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 addicted year?
When can you employ? Do you have to be licensed first? Can you handle during your roost or only after it’s wrapped up?
Is there more than one way to obtain a J1 waiver for that state? For example, some states ( parallel as Alabama ), have regions that fall unbefitting the term of the ARC, DRA, and VA, as well as the Conrad 30. Having all of these options for sponsorship might increase your odds of recipient 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 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 valued 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 right now useful if you will be applying during a following 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 / support /? 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 / guide. 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 / inventory. 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. net /
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 / register. asp
STEP FOUR: HIRE AN IMMIGRATION ATTORNEY
Given the unaccountable individuality of the J Waiver process, a good immigration attorney is virtually a necessity. Once you have unfaltering the state you want to work in, contact an attorney in that state. He / chick can ensure that no stone goes unturned, and help clarify inexplicable aspects of the application process. The attorney can also work with your scheduled manager to make thorough 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 / missy is truly committed to sector 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 forcible 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: Give impulse YOUR JOB SEARCH
Once you have originate the state ( s ) that best matches your needs, it’s time introduce 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 trained 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 desired denomination ( see HPSA / MUA section hefty for links to websites ).
From there, you can drive 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 approximative as The Doctor Job can recognize hiring contacts for you. Seeing The Doctor Job has the ability to search for contacts by pizzazz code, they will be able to find all ulterior employers within a especial MUA, HPSA, or MUP.
Contacting Budgeted Employers
Since the J Waiver process is like a mingled one, the best thing you can do to increase your chances of success is maintain coming employers with monumental information about what it means to engage a J Waiver candidate. Many employers who might truly benefit from hiring a J - 1 visa physician may humble away from the process tidily considering it is illegible. By effectual them that you are an expert on the J - 1 waiver process, you will sate many of their concerns.
When contacting inevitable employers, you should make it sunshiny that you are a J - 1 visa knob and that you are looking to deliver a need in a medically underserved area. You should also prove that you have a full understanding of the procedures needed to get a J Waiver, and that you would be happy to solve these procedures in an tarriance setting.
In a typical job search, the physician candidate is focused on conclave the needs of a approaching administrator. While this is waveless true in a J - 1 Visa holder’s job search, it is equally important that your future employer meet a number of criteria. The website of the IGA or state you will be applying to should have this criteria decidedly listed. At the time you turn out to to be 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 imperative of them religious to contacting you for an evening. As a completion, you can spend your sojourn discussing the ways in which you can help the practice, moderately than discussing the logistics of the waiver elbow grease process.
While this again will vary from state to state and agency to agency, here are some of the most common criteria that your director must meet:
If the manager decides to engage you, you both must a check fault for no less than three years indicating that you will be working 40 hours a week.
The gaffer must practice in a geographic area or areas rare by the Secretary of Health and Human Services as a Health Ace Shortage Area ( HPSA ) or Medically Underserved Area ( MUA ) ( depending on peculiar agency requirements ).
The health care facility must believe Medicaid / Medicare eligible patients, as well as medically poor patients.
The health care facility must image concerted recruitment / retention efforts for an American physician. It must be markedly demonstrated that a non - visa physician could not be settle.
The health care facility must consign that it will not aid the process of acquiring continuing residence for the physician until he / coed has been occupied in assent with these requirements for at fundamental two years.
The health care facility must employ a discounted / sliding payment programme and procure a copy of their public understanding of the availability of this discounted / sliding cost plan.
Note: Owing 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 into in hiring you after their period of recruitment for an American physician has passed. For this cause, it is a good idea to approach practices as like now as possible. A service commensurate The Doctor Job can concede you to make contact with many employers simultaneously to certify that you find a J - 1 waiver job as chewed as possible.
When You Receive an Vacation
If you did not enter information about J - 1 waiver regulations with your initial submission of a CV and cover letter, you should make inarguable to copy out this information and take it with you to your visitation. Plan on giving this to subsequent 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, presentation that you are an expert in the J1 waiver process will show ultimate employers that you have done your homework, and it will make you a more attractive candidate. In addition, it will prevent a situation where an offer is disposed and then rescinded subsequent when the executive finds out what is involved with the J - 1 visa and waiver process.
Beyond waiver issues, make conclusive you really sell yourself in the holiday! Although the waiver process is deceitful, at the root of the process is the fact 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 near employers of the charge you can bring to their practice and to the surrounding community.
Verifying HPSA or MUA Station
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 show cause where the particular healthcare facility has known MUA or HPSA sign.
1 - 888 - 275 - 4772. Press option 1, then option 2 or contact the Shortage Term Branch.
Please note that even when a website indicates an area is medically underserved, you should acquit 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 grade has changed since it was scholarly online.
The timeline of your job search can be a chicken one. Normally when someone applies for a job, he / piece 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 eventuate working.
The time frame to achieve a J waiver recurrently ranges from six to nine months, from the first contact with the Primary Care Office until final standard from the BCIS. But also factored into this timeline is the reality that you may have to wait until you’ve fully ended your pied-a-terre and obtained your license before applying.
In addition, physicians must set to commence employment within ninety ( 90 ) days of stab of the waiver. Then, the filing of the application should be timed with this requirement in mind. Make rank you don’t advance so early that you are still completing your edifice or collaboration training at the time you are supposed to do working.
Since the timeline will vary for each individual FMG, you should sit down with your attorney or advisor to opt the best time employ. Also, make express you have lucid 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 trigger searching for a J - 1 waiver position around 12 - 20 months before you plan on rudimental 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 entirely or partially refunded in the occurrence that the waiver is not approved. The DRA, however, charges a $3000 application fee, which is nonrefundable.
AFTER GETTING APPROVED
Once you’ve successfully obtained a waiver ( congratulations! ), your boss must propose an H - 1B suit with the INS. The commercial must be accompanied by various documents, including a Labor Mark Application accepted by the Labor Department. Upon substantiation of both the J waiver and the H - 1B begging, you will be allowed to remain and practice in the United States following the decision of your three - year MUA / HPSA use.
MATCHES CAN BE MADE!
While the process of acceptance a J Waiver can be extreme, think back 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 in rags facility and a good FMG oppressive to make at times. But with persistence and perseverance, 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 accord a J - 1 Waiver position. We specialize in ingredient J - 1 Waiver physicians find jobs with employers who will NOT below - pay you or take advantage of you!