By Attorney Farhad Sethna © 2014
And you thought only Physicians could write indecipherable prescriptions?
J-1 PHYSICIAN OPTIONS
As background, foreign medical graduates (FMG’s) who come to the United States for further medical education or residencies are often issued J-1 visas. Under the J-1, which may or may not be subject to the two-year home country requirement, the physician is permitted to work only for the sponsoring institution. If the J-1 is further subject to the two-year home country residency requirement, the J-1 also has to return to his or her home country and remain there for a minimum period of two-years before reentering the United States on any work-related or immigrant visa approval.
The U.S. Department of States offers a limited waiver process to permit foreign physicians who do not wish to return to their home country for specified reasons. These reasons fall into two categories: persecution in the home country, or extremely severe hardship to a U.S. citizen spouse or child. State Department waivers are not easily granted.
There is another option, which is the Conrad-30 Waiver Program. Under that program, named after Senator Ken Conrad who was the chief sponsor of this legislation, each state can issue upto 30 “waivers” to physicians excepting them from the two-year home country requirement, if they provide primary care for at least three years in the state in an area that is medically underserved, or in a federally qualified health center. More on this issue is available on other articles on this blog. However, this waiver is limited to only 30 slots per fiscal year, per state. States are allowed to allocate some of their 30 slots for non-shortage areas or for specialist care. For some states, those slots are filled up very quickly. Other states however, do not use all their allotted slots. Articles on usage by states are also elsewhere on this blog.
What if a J-1 physician cannot obtain a Conrad-30 slot in a state of his or her choosing?
Even though Conrad-30 slots may be used up, there may be other options for a physician to obtain a waiver. There are three “interested government agencies” which currently issue waivers, and a fourth, the Veterans Administration, which has a waiver policy in place but does not as a blanket rule grant waivers to foreign medical graduates.
What are these interested government agencies and what is the waiver process for each?
The three interested government agencies who are currently granting waivers to foreign medical graduates are:
The U.S. Department of Human Services – grants waivers for individuals who are going to work in rural or community health centers and other medically underserved areas. Information on these waivers can be found at:
Another government agency that issues waivers is the Appalachian Review Commission. However, the ARC will sponsor waivers only for certain states that fall within the Appalachian region. This includes the states of: Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia.
Details about the Appalachian Review Commission’s waiver process can be found at:
Finally, the Delta Regional Authority also offers waivers to doctors who will serve in underserved areas within its jurisdiction. The DRA covers portions of the states of Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee.
Again, details regarding the DRA program can be found at:
As stated above, while the Veterans Administration does have a policy to approve waivers for foreign medical graduates, that waiver is dependent on a case by case basis through the particular VA institution. Details about the VA waiver can be found at:
While the Conrad-30 waiver process can be in some cases the only way for a foreign medical graduate to obtain a waiver from the two-year home residency requirement, there are other avenues as described above. Most specialists will have to, of necessity participate in the Conrad-30 Program because of the availability of the “Flex-10” for specialists. However, primary care providers – physicians, pediatricians, psychologists, and OBGYN’s – will typically find it possible to obtain a waiver in any of the four categories described above.
Therefore, there are several alternate options available for physicians who do not qualify for a state Conrad-30 Waiver.
About the author: Attorney Farhad Sethna has practiced law for over 20 years. Since 1996, he has been an adjunct professor of Immigration Law at the University of Akron, School of Law, in Akron, Ohio. He is a frequent speaker at Continuing Legal Education and professional development seminars on various immigration-related topics. His practice is limited to immigration and small business. With offices in Cuyahoga Falls, Akron and Dover, Ohio, Attorney Sethna represents clients in all types of immigration cases. Our number is: (330)-384-8000. Please send your general immigration questions to AttorneySethna@immigration-america.com. We will try to answer as many questions as possible.
This is only general legal information. Please consult a qualified immigration attorney for advice on your specific case.