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You may also want to see this guide: Health Care Workforce
Introduction
Having quality physicians is essential to providing healthcare in rural communities. In many cases, the ability of healthcare facilities to remain open depends on having an adequate staff of physicians. Unfortunately, rural areas often experience difficulties in the recruitment and retention of physicians. Due to these difficulties, many communities turn to the recruitment of foreign medical graduates with J-1 Visa Waivers to fill their physician vacancies.
The J-1 Visa Program is for foreign medical graduates who wish to pursue graduate medical training in the United States.
J-1 Physicians, also known as Foreign Medical Graduates or
International Medical Graduates, are physicians from other
countries who have sought and received a J-1 exchange visitor visa.
The visa allows holders to remain in the U.S. until their studies
are completed. At the completion of their studies they are expected to return to their home countries for two years before applying for a permanent visa in the United States. A J-1 Visa Waiver waives the two year home residency requirement and allows a physician to stay
in the country to practice in a federally designated Health Professional
Shortage Area (HPSA) or Medically Underserved Area (MUA) if sponsored
by an interested U.S. government agency. State government agencies
may also sponsor J-1 physician waiver requests which are called
Conrad State 30 programs.
This guide also discusses the H1-B Visa, a non-immigrant visa which allows a U.S. company to employ a foreign individual in a specialty occupation.
Communities have a unique opportunity to recruit and retain physicians who enter the U.S. on a J-1 visa and need to practice in a HPSA or MUA. Those communities that welcome these physicians to their new town are often able to retain them for years. If a community can attract a physician on a visa, an honest and early welcoming process that leads into a long term retention program is very important. Physicians who leave a town after their commitment suggest they do so because they did not have a sense of belonging.
The recruitment process should take into consideration the “fit” with the practice, the community and needs of the physician and family. If the recruitment and retention process is sensitive to the needs of the community and the physician, the potential for retention grows.
Frequently Asked Questions
Tools
ARC J-1 Visa Waiver Program
Web site
Requests for waivers under the ARC J-1 Visa Program must be sponsored by a state within the Appalachian Region. All inquiries should be made to state contacts, a list of which is provided.
Bringing Doctors to the Delta
Web site
Allows foreign physicians, who are trained in the U.S., to work in medically underserved areas for three years. Accepts waiver requests for medical specialists, and has assisted with the placement of more than 50 physicians in the region.
Directory of Primary Care Offices (PCO)
Web site
Lists contact information for each state's Primary Care Office (PCO). PCOs represent the needs of the underserved populations and the providers who serve them. These offices can provide information on Conrad 30 J-1 Visa Waiver programs, loan repayment programs, and recruitment and retention.
Electronic Residency Application Service (ERAS)
Database
Transmits residency applications, letters of recommendation, Dean's Letters/MSPE, transcripts, and other supporting credentials from applicants and medical schools to Fellowship, Osteopathic Internship and Residency programs using the Internet.
Find Shortage Areas: HPSA by State & County
Database
Provides searching for Health Professional Shortage Areas (HPSAs) by region, state, county, designation status, and type of service- primary medical care, dental, and mental health. Includes date of latest designation status.
FindAResident
Database
Helps to locate residency and fellowship positions; puts residents in contact with programs looking to fill these positions; supplements the Electronic Residency Application Service (ERAS); and is a resource when changing specialty, location, or residency program.
FREIDA Online
Database
Stands for Fellowship and Residency Electronic Interactive Database. Contains over 7800 medical education programs accredited by the Accreditation Council for Graduate Medical Education, as well as over 200 combined specialty programs. Allows searching for specialty and subspecialty programs, training institutions, medical schools, aggregate training statistics by specialty, and career plans of recent graduates.
Global Health: Exchange Visitor Program
Web site
Provides information and updates on the Exchange Visitor Program (J-1 Visa Waiver) eliminating the two-year foreign residence requirement.
Guidelines for Medically Underserved Area and Population Designation
Web site
Supplies guidelines for use in applying the established Criteria for Designation of Medically Underserved Areas (MUAs) and Populations (MUPs). Describes three methods for designation.
Rural Health Research: International Medical Graduates (IMGs)
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of International Medical Graduates (IMGs), produced by the Office of Rural Health Policy's funded rural health research centers.
Rural Health Research: J-1 Visa Waiver
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of the J-1 Visa Waiver, produced by the Office of Rural Health Policy's funded rural health research centers.
Shortage Designation: HPSAs, MUAs & MUPs
Web site
Provides information about health care shortage designations: Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas and Populations (MUAs/MUPs). Includes information on how to apply for these designations and how to find shortage areas.
U.S. Licensure for International Dentists
Web site
Provides information to dentists who were educated outside the United States and Canada and wish to obtain a dental license in the U.S.
Maps & Map Collections
Health Professional Shortage Areas (HPSA) - Dental Health, Designated Populations
Geographic coverage: United States
Printable and customizable map that shows the location and type of population that is underserved for population group dental HPSAs nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, July 2008.
Date: 2009
Health Professional Shortage Areas (HPSA) - Mental Health, Designated Populations
Geographic coverage: United States
Printable map that shows the location and type of population that is underserved for population group mental health HPSAs nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, July 2008.
Date: 2009
Health Professional Shortage Areas (HPSA) - Primary Medical Care, Designated Populations
Geographic coverage: United States
Printable map that shows the location and type of population that is underserved for population group primary medical care HPSAs nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, July 2008.
Date: 2009
Health Professional Shortage Areas (HPSAs)
Interactive
Geographic coverage: United States
Shows geographical distribution of HPSAs using the CARES Interactive Mapping System. You can zoom, pan, and modify this map in a variety of ways. You can also print customized maps and download data directly to your desktop for use in further analysis. Updated quarterly.
Medically Underserved Areas (MUAs) and Medically Underserved Populations (MUPs), Designated Type
Geographic coverage: United States
Printable map that shows the designated type of MUAs and MUPs nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, July 2008.
Date: 2009
Organizations
Educational Commission for Foreign Medical Graduates (ECFMG)
National organization
Assesses the readiness of international medical graduates to enter residency or fellowship programs in the United States. Offers a variety of other programs and services to physicians educated abroad and other members of the international medical community.
National Resident Matching Program (NRMP)
Nonprofit/Foundation
Provides a uniform date of appointment to positions in graduate medical education (GME) in the United States.
National Rural Recruitment & Retention Network (3RNet)
National organization
Works to help health care professionals, including dentists and dental hygienists, find practice opportunities in rural areas throughout the country. Includes state information and a list of state contacts.
U.S. Department of State Bureau of Consular Affairs
Federal government
Provides information on international travel including travel warnings and paperwork needed. Includes J-1 Visa Waiver Recommendation Application form.
Terms & Acronyms
Foreign Medical Graduates (FMGs) Physicians from other countries who wish to pursue graduate medical training in the United States. Also called IMGs (International Medical Graduates).
Health Professional Shortage Area (HPSA) Geographic regions that have shortages of professionals working in primary medical care, dental or mental health care. HPSAs may be urban or rural areas, population groups or medical or other public facilities. Geographically, HPSAs can be cities or towns, counties or groups of counties. HPSA designations are reviewed and revised annually by the Secretary of Health and Human Services based on criteria set forth in the Public Health Service Act.
International Medical Graduates (IMGs) Physicians from other countries who wish to pursue graduate medical training in the United States. Also called FMGs (Foreign Medical Graduates).
J-1 Visa Waiver Eliminates the two year residency requirement for foreign physicians training on a J-1 Visa. Allows foreign physicians to remain and practice in the United States after their training is completed.
J-2 Visa Visa for spouses and minor, unmarried children under the age of 21. They must have form IAP-66 as well as other basic documentation and demonstrate sufficient financial resources to support themselves while in the United States.
Medically Underserved Area (MUA) Medically Underserved Areas (MUAs) are federal designations derived from the Index of Medical Underservice (IMU). This index ranges from 0 to 100 and is based on four criteria: 1) ratio of primary medical care physicians per 1,000 people, 2) infant mortality rate, 3) percent of the population with incomes below the poverty level and 4) the percent of the population age 65 or older. An IMU of 62.0 or less qualifies an area to be designated a MUA. Geographic areas designated as MUAs can be a whole county or a group of contiguous (adjoining) counties, minor civil divisions (MCD), census county divisions (CCD) or census tracts.
Medically Underserved Population (MUP) A federal designation that is derived by using the Index of Medical Underservice (IMU). This index ranges from 0 to 100 and is based on four criteria: 1) ratio of primary medical care physicians per 1,000 people, 2) infant mortality rate, 3) percent of the population with incomes below the poverty level and 4) the percent of the population age 65 or older.
State Conrad 30 Program Allows states to sponsor up to 30 international medical graduates per year who agree to serve in underserved areas.
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