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J-1 Visa Waiver

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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.
Sponsoring organization: Appalachian Regional Commission

Bringing Doctors to the Delta
Web site
Allows foreign physicians who are trained in this country to work in medically underserved areas for three years. The Delta Doctors program accepts waiver requests for medical specialists, and has assisted with the placement of more than 50 physicians in the region.
Sponsoring organization: Delta Regional Authority

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.
Sponsoring organization: Bureau of Primary Health Care

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.
Sponsoring organization: Association of American Medical Colleges

FindAResident
Database
Helps in locating residency and fellowship positions; puts residents in direct contact with the programs looking to fill these positions; supplements the Electronic Residency Application Service (ERAS); and is an effective resource when changing specialty, location or residency program.
Sponsoring organization: Association of American Medical Colleges

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.
Sponsoring organization: American Medical Association

global health.gov
Web site
Provides information on the waiver of the two-year foreign residence requirement. Includes J-1 Visa updates, travel advisories and more.
Sponsoring organization: U.S. Department of Health and Human Services

Guidelines for Medically Underserved Area and Population Designation
Web site
Guidelines for use in applying the established Criteria for Designation of Medically Underserved Areas (MUAs) and Populations (MUPs). Describes three methods for designation.
Sponsoring organization: Bureau of Health Professions

Health Care Shortage Designations
Web site
Contains information about health care shortage designations such as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas and Populations (MUAs/MUPs).
Sponsoring organization: Bureau of Health Professions

Health Professional Shortage Area Database
Database
Provides searching for Health Professional Shortage Areas (HPSAs) by region, state, county, designation status, type of service and more. Includes date of latest designation status.
Sponsoring organization: Bureau of Primary Health Care

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.
Sponsoring organization: Rural Health Research Gateway

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.
Sponsoring organization: Rural Health Research Gateway

Maps & Map Collections

Health Professional Shortage Areas (HPSA) - Dental Health, Designated Populations
Geographic coverage: United States
Printable 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, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

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, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

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, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Health Professional Shortage Areas (HPSAs)
Interactive
Geographic coverage: United States
Shows geographical distribution of HPSAs using the CIRC 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.
Sponsoring organization: Community Information Resource Center

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, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Regulations, Forms & Other Useful Documents

Foreign Medical Graduates: A Brief Overview of the J-1 Visa Waiver Program
Author(s): Karma Ester
Sponsoring organization: Congressional Research Service
Provides background information on the J-1 Visa Waiver program which allows foreign medical graduates to remain in the U.S. after completing graduate medical education, in exchange for agreeing to work in a designated healthcare professional shortage area for a minimum of three years. Includes a description of the waiver process.
Date: 01 / 2007

Foreign Physicians: Data on Use of J-1 Visa Waivers Needed to Better Address Physician Shortages
Sponsoring organization: Government Accountability Office
Examines the number of J-1 visa waivers requested by states and federal agencies; waiver physicians' practice specialties, settings, and locations; and the extent to which waiver physicians are accounted for in the Department of Health and Human Services efforts to address physician shortages.
Date: 11 / 2006

Foreign Physicians: Preliminary Findings on the Use of J-1 Visa Waivers to Practice in Underserved Areas
Sponsoring organization: Government Accountability Office
Reports preliminary findings regarding the number of J-1 visa waivers requested by states and federal agencies and states' views on the 30-waiver limit and on their willingness to have unused waiver allotments redistributed.
Date: 05 / 2006

International Medical Graduates and the Primary Care Workforce for Rural Underserved Areas
Author(s): Kenneth S. Fink
An analysis of primary care IMGs compared to U.S. medical graduates working in rural underserved areas.
Journal citation: Health Affairs Volume 22 Issue 2 Pages: 255-262
Date: 04 / 2003

On-Line Atlas of International Medical Graduates
Sponsoring organization: WWAMI Center for Health Workforce Studies
Displays trends in the geographic distribution of IMGs over the past 20 years through a series of maps.
Date: 2006

Recruitment Process of Foreign Nurses gets a Boost from INS
Author(s): Scott Shepard
Discusses how the Immigration and Naturalization Service gave the recruiting industry a boost at the end of the year by issuing for the first time clear guidelines for using a H1-B visa for a nurse.
Journal citation: Memphis Business Journal
Date: 02 / 2003

United States Licensure for International Dentists
Sponsoring organization: American Dental Association
Provides information to dentists, who were educated outside the United States and Canada and wish to obtain a dental license in the U.S.
Date: 01 / 2006

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
Helps health care professionals, including dentists and dental hygienists find practice opportunities in rural areas throughout the country. Includes individual state information as well as a list of state contacts.

U.S. Department of State Bureau of Consular Affairs
Federal government
Provides information on international travel including travel warnings, paperwork needed and more. Includes J 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, allowing the physician to remain and practice in the United States.

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.

Contacts

For assistance in locating practice sites in rural and underserved areas throughout the country, visit 3RNet State J-1 Visa Contacts.

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Page last updated 4/24/2008
Topic last reviewed 5/1/2008

Events
Oct 14 - 16, 2008
2008 3RNet Annual Conference
National Rural Recruitment & Retention Network
Embassy Suites Downtown
Omaha, NE
Contact:
  Nikki Kennedy
  800.787.2512
  info@3rnet.org


Sep 23 - 25, 2009
2009 3RNet Annual Conference
National Rural Recruitment & Retention Network
Albuquerque Hyatt
Albuquerque, NM
Contact:
  Nikki Kennedy
  800.787.2512
  info@3rnet.org


About this Page
Credits

Thanks goes to:

Mary Amundson, UND Center for Rural Health

Fred Moskol and Tim Skinner, 3rnet
Mike Berry, HRSA

Jerry Coopey, ORHP

Jennell Prentice, WA Office of Community and Rural Health
 
Developed by:
Mary Reinertson-Sand
mary@raconline.org



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