Frequently Asked Questions about J-1 Waivers for Physicians

Waivers for Practicing in Underserved Areas
Waivers for Practicing in VA Hospitals
State Health Agency Waivers

Waivers for Practicing in Underserved Areas

What is considered an "underserved" area?

Underserved areas are places designated by the U.S. Department of Health and Human Services as experiencing a shortage of physicians. This means a Mental Health or Primary Care Health Professional Shortage Area (HPSA) or a federally designated Medically Underserved Area (MUA) or Medically Underserved Population (MUP). While the HPSA designation is universally accepted, certain states do not recognize the MUA/MUP designation. Both HPSA and MUA/MUP areas are designated by the U.S. Department of Health and Human Services

How can I obtain an application for a waiver?

You can download the Application for Waiver of the Two-year Foreign Residence Requirement from the U.S. Department of Health and Human Services website.

Which U.S. Government agencies can apply for the waiver on behalf of foreign medical graduates?

Appalachian Regional Commission, Department of Agriculture, Department of Veterans Affairs and Department of Interior for Indian Reservations. Foreign medical graduates may also apply through an individual State's department of health that participates in the Conrad State 30 program.

If I am an exchange visitor physician and I plan to work in an underserved area in the United States, what must be presented to obtain a waiver based on an interested U.S. Government agency application?

You will need to provide the following:

Data sheet
Processing fee in a cashier's check or money order for $230
DS-2019/IAP-66 forms
Curriculum vitae
Physician statement: A signed and dated statement from you.
Form G-28 or letter from your attorney, if you have one.
Two self-addressed, stamped, legal-size envelopes.

The interested U.S. Government agency will need to gather and send directly to the Waiver Review Division the following:

Letter of request from head of the agency, or designated official stating why it is in the public interest that your be granted a waiver of the residency requirements.
Signed contract for no less that three years and 40 hours a week between you and the facility.
Evidence that the clinic/facility is located in a U.S. Department of Health and Human Services designated Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA).
"No objection" statement from your government, if you accepted foreign government funding.
Facility statement: A statement signed by the head of the facility where you will be employed stating the facility is located in a designated HPSA or MUA area and provides medical care to both Medicaid and Medicare eligible patients, and indigent uninsured patients. The statement should also include the Federal Information Processing Standards county code and census tract or block numbering area number (assigned by the Bureau of Census) or the 9-digit zipcode of the area where the facility is located.
Recruiting: Evidence that unsuccessful efforts were made to recruit an American physician for the position, such as medical journal advertisements; labor certification or a cover letter stating efforts to recruit an American physician have been unsuccessful.

Waivers for Veteran Administration Hospitals

I am a physician in J-1 status and I plan to work in a Veteran Administration hospital. What must be presented to obtain a waiver of the home residency requirement?

You can receive a waiver based on an Interested Government Agency from the Department of Veterans Affairs if you agree to serve in a VA hospital. VA hospitals do not have to be in an underserved area. You must the information above, but include a memorandum of agreement between you and the hospital in lieu of a three-year contract.

State Health Agency Requests

How do I apply for a waiver based on a request from a State health agency?

You must provide the following documents to apply for a waiver based on a request from a State health agency:

Data sheet;
Processing fee, in the form of a cashier's check or money order for $230;
IAP-66 forms;
Curriculum vitae;
"No objection" statement from the visitor’s government in cases in which foreign government funding is involved;
Form G-28 or letter from a law office if applicant has an attorney; and,
Two self-addressed stamped, legal-size envelopes.

The designated official of the State health agency must prepare a letter stating that it is in the "public interest" that you remain in the United States. This letter must be sent directly to the State Department's Waiver Review Division, and include the following:

Exchange visitor’s name
Country of last legal permanent residence
Name of medical facility
Address of facility
U.S. Department of Health and Human Services designated Health Professional Shortage Area (HPSA) ID number of medical shortage area

You must also include:

A letter from the facility that wishes to hire physicians.
Evidence that the facility is in a Health Professional Shortage Area (HPSA) or a Medically Underserved Area (MUA)
A signed contract for no less than 40 hours a week for three years between the facility and the physician, with signatures of physician and head of the facility.

For quicker processing, the State health agency may submit both its and the applicant's required documentation together to the State Department's Waiver Review Division.