One method for recruiting primary care physicians to rural HPSAs is to utilize the J-1 Visa Waiver Program to help secure the services of a foreign physician.
Federal law requires that foreign physicians seeking to pursue graduate medical education or training in the U.S. must obtain a J-1 exchange visitor visa. The J-1 visa allows physicians to remain in the U.S. until their studies are completed. However, upon completion of their studies, the physicians must return to their home country for at least two years before they will be able to return to the U.S.
Physicians who are subject to, but do not wish to comply with, the two-year home country residence requirement may apply for a waiver of that requirement under anyone of the four grounds provided by U.S. Immigration law:
- Exceptional hardship to his/her U.S. citizen or permanent resident spouse or child
- Persecution if forced to return to home country
- A statement in support of a waiver from an interested U.S. government agency
- A statement in support of a waiver from a state department of public health or its equivalent
It is important to note that the J-1 visa waiver is not a visa; it simply eliminates the requirement that the physician return to his/her home country for two years before he/she can return to the U.S. In order for a foreign physician to stay in the U.S. after medical school without the two-year return to his or her country, he or she must:
The United States Information Agency (USIA) requires that the waiver request from the state health department include a copy of a “no objection” letter from the J-1 physician’s home government. This is a letter from the physician’s home government that states the home government has no objection to the physician remaining in the United States to practice medicine.
The physician needs to contact his/her home government embassy in the United States and request that they write a letter of “no objection” on their behalf to:
United States Information Agency
Waiver Review Branch
301 4th Street S.W.
Washington, DC 20547
USIA does not require that a “no objection” letter be of or on a particular form, however, the “no objection” letter must reference Public Law 103-416, i.e.:
Pursuant to Public Law 103-416, the government of Name of Country has no objections if Name of Physician, address, date of birth does not return to Name of Country to satisfy the two-year foreign residency requirements of Section 212(e) of the Immigration and Nationality Act.
Physicians interested in obtaining an H-1B visa may want to seek legal counsel for assistance in the preparation and submission of the required U.S. Immigration and Naturalization Service forms and documentation.
3. Obligatory Service
In order to obtain the J-1 visa waiver in this scenario, a physician must be willing to practice either primary care or specialty medicine, full-time for three years, in an area or areas of a state that are designated by the Secretary of Health and Human Services as Health Professional Shortage Areas (HPSA) or Medically Underserved Areas or Populations (MUA/P). After the three year obligation he or she may apply for Permanent Residence Visa status.
The availability and processes for using J-1 visa waivers varies from state to state. Please visit the following websites for information regarding the programs in Region VIII: