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J-1 Physicians - What You Need to Know

Options for J-1 Physicians

A person who is in the United States in J-1 status for the purpose of clinical training is subject to the two year home residence requirement, which means they are not permitted to change their status to H or L status, or apply for permanent residence, until they have returned to their home country for a period of two years.

As an alternative to returning home for two years, a J-1 physician has several options, some of which include:

  1. Apply for a waiver on the basis of employment in an underserved area (interested government agency waiver);
  2. Apply for a waiver on the basis of extreme hardship to a US citizen or lawful permanent resident spouse or child;
  3. Apply for a waiver on the basis of persecution;
  4. Apply for an O-1 visa

Applying for a Waiver on the Basis of Employment in an Underserved Area (Interested Government Agency Waiver)

If a J-1 physician locates an offer of employment in an underserved area, his or her sponsor may be able to file a J-1 Waiver Request with an interested government agency. There are many interested government agencies willing to support a waiver filed on behalf of a J-1 including:

  1. The Department of Veterans Affairs (VA);
  2. The Appalachian Rural Commission (ARC);
  3. The Conrad State 30 Program;
  4. The Delta Regional Authority;
  5. The Department of Health and Human Services;
  6. The United States-Mexico Border Health Commission;

The rules governing each interested government agencies' program differ, but in general, the following requirements must be met:

  1. A physician must agree to work in an underserved area for 40 hours per week, for a minimum of 3 years;
  2. The physician and the employer must sign an employment contract;
  3. Employers must demonstrate that they have unsuccessfully attempted to search for American workers for the position.
  4. A physician must have a case number from the US Department of States (DOS).

The waiver application is initially filed with the interested government agency. If the IGA approves the waiver, it is forwarded to the US Department of State (DOS). If DOS approves the waiver, it is forwarded to USCIS.

A physician who is granted a J-1 waiver on the basis of an IGA must work for three years in H-1B status.

Applying for a Waiver on the Basis of Extreme Hardship

To file a J-1 waiver request on the basis of extreme hardship, a J-1 physician must have a qualifying relative. Qualifying relatives include US citizen and lawful permanent resident spouses and/or children.

The J-1 physician must be able to demonstrate that the qualifying relative will suffer extreme hardship under both of the following scenarios:

  1. If the J-1 physician returns to his or her home country without the qualifying relative for a period of two years;
  2. If the qualifying relatives accompany the J-1 physician to the home country for 2 years.

Hardship waivers can be filed on the basis of medical, psychological, educational and financial hardships, among others.

A hardship waiver is initially filed with the USCIS service center. If USCIS determines that there is hardship, the case is forwarded to the US Department of States (DOS). The State Department conducts an independent review, and returns their finding to USCIS for final adjudication.