Individuals from other countries who are training to be doctors in the U.S. normally are required to return to their home countries at the end of their residencies, as per the terms of their J-1 visas. However, these physicians can attempt to get the two-year home residency requirement waived, usually by seeking a J-1 Conrad Waiver.
There are 1,500 Conrad Waivers available each year and there are 30 waivers available per state. Applicants must be sponsored by a state health department and commit to practice in a medically underserved area for at least three years. Those who successful receive this waiver will switch from J-1 to H-1B status and can remain in the U.S. without first returning to their home countries. In most cases, states fill these positions with primary care physicians and psychiatrists, so there may be few spots available for specialists.
What is a J-1 Conrad Waiver?
Applicants for Conrad Waiver must both apply for consideration by the state health department and the U.S. Department of State Waiver Review Division (DOS). Each state health department selects 30 applicants and forwards their recommendations to the DOS. U.S. Citizenship and Immigration Services (USCIS) issues the final waiver approval after this lengthy process, which often may take six to ten months.
Next, the employer must file a H-1B petition on behalf of the physician, which grants the physician three years of legal work status in the U.S. The employers must meet certain criteria, as well, other than being in a certifiable medically underserved area. For example, the employers must accept state Medicaid and Medicare and offer sliding scale fees for patients who have no insurance or whose household income falls below 200% of poverty. To participate in this program, the physician must agree to begin work for the employer within 90 days of receiving the waiver, so timing is important when going through this process.
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