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Conrad 30/J-1 Visa Waiver for Foreign Medical Doctors

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By Yingfei Zhou, Esq.

The Conrad 30/J-1 Visa Waiver program allows J-1 medical doctors to apply for a waiver of the 2-year residence requirement upon completion of the J-1 exchange visitor program. From October 1 through September 30 of each year, up to 30 waivers can be recommended by each state’s Department of Health. If the home government funded the physician’s exchange program, the physician also needs to obtain a “no objection” letter from his or her home country. Once the waiver is approved, applicants can file for cap-exempt H-1B visa to work for the health care facility.

In order to be eligible, the applicant must be a physician practicing clinical medicine full time (no less than 40 hours per week) in an area designated by U.S. Department of Health and Human Services (HHS) as a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP). The employment should commence within 90 days from the date the waiver is approved by the USCIS.

The facility, on the other hand, upon recommendation of waiver application, must accept Medicaid/Medicare clients, employ a discounted/sliding fee schedule for low-income clients, and post a notice in a conspicuous place in the waiting area that all clients will be seen regardless of their ability to pay.

The deadline for submitting applications is the first Monday in November of every year. The application process is on a first come, first served basis. There are no restrictions regarding the type of specialists allowed, with the exception of those involved in care that is not medically essential, such as, cosmetic surgery. Each state may have its own priorities, depending on the needs.

Take Florida for example, where primary care specialists that include family medicine, internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and hospitalist specialties, are the priority for the State of Florida. Additional waivers for specialists will be considered only if there are unused waivers after the review and scoring process is complete.

Normally, there is no limit to the number of applications submitted by an employer. However, only one application per specialty may be recommended. If unused waiver slots remain, additional applications from similar specialties may be considered. The State will ask the employer to prioritize the applicants from similar specialties based on their clinic needs. So, we recommend you to check on your state’s public health department website for specific details.

With regard to an application process, there are two steps: 1) first to obtain your waiver case number from the U.S. Department of State (DOS); 2) then to obtain the sponsorship of your state health department.

The first step is much the same with other types of J-1 Visa Waiver application. The Conrad 30 applicant first obtains his or her waiver case number, by completing Form DS-3035, J-1 Visa Waiver Review Application at the U.S Department of State website at: https://j1visawaiverrecommendation.state.gov/. Once the DS-3035 is submitted online, applicant needs to assemble and mail application packet to the Department of State, including the submitted DS-3035, check for application fee in the amount of $215 per applicant, the applicant’s passport I.D. page containing name and birth date, copies of all DS-2019, statement of reason, Form G-28 is the application is prepared by an attorney, and one self-addressed, stamped envelope.

The second step is distinguished from other types of J-1 Visa Waiver, which is to obtain a recommendation from the state’s health department. Normally, this process takes about 3 months if the case is prepared is a correct way.

For this step, again, we recommend you the check with your state’s J-1 Visa Waiver Program guidelines and procedures, as the documentation requirements may vary from state to state. The documents commonly required by state health agency are:

1) State J-1 Visa Waiver application form,

2) cover letter from the practice facility that indicates a desire to hire the physician,

3) employment contract,

4) physician attestation,

5) employer attestation,

6) evidence of shortage designation status,

7) copies of the facility’s discounted/sliding fee schedule and the public notice of the availability of the discounted/sliding fee schedule,

8) copy of the physician’s medical license,

9) personal statement from the J-1 physician regarding his or her reason for not wishing to fulfill the two-year home country residence requirement,

10) Form DS-3035,

11) copies of all DS-2019s,

12) a “no objection” letter if foreign government funding is involved in the J-1 program, and

13) G-28 form is the case is prepared by an attorney.

Some states may also require the Department of State Waiver Case File Number appear on the lower right corner of every page of the application.

Once approved at the State Health Department’s level, the state public health department that agreed to sponsor the J-1 medical doctor for a waiver must then send the waiver application to the Department of State Waiver Review Division (DOS-WRD) for a recommendation. Once the recommendation is issued, its Waiver Review Division will forward a recommendation letter directly to the USCIS and the case is considered closed at the Department of State. Any further action on the case falls under the jurisdiction of the USCIS.

USCIS will then make a final determination on whether to approve the waiver application.  Upon a favorable recommendation by the Department of State, USCIS will generally grant the waiver as long as there are no underlying concerns. USCIS will provide written notice of its decision (I-612 Approval Notice) to the J-1 medical doctor and his or her representative (if applicable).

There are quite a few responsibilities after being granted a Waiver:

  • The petitioner must submit a Form I-129, Petition for a Nonimmigrant Worker, along with the Department of State favorable recommendation letter, in order to request a change of the J-1 medical doctor’s nonimmigrant status to H-1B.
  • The spouse and/or child of the waiver recipient must submit Form I-539, Application to Extend/Change Nonimmigrant Status, in order to change status from J-2 to H-4 nonimmigrant status.
  • The J-1 medical doctor must practice medicine full time (40 hours per week) for at least three years in an area designated by HHS as a HPSA, MUA, or MUP and the employment must commence within 90 days after Waiver approval.
  • Some states require the J-1 physician and employer to complete practice status report every year to allow the state to monitor the status of the J-1 physician and information about the practice sites. The state agency or its representatives may also conduct periodic monitoring through telephone calls or site visits to ensure compliance with federal and state policies and procedures.
  • Contract changes which result in termination of employment, change in practice scope, or relocation from a site approved in the application request to a new site must be presented in writing to the state health agency prior to the change. If waiver recipient fails to fulfill the terms and conditions imposed on the waiver, he or she (and his or her spouse and/or child) will once again become subject to the 2-year foreign residence requirement under section 212(e) of the INA. Once the Conrad 30 waiver recipient has fulfilled all of the terms and conditions imposed on the waiver, including the 3-year period of employment with the health care facility, he or she (and his or her spouse and/or child) will become eligible to apply for an immigrant visa, permanent residence, or H or L nonimmigrant visa.

If you need to more information about a specific state’s Conrad 30/J-1 Waiver program, please feel free to contact us.