There is still time to obtain a J-1 waiver.   Many states such as California that normally receive a large number of J-1 waiver applications are far from reaching their quota:  California has only received eight applications, Washington has received 4 applications, but Texas does not have any availability for their Conrad 30 Program.  (It is interesting to note that this year, Texas, one of the most popular Conrad 30 programs, did not fill all of their Conrad 30 slots on the first day, as they normally do).

There has been a significant decline in J-1 Waiver Conrad 30 applications this year due to the overall decline in the J-1 visa program.  In 2007 approximately 850 J-1 waiver applications were granted.  In contrast, in 2006 approximately 1000 J-1 waiver applications were granted.  The Wall Street Journal reports that “the number of foreign physicians with J-1 visas has decreased from 11,000 in 1995-1996 to 6,000 in 2005-2006″  (Jordan, Wall Street Journal, 2/16).  The popularity of the H-1B visa as an alterniative to the J-1 visa, and without the two year home residency requirement, is one of primary reasons that the popularity of the J-1 visa is in its decline.

However, the decline in J-1 waiver applications is a boon to physicians who have not applied for their J-1 waiver this year.

More information on the Conrad 30 Waiver page.

The President has approved new legislation that extends the Conrad 30 program.  This extension was critical to the survival of the Conrad 30 program.

This legislation has three subsections. Section one simply highlights the dates that are to be amended.

Section two targets to expand the flexibility of the Conrad state 30 program and implements this by changing the figure “5″ to “10″ in Section 214(1)(1)(D)(ii) of the aforementioned Act.  This section is advantageous since the new legislation expands the number of flex spots from 5 to 10.  Thus, a health care facility does not need to be in a Health Professional Shortage Area (HPSA) if a considerable number of patients from the HPSA are served at the health care facility.

Lastly, Section three accents the terms of the new waiver into two parts, the first of which states that federal programs granting the two year waivers for medical doctors are typically geared towards making sure these doctors practice in underserved areas, and the second of which emphasizes that the Secretary of Health and Human Services should consider the needs of vulnerable populations in low-income and impoverished communities, and communities with high infant mortality rates when determining whether or not a location qualifies as a HPSA.

This is the new bill that the President signed:

One Hundred Tenth Congress

of the

United States of America

AT THE SECOND SESSION

Begun and held at the City of Washington on Thursday,

the third day of January, two thousand and eight

An Act

To extend for 5 years the program relating to waiver of the foreign country residence

requirement with respect to international medical graduates, and for other purposes.

Be it enacted by the Senate and House of Representatives of

the United States of America in Congress assembled,

SECTION 1. EXTENSION OF WAIVER PROGRAM.

Section 220(c) of the Immigration and Nationality Technical

Corrections Act of 1994 (8 U.S.C. 1182 note) is amended by striking

‘‘June 1, 2008” and inserting ‘‘March 6, 2009”.

SEC. 2. EXPANDING THE FLEXIBILITY OF THE CONRAD STATE 30 PROGRAM.

Section 214(l)(1)(D)(ii) of the Immigration and Nationality Act

(8 U.S.C. 1184(l)(1)(D)(ii)) is amended by striking ‘‘5” and inserting

‘‘10”.

SEC. 3. SENSE OF CONGRESS.

It is the sense of the Congress that-

(1) Federal programs waiving the 2-year foreign residence

requirement under section 212(e) of the Immigration and

Nationality Act (8 U.S.C. 1182(e)) for physicians are generally

designed to promote the delivery of critically needed medical

services to people in the United States lacking adequate access

to physician care; and

(2) when determining the qualification of a location for

designation as a health professional shortage area, the Secretary

of Health and Human Services should consider the needs

of vulnerable populations in low-income and impoverished

communities, communities with high infant mortality rates,

and communities exhibiting other signs of a lack of necessary

physician services.

Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.

California has updated its policy regarding whether or not their program will consider applications from specialist physicians.  Specialist physcians may apply for a J-1 Conrad 30 waiver until September 30, 2008.

On September 3, 2008 Texas started to accept J-1 Waiver applications and as of September 4, 2008 Texas has 10 J-1 waiver slots available.

Primary care physicians, as defined by Federal Regulations, are physicians who practice internal medicine, pediatrics, OB/GYN, psychiatry, or family medicine.  Specialists may qualify for the Conrad 30 program depending upon the state’s policy.  Pursuant to Public Law 108-441 of the United States 108th Congress, December 3, 2004: states do have the option to consider if some of the 30 slots may be allocated to licensed and contracted specialist physicians.  Not all of the 50 states in the union exercise their option to allow specialists apply for the J-1 waiver.  For instance, California does not accept J-1 waiver applications for a doctor that practices specialty medicine.  However, in California, specialists may qualify for a J-1 waiver by working as a primary care physician.  In January 2009 California could change its policy regarding allowing specialists to apply for a J-1 waiver, if all of the J-1 waiver Conrad 30 slots are not utilized.

Based on the foregoing, it becomes apparent that if you are a specialist you should ensure that your potential employer is in a state that allows specialists to apply for the Conrad 30 waiver.

Are Conrad 30 Waivers available for California this fiscal year (October 2007-September 2008)? 

California, my home state, has availability for seven Conrad 30 positions this fiscal year.  The availability of Conrad 30 waivers this late in the fiscal year is unusual and does reflect the normal demand for California Conrad 30 waivers.  If you will apply for the Conrad 30 waiver before the fiscal year ends, you should be prepared to commence employment before the year ends.

HPSA and MUA designations and treating the Homeless

States do have some discretion in evaluating HPSA and MUA designations and it is important that you determine the state’s methodology in determining whether the health care facility falls within a underserved area at the the very begininnig of the waiver process.  While California’s interpretation of HPSA and MUA designations are not unusual,  some states also allow physicians to work at health care facilities that receive 330 funding from the federal government.  There are three primary HPSA designations that California recognizes as a HPSA location for the Conrad 30 waiver.  The three designations are the following:  Geographic location, Federally Qualified Health Center and by Population Group.  In the great state of Texas, if the Health Care Facility is receiving 330 funding the physician can work for any health care facility that receives this type of funding as long as the physician will be employed to serve the health care facility that receives 330 funding.

What do you do if your J-1 visa will expire before you are able to apply for a waiver? 

If you have expertise in your field the O-1 visa is an excellent option for physicians.  By utilizing this option you also would not be subject to the J-1 two year home residency requirement when you apply for the O-1 visa at the U.S. Embassy (consular processing).

States are accepting Conrad 30 Waiver applications for fiscal year 2009

The deadline for many Conrad 30 waivers is approaching. For instance Texas will begin accepting Conrad 30 waiver applications on September 3, 2008, while California will accept applications on October 1, 2008. Only thirty (30) waivers may be granted per federal fiscal year (October 1, 2008 through September 30, 2009 for California). With the exception of last year Texas had over 30 applications on first day of filing, for the last couple of years. Therefore, it is advantageous to file your application as soon as possible.

Timing is Everything

As with many things in life, timing is paramount. First, if you are considering a J-1 waiver, you should consider which city and state you would like to work in. You may contact me at info@j1visawaiver.net if you have questions regarding individual state requirements and filing deadlines. After determining where you would like to work you can determine the state’s filing deadline.

Physicians interested in applying for a J-1 waiver should start preparing their J-1 waiver application now. Many states allow new J-1 Waiver applications at the beginning of the fiscal year as discussed earlier.  With this in mind, it is advantageous for physicians to commence preparation of the J-1 waiver application in their third year of residency or one year before their residency ends. Planning well in advance of your graduation is paramount because of the following:

• Licensing – You should ensure that you obtain the appropriate state license in order to obtain your license before your J-1 visa expires. Submission of your state license is a requirement for filing the H-1B application. (when applying for your license you should apply for the type of license that does not expire. If your license has an expiration date USCIS may grant your H-1B visa up until the date your license expires.)

• No objection letter- If you received funding from your home government, you will need to obtain a no objection letter. Depending on your home government, it may anywhere from a few months to a year or longer to obtain this document.

• Prevailing Wage Requirements – The prevailing wage as set forth by the Department of Labor, must be paid to the physician working in H-1B status. After you find an employer, you should confirm that the employer is willing to pay the prevailing wage. For instance, the prevailing wage for a Level II psychiatrist in Central California is $117,333 a year. The employer must pay the prevailing wage in order to meet H-1B requirements.

• Letters of recommendation – Some J-1 waiver Conrad 30 programs require letters of recommendation and it may take a couple of months to obtain appropriate letters.