Each year, the H-1B “season,” which commences when U.S. Citizenship and Immigration Services (USCIS) begins accepting H-1B visa petitions on April 1 for an October 1 employment start date, receives significant attention. However, there is another less publicized, yet vitally important, immigration season that also deserves special mention: the Conrad 30 J-1 waiver program season.
On October 1, following the federal fiscal year, numerous state departments of health will begin accepting applications filed on behalf of foreign medical graduates (FMGs) to waive the J-1 two-year foreign residence requirement. This requirement attaches to all FMGs who come to the United States in J-1 status to pursue graduate medical education, requiring them to return to their home country for a minimum of two years before applying for certain non-immigrant visas, including the H-1B, or seeking permanent residence in the United States.
Pursuant to the Conrad 30 J-1 waiver program, state health departments and agencies can recommend up to 30 J-1 waivers each fiscal year for FMGs who have agreed to practice medicine in designated Health Professional Shortage Areas (HPSAs), mental health HPSAs, Medically Underserved Areas (MUAs), or serve Medical Underserved Populations (MUPs) for 40 hours per week for a minimum of three years in H-1B status. Some states consider waivers for what are known as “flex slots” for FMGs who will be serving patients from a designated area at a worksite location in a non-designated area. States are allowed to grant up to 10 flex slots per fiscal year. If recommended, the waiver is then considered by the U.S. Department of State (DOS) and finally, USCIS.
Below are some practical hints for FMGs to consider when evaluating their Conrad 30 J-1 waiver program options:
- Before preparing and filing a waiver application with a state health department or agency, applicants must obtain a case number from DOS. The case number application fee is $215.00.
- Not all states begin accepting J-1 waiver applications on October 1. Some states, such as Texas, which began accepting applications on September 5 this year, operate on a different application cycle.
- Some states, such as South Carolina, require site approval, pre-authorization, or a slot pre-assignment before a waiver application can be filed on behalf of an FMG. FMGs interested in relocating to or remaining in such states are therefore advised to begin the process early to make sure they do not experience a time crunch as they near completion of their training – if DOS does not recommend approval of the waiver within 30 days of the DS-2019’s expiration, the physician will likely be required to leave the country.
- Many states express a preference for primary care physicians under their Conrad 30 J-1 programs, and will not accept waiver applications for specialist physicians. For example, California will generally only consider J-1 waiver applications filed for primary care physicians, which are defined as “internist, family practice, pediatrician, psychiatrist, and OB/GYN.”
- If the state to which you are applying does not accept flex slot applications, check and double-check (or have your attorney verify for you) that the practice site at which you will be working is located in a HPSA, mental health HPSA, MUA, or MUP.
- While many states do not, some states, such as Ohio and Texas, charge an application fee to process J-1 waiver applications. Ohio’s application fee is a whopping $3,571.00 and Texas’ is $2,500.00.
- Not all states consider J-1 waiver applications on a “first-in-first out” basis. Some states prioritize applications based on the state’s need for particular types of physicians, or based on the particular merits of the application.
- H-1B petitions based on Conrad 30 J-1 waivers are exempt from the annual H-1B “cap” and allow for the physician to change status within the U.S. rather than applying for the H-1B visa abroad.