Immigration Services

Immigration Services

For Physicians

J-1 Waivers of the Two-Year Home Residence Requirement

Exchange visitors (EVs) in J-1 status may be subject to the two-year home residence requirement because of:
  • Skills List;
  • Government funding (U.S. or home country); or
  • Graduate medical training (medical residency or fellowship).
If you are subject to the two-year home residence requirement, you may, instead of returning to your home country, obtain a waiver of the two-year requirement. Several waiver options may be available, depending on the EV's circumstances:
  • No-objection waiver: By far, the easiest way to avoid fulfilling the requirement is to apply for a statement of no-objection from your home government. This option, however, is not available to International Medical Graduates unless they came to the United States to observe, consult, teach or conduct research. The no-objection waiver also will not qualify an individual who received U.S. government funding for a waiver unless he or she receives a statement of no-objection from the funding agency.
  • Hardship waiver: To qualify, you must demonstrate that your departure from the United States would impose exceptional hardship on your U.S. citizen or permanent resident spouse or child. Keep in mind that you must prove that your spouse or child will be subjected to exceptional hardship if they accompany you to fulfill the two-year requirement abroad or if they remain in the U.S. while you fulfill the requirement.
  • Persecution waiver: This is available to those individuals who can demonstrate that they would be subject to persecution on account of race, religion or political opinion in their home residence.
  • Interested Government Agency (IGA) waiver: You may qualify for a waiver based on a recommendation from an IGA if a waiver is in the public interest and compliance with the two-year requirement would be detrimental to a program that is of official interest to the recommending agency.
    While any government agency can serve as an IGA, physicians frequently seek waivers from federal or state agencies in exchange for agreeing to provide full-time clinical services in an area designated as having a shortage of healthcare professionals for at least three years. Currently, every U.S. state, as well as the District of Columbia, Puerto Rico and Guam, offers the Conrad State 30 Waiver Program, which allows a state health department to grant up to 30 waivers annually to qualified physicians.

    In addition, an international physician practicing in a designated area may qualify for a waiver by requesting that another agency, such as the Appalachian Regional Commission (ARC), Delta Regional Authority (DRA) or the U.S. Department of Veterans Affairs (VA), act as an IGA on his or her behalf.

    Furthermore, HHS processes waiver applications for physicians practicing in designated areas suffering from a shortage of physicians. Finally, those exchange visitors, including physicians, who do not provide medical services to underserved populations but perform research that may be found to be in public interest and in the interest of a federal agency, may seek waivers from other participating federal agencies, such as the National Science Foundation, the Department of Education, the Department of Defense or HHS.
The J-1 waiver application is a three-step process, with the application to the initial agency being the first and most critical step. The agency can take a few months to decide whether or not it would recommend that a waiver be issued on your behalf. Second, if the initial agency issues a waiver recommendation, it will transfer your file to the U.S. Department of State (DOS), which will take 4-6 weeks to render its decision on whether or not to recommend a waiver. Third, after the DOS issues a positive waiver recommendation, it will transfer your file to the U.S. Citizenship & Immigration Services (USCIS) for a final decision. The entire waiver process may take several months, and you must maintain valid nonimmigrant status in order to be able to remain in the U.S. during the process.

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