Rural J-1 Visa Waiver

Having quality physicians is essential to providing healthcare in rural communities. In many cases, the ability of healthcare facilities to remain open depends on having an adequate staff of physicians. Unfortunately, rural areas often experience difficulties in the recruitment and retention of physicians. Due to these difficulties, many communities turn to the recruitment of foreign medical graduates who trained on a J-1 Visa to fill their physician vacancies.

The J-1 Visa is an exchange visitor visa that can be used by students. International medical graduates pursuing residency and fellowship training in the United States often have J-1 Visas. The J-1 visa allows holders to remain in the U.S. until their studies are completed. At the completion of their studies they are expected to return to their home countries for two years before applying to re-enter the United States.

A J-1 Visa Waiver waives the two year home residency requirement and allows a physician to stay in the country to practice in a federally designated Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA) if recommended by an interested federal government agency. State government agencies may also recommend J-1 physician waiver requests through the Conrad State 30 program.


For assistance in locating practice sites in rural and underserved areas throughout the country, visit 3RNet State J-1 Visa Contacts.

For additional information regarding HPSA or MUA designations, contact your state Primary Care Office or the Shortage Designation Branch: or 888.275.4772. Press option 1, then option 2.

There are more organizations related to J-1 Visa Waiver in the organizations section.

Frequently Asked Questions

Why is the J-1 Visa Waiver program so important to rural health?

Shortages of physicians willing to serve in rural areas can make it very difficult for rural communities to recruit physicians. Physicians with J-1 Visa Waivers have filled a critical need in many rural communities over the years. Through the Conrad 30 program, over 300 physicians each year are recommended for J-1 Visa waivers in rural communities. The program works well for eligible communities in Health Professional Shortage Areas (HPSAs) or Medically Underserved Areas (MUAs) who need a physician, as well as for the foreign physicians who wish to stay in the United States.

What organizations can recommend a J-1 Visa Waiver?

The two primary ways a person may obtain a J-1 Visa Waiver are either through the respective state where they are seeking employment via the Conrad 30 program or through sponsorship from a federal agency. For Rural Health Clinics, Federally Qualified Health Centers and Indian Health Service clinics, the Office of Global Health at HHS will recommend waivers for primary care physicians to work in these facilities if the HPSA score is higher than 7. The Veterans Administration will also recommend waivers for its facilities. 

Outside of these avenues, there are two regional commissions that can recommend J-1 visa waivers: The Appalachian Regional Commission (ARC) and the Delta Regional Authority (DRA). These two entities only recommend J-1 Visa Waivers for primary care physicians.

What is the Conrad State 30 Program?

The Conrad State 30 program was initiated in 1994 through Public Law No: 109-477 to address physician shortages.  Under the program, each U.S. state‚Äôs health department can request J-1 Visa Waivers for up to 30 foreign physicians per year. The physicians must agree to work in federally designated health professional shortage areas or medically underserved areas. Referred to as the FLEX 10, 10 of a state's 30 annual waiver slots may be used for practice locations outside of designated shortage areas where the employer can demonstrate that the physician will serve patients who live in shortage areas.

Each state has been given some flexibility to implement its own guidelines, and while exact requirements vary from State to State, all of the following is generally required by the U.S. and Immigration Services:

  • A full-time contract for employment (40 hours per week) as a direct care physician in a health professional shortage area or medically underserved area
  • A letter of support from the authorized official requesting the physician's waiver recommendation
  • A 'no-objection' letter from the foreign physician's home country; generally needed in lieu of a recommendation for the waiver

Interested parties should contact the Primary Care Office in the state of their intended employment for more information and for exact requirements.

How can a rural community recruit a J-1 physician?

To learn about the Conrad State 30 program in your state, contact your state's Primary Care Office (PCO). The PCO can help you:

  • Determine if your community is eligible to recruit a J-1 physician
  • Assist you in deciding whether pursuing a J-1 Visa Waiver is right for your community
  • Guide you through the recruitment process.

The National Rural Recruitment and Retention Network (3RNet), a network of state level organizations, can also help you in your recruitment efforts. 3RNet helps match healthcare professionals and rural practice opportunities. Their website lists contact information and J-1 employment opportunities for each state. Your job openings can be posted on this site to increase your chances of finding an appropriate candidate.

Communities have a unique opportunity to retain physicians who enter the U.S. on a J-1 visa and are willing to practice in a HPSA or MUA. To read more about both recruitment and retention strategies and tips visit our related Recruitment and Retention for Rural Health Facilities topic guide.

Which healthcare professions are eligible for J-1 Visa Waivers?

The J-1 Visa Waiver Program is only for physicians.

Last Reviewed: 5/28/2014