Immigration Services

Immigration Services

For Physicians


J-1 Waiver Application Based on Recommendation of State Department of Health (Conrad State 30 Waiver)


All 50 states of the United States, as well as Guam and Puerto Rico, offer the Conrad J-1 waiver program, where their respective Departments of Health may recommend up to 30 waivers per fiscal year to eligible physicians. In order to qualify for a favorable recommendation from a State Department of Health, you and your employer must demonstrate that your employment in the U.S. will substantially benefit medically underserved patients. The medical facility/site where you will work must be physically located in a place designated by the U.S. Department of Health and Human Services as a HPSA (Health Professional Shortage Area) or Medically Underserved Area (MUA). We must, therefore, show the following:
  • That the employer has a legitimate need for your services;
  • That another suitable candidate could not be found; and
  • That you will provide critically needed medical services to an underserved area.
If you are able to meet these criteria, the State Department of Health will act as an interested government agency on your behalf and recommend to the U.S. Department of State (DOS) that it is in the public interest to issue you a waiver of the two-year foreign residence requirement.

The Conrad State 30 J-1 waiver program targets primary care physicians who have completed a U.S. residency training program and will practice medicine in one of the following specialties: Family Medicine, General Pediatrics, General Obstetrics, General Internal Medicine or General Psychiatry. However, some states allow sponsorship of specialist physicians, provided that the service area has a shortage of physicians practicing that particular specialty. Additionally, a number of states grant waivers to physicians working in an area not designated as a HPSA or MUA/MUP, if they will serve patients residing in underserved areas. Note that only up to 10 out of the 30 waiver slots may be designated as the so-called “flex slots” and they are distributed on a first-some-first-served basis.

Most states run out of the 30 available waiver slots before the end of their fiscal year, with many states reaching the maximum limit only weeks or months after the year starts. Therefore, a timely filing is imperative to securing a waiver. For many states, fiscal year generally starts on October 1.


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