J-1 Waiver Season for Physicians Is Here

J-1 Conrad waiver slots for physicians open up on October 1st. Health Departments around the country will begin accepting J-1 waiver applications under the Conrad program. Each state is allotted 30 spots, with the majority going to primary care physicians, who agree to work for three years in a health professional shortage area. In turn, their two year foreign residency requirement is waived. We routinely prepare these applications.

Rules vary state to state, although the federal government has minimum requirements. Washington State, where we are located, historically takes between six and twelve months to fill all of its spots. In recent years, Oregon has been filling its 30 spots faster. Alaska, Idaho, and Montana make limited use of the program, and so spots tend to remain open through the year. Some states though receive more than 30 applications on the first day the window opens.

Here are a few of the key rules for Washington State:

– Up to ten sponsorships are available for Specialists between October 1st to March 31st. Additional spots may be available after March 31st.

– Washington State also allows 10 non-designated FLEX waivers per year, with these slots opening on January 15th. FLEX spots allow certain physicians to work in areas that are not designated as health professional shortage areas, provided they are assisting populations that are underserved. For example, a Seattle specialist physician that sees patients from all over Washington (or multiple states) might qualify for a FLEX waiver.

– Washington State limits employers to three waivers each, prior to June 1st of the fiscal year.

– Applicants, including integrated health care systems in a single HPSA, are limited to a.) two sponsorships per practice location; b.) one hospitalist sponsorship per hospital; c.) no more than three sponsorships total across all practice locations in the HPSA between October 1st and May 31st; d.) and no more than three FLEX spots by a an applicant for a single county.

– Sponsors must show at least 15% of total patient visits are for Medicaid or other low income patients. This is up from the former 10% figure.

– Washington State requires that sponsors show at least six months of qualifying recruitment in the past 12 months in Washington State. This sometimes can be an obstacle to filing, and so it is important to evaluate what forms of recruitment have taken place, and for how long, for prospective waiver applicants.

We are available to consult with physicians and medical facilities, to discuss this process as well as other potential options for physicians. For better or worse, there are many rules in immigration specific to physicians, such as the Conrad and other J-1 waiver programs, H-1B requirements, and admission requirements. The processes also can involve multiple state and federal agencies. We know the way, and are happy to assist.