J1 Training Visa
J visa students, researchers, and business or industrial trainees come to the US to participate in training programs authorized by the United States Information Agency (USIA).  A company can even start its own J1 training program or use an organization that is already recognized for sponsoring training programs.  The trainee can be engaged in any productive employment that gives him knowledge of specific company practices in the US or of US business practices in general.  This visa is valid for a minimum of three months and for a maximum of 18 months.  Note that a two year home residency requirement may be imposed by job type or funding source.

Under the terms of a J1 visa, an International Medical Graduate who completes a residency or fellowship in the United States must return to his or her home country to practice for at least two years.  However, there are two common J1 waivers for foreign physicians and avoid the two year foreign residency requirement:

J1 Conrad Waivers
An Interest Government Agency (IGA) shows that the IMG is needed in the US to work in a medically underserved area, as designated by the Department of Health and Human Services.  The Conrad Program authorizes each state to recommend waivers for a specific number of foreign national physicals per fiscal year (October 1 through September 30).    Each state has the flexibility to designate its own yearly waiver quota depending on how many foreign physicians they need to staff physical shortage areas.  The program also affords J1 visa holders the opportunity to waive their two year foreign residency requirement in exchange for providing primary healthcare and some specialty care in a federally designated physician shortage area for a period of three years.  Each state sets its own waiver guidelines; however, the general requirements for the foreign physician are the following:

• Work at least 40 hours a week for at least 3 years in a medically underserved area;
• Begin work within 90 days of obtaining the waiver;
• Obtain a no objection statement by the home government if contractually obligated to the home government;
• A written contract between the employer and the IMG;
• The working site must agree to care for Medical Assistance and Medicare;
• A statement signed by the IMG stating that s/he has no other pending waiver applications; and
• Evidence proving that efforts to recruit American physicians for the vacancy were unsuccessful.

We emphasize that each state has its own state specific requirements and therefore before you proceed with the Conrad Waiver please remember to check the appropriate State’s Department of Health for its specific waiver requirements.

J1 National Interest Waiver
The National Interest Waiver may be requested by an interested US government agency in the “national or public interest.”  You must demonstrate how you will provide a direct or indirect benefit through regional or local action, and case law suggests the following factors that might satisfy the “national interest” requirement:

• Improving the US economy;
• Improving wages or working conditions for US workers;
• Improving education and training programs for US children and under qualified workers;
• Improving health care;
• Providing more affordable housing for young and; or older, poorer, US citizens;
• Improving the environment of the US and make more productive use of natural resources;
• A request from a US government agency.

Sample agencies that have sponsored National Interest Waivers include the Department of Housing and Urban Development, the Department of Agriculture, the Department of Veterans Affair, The Department of Health and Human Services, the Department of Defense, and the Department of Education.