J-1 Waiver Requirements Further Relaxed During Pandemic

The U.S. Department of Health and Human Services (HHS) has announced changes to the J-1 waiver program for clinical care in response to the public health emergency created by COVID-19. These changes expand the potential pool of physicians and their employers who could seek J-1 waiver sponsorship recommendations from the HHS.

Home Residency Requirement

Physicians who come to the United States to participate in graduate medical education programs (residency or fellowship) via the J-1 visa exchange visitor program are subject to a home residency requirement (HRR). Per the HRR, J-1 physicians must return to their respective country of citizenship or last permanent residence for two years before applying for an H1B visa or immigrant visa / adjustment of status.

HRR Waiver Requirements

Oftentimes, physicians and their employers seek waivers of the HRR from interested government agencies. Physicians who receive these interested government agency waivers are required to work for three years in H1B status in federally designated medical professional shortage areas. In exchange, a waiver to the HRR is granted. The most common of these programs are referred to collectively as Conrad 30, but other interested government agency waiver programs for physicians are also administered by the Veterans Administration, Appalachian Regional Commission, Delta Regional Authority, and the HHS.

HHS Broadens Criteria

Historically, the HHS has limited participation in its waiver program for clinical care to only certain categories of healthcare facilities that are located in a health professional shortage area (HPSA) with a score of 7 or higher. The program changes, which are effective immediately, expand participation to ALL facilities that are located in an HPSA with a score of 7 or higher. It is unclear at this time whether the expansion is temporary, during the current public health emergency, or permanent.

Must Have Completed Residency Within Past Year

Although the types of facilities considered have expanded beyond the original limits, HHS continues to have other restrictions in place. The HHS only considers clinical waiver applications for primary-care doctors practicing in family medicine, general internal medicine, general pediatrics, obstetrics and gynecology, or general psychiatry who have graduated from a primary-care residency within the last year. Physicians must agree to deliver health care services for three years in a mental health (if a psychiatrist) or primary care HPSA. Facilities in medically underserved areas / medically underserved populations (MUA/MUPs) are not considered.

No Limit on HHS Waivers

Unlike the Conrad 30, there is no limit to HHS waivers for clinical care per fiscal year. Eligible physicians and their employers may want to consider the HHS program if they were not successful in the Conrad 30 program because programs had already exhausted their waiver allotment for the fiscal year.


The Murthy Law Firm has extensive experience exploring J-1 waiver options. Physicians requiring assistance with immigration matters are encouraged to contact the Murthy Law Firm at <doctors@murthy.com>.


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Disclaimer: The information provided here is of a general nature and may not apply to any specific or particular circumstance. It is not to be construed as legal advice nor presumed indefinitely up to date.