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The J-1 Visa and Other Alternatives for Foreign Resident Physicians

The current immigration system in the U.S. creates many hurdles and obstacles for foreign healthcare professionals wishing to live, study, and work in the U.S. The J-1 status in particular can be burdensome for those foreign nationals wishing to enter the U.S. to receive a graduate medical degree. While the H-1B visa option may be preferable and confer many advantages to a foreign medical professional, many medical programs still are using the J-1 visa program. As time may be short near the end of your J-1 visa stay, it is important to consult with an experienced immigration attorney who is knowledgeable on this subject. Please do not hesitate to call The Law Firm of Shihab & Associates for a consultation today or use our Contact form to inquire about your visa options.

What is a J-1 Visa, and What Difficulties Might I Face Under this Status?

The J-1 visa was originally created shortly after World War II as a nonimmigrant, international exchange program with the purpose of fostering international goodwill, and with the intent that physicians would return to their home country after their training was complete. However, the current international reality is that the U.S. has been facing a shortage of physicians for some time, and many foreign nationals wish to come to the U.S. to live, study, and work. And, training foreign physicians for many years here in the U.S., many institutions desire to hire them on afterwards.

The J-1 visa has the significant drawback of a two-year foreign residence requirement. This means that after your residency training is complete, you must return to your home country or country of origin for a minimum of two years. This questionable requirement was designed with the intent that foreign medical professionals would return home with the training they received in the U.S. to improve relations with their country of origin.

Furthermore, the J-1 visa is limited to a maximum seven-year period, or the time required for you to complete your resident program, whichever is shorter. “Exceptional need” extensions may be available, but are very difficult to obtain, requiring you to demonstrate specific practice needs in your home country for your extra training. This can be a major constraint for you if you are in a specialty field requiring advanced training, such as thoracic surgery, or if you decide to change your specialty mid-residency.

In conclusion, once you enter the U.S. under a J-1 visa, you may face very difficult problems remaining in the U.S. in the future. Years later, after receiving your residency training at a U.S. institution, you may be forced to leave the United States because of the two-year foreign residence requirement, unless further action for relief is taken. This is a puzzling immigration policy for the United States, a country that faces a shortage of qualified physicians to handle significant increases in an aging populace that demands ever greater and more sophisticated medical care. The council on Graduate Medical Education estimates an 85,000 physician shortage by the year 2020, and the American Medical Association has called for an expansion of the nation’s doctor workforce.

What Alternatives are there to the J-1 Visa for Foreign Physicians?

The H-1B Visa Option: Since 1990, foreign physicians have had the ability to enter the U.S. to participate in graduate medical training under the H-1B program. A significant number of medical schools have since changed their residency programs to admit foreign residents under the H-1B program, although a large number of institutions still prefer the more restrictive J-1 visa program which imposes the two-year foreign residence requirement.

An H-1B visa has a maximum stay of six years. While some residency programs are longer than this, the H-1B visa has the added benefit of “dual intent,” allowing the foreign physician to adjust their status and apply for permanent residency, while their H-1B status remains unaffected. This confers much greater flexibility for foreign physicians to remain in the U.S. after their residency is complete.

A National Interest or Conrad Waiver: You may be able to obtain a national interest waiver for permanent residence, if you are a foreign physician willing to work in under-served or professional shortage areas. If you can make a five year commitment to work in an under-served area or a Veteran’s Administration (VA) medical facility, then you will be eligible to receive a national interest waiver.

Another avenue to receive a waiver is known as the Conrad Waiver, which permits U.S. states and federal agencies to act as sponsors for waivers for foreign physicians. This has proven to be an excellent way for public institutions to secure needed care from well-trained foreign physicians.

E-3 Australian Specialty Occupation Workers: While an appealing option, this visa is only available for Australian nationals. This visa status requires a theoretical and practical application of knowledge in a practical field requiring at least a bachelor’s degree. To qualify, you must have a job offer of employment within the U.S., possess all the necessary academic and qualifying credentials, and be a national of Australia. You will also need a Labor Condition Application that is separate from any previous ones used for H-1B applications. You will also need the required license or permission to practice in your field within the U.S.

Other Visa Alternatives: Beyond these types of visas, there are at least two other appealing options for foreign physicians wishing to remain in the United States: The E-2 Treaty Investor visa, and the TN (NAFTA) visa for nationals of Mexico or Canada. These types of visas are dependent upon your home country having a treaty or international trade agreement with your specific home country, among other requirements. Preparing a successful Treaty Investor or TN visa application is an intricate process—please contact one of our experienced immigration attorneys today.

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With the U.S. facing a looming healthcare crisis based on an aging population and a shortage of qualified medical professionals, a J-1 visa immigration policy that limits and restricts the duration of stay of well-trained foreign physicians makes no sense. It is therefore important that a law firm not only represent you as an individual, but also consider the broader goal of social change through the evolution of the law.

At The Law Firm of Shihab & Associates, we represent foreign physicians, healthcare providers, and companies in applying for visas and green cards for healthcare professionals. Please contact our experienced immigration attorneys or call us at the nearest office close to you to consult with one of our experienced and helpful attorneys today.

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