J-1 Visa Waiver Program Description
The Wisconsin J-1 visa waiver program increases access to primary health and mental health care in rural and urban communities that have shortages of primary care physicians and general psychiatrists, by helping medical clinics recruit and retain foreign physicians.
Graduates of foreign medical schools can obtain a J-1 visa (education exchange visa) to attend a medical residency or fellowship training program in the U.S. This J-1 visa requires that upon completion of the training program, the foreign physician returns to their home country for at least two years, before applying for immigrant status to the U.S. The foreign physician can have this J-1 visa "home-residence" requirement waived, in return for providing primary care or general mental health care in federally designated rural and urban communities that have shortages of primary care physicians or psychiatrists. Foreign physicians usually apply for J-1 visa waivers in the summer before the last year of their training program.
Federal immigration law authorizes each state health department to request waivers of the two-year "home-residence" requirement on behalf of 30 foreign J-1 visa physicians annually (State-30 program).
State health departments can recommend up to (10) J-1 visa waivers per year for physicians to be employed in non-designated areas. To qualify, clinicians must serve populations in surrounding shortage areas. At least 40% of the physician's patients must come from surrounding shortage areas. The hiring agency must also show exceptional need and public interest for the clinician to be hired in a non-designated area.
Wisconsin's J-1 waiver program can also consider recommending a J-1 visa waiver for foreign physicians in other medical specialties when exceptional need and public interest can be demonstrated.
The Wisconsin Division of Public Health (DPH) is the designated state agency that can submit State-30 recommendations to the U.S. Department of State (USDOS). The DPH accepts applications for State-30 recommendations from health facilities or their attorneys after an offer of employment has been made to the foreign physician.
Starting on October 1st of each year, Wisconsin will begin accepting J-1 visa waiver applications from employers. Applications are reviewed and decisions made (see requirements below) on a first-come, first-served basis until all 30 slots are used. For federal updates and more information on the U.S. Department of State J-1 visa waiver program, see the USDOS web site.
The USDOS reviews state recommendations and submits its recommendation to the U.S. Citizenship and Immigration Services (USCIS), which makes the final J-1 visa waiver decision. Once a J-1 visa waiver is granted, the sponsoring employer must petition USCIS for an H-1b (work) visa. The H-1b visa must be approved by USCIS before the foreign physician can begin employment. The complete J-1 waiver and H-1b process can take up to 6 months.
Key Requirements for State-30 Program:
- The applicant physician must provide care at a facility that is physically located in a geographic area federally designated as a Health Professional Shortage Area (primary care or mental health HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP). Wisconsin can submit up to ten (10) J-1 visa waiver recommendations per year for sites that are not physically located in a designated shortage area but that serve populations from a surrounding shortage area(s). At least 40% of the clinician's patients must come from surrounding shortage areas.
- The applicant physician must agree to provide full-time primary care, general mental health care or specialty care in this shortage area/service area for three years and 40 hours per week, with at least 32 hours/week spent in direct patient care.
- The applicant physician must have completed a residency or fellowship in the U.S. in the specialty associated with the applicant?s employment agreement (e.g., family medicine, internal medicine, pediatrics, obstetrics, psychiatry or other subspecialty);
- The physician and facility must provide care to clients eligible for Medicaid and Medicare and for medically indigent clients;
- The physician must begin working at the facility within 90 days of the effective date of the J-1 visa waiver (after completion of the physician?s residency training);
- The employer must provide evidence of unsuccessful efforts to recruit U.S. physicians for the position; and
- The employment agreement must demonstrate the employer's commitment to recruit and retain the physician for at least three years.
US Dept. of State User Fee:
The U.S. Department of State (USDOS) requires that J-1 visa waiver applicants (J-1 visa physicians) submit a "user" fee for USDOS to process the application. J-1 visa physicians or their attorneys should submit the fee and the USDOS "J-1 Visa Waiver Review Application" directly to the U.S. Department of State. Please note: a Wisconsin State-30 "slot" will not be assigned until DPH has received, reviewed and approved a complete application from the employer, including the physician?s USDOS case file number. More detailed instructions are included in the "Application Information" section of this web site, or the USDOS web site.
The lists of federally designated primary care and mental health shortage areas, HPSAs, MUAs, and MUPs are updated on an ongoing basis. The employment offer must include a practice site that is located in a primary care HPSA or MUA or a mental health HPSA for psychiatrists. Wisconsin can consider recommending a J-1 visa waiver in a non-designated service area, when exceptional need and public interest can be demonstrated. See "Shortage Areas" for more information.
Check if street address of the practice site is located within a designated shortage area: Use this link to check if a street address is located within a current HPSA or MUA/MUP and get the designation details.
Wisconsin does not maintain a list of vacancies specifically for J-1 visa physicians or provide a placement service. Many physicians search through private recruiters or employment ads. Internet sites that might be helpful include:
- The Federal National Health Service Corps Job Opportunities list (vacancy list used primarily for federal loan repayment for U.S. Physicians practicing in HPSAs)
- The National Rural Recruitment and Retention Network (a membership-based private non-profit placement service)
State-30 Application Information:
Click on "Application Information" for more detailed information and to view and print a copy of the Wisconsin Guidelines for State-30 Recommendations for J-1 Visa Waivers from this web site. Application instructions can also be requested by mail by contacting:
Primary Care Office
Wisconsin Division of Public Health
PO Box 2659
Madison, WI 53701-2659.
Primary Care Office
Wisconsin Division of Public Health
1 W. Wilson St., Room 250
Madison, WI 53703-3445
or by calling the Primary Care Program at 608-267-1440.
Requesting an H-1b Work Visa:
Once USCIS notifies the foreign physician that the J-1 visa home-residence requirement is waived, the next part of the employment process is for the sponsoring employer to submit a H-1b work visa petition to USCIS. The Wisconsin Division of Public Health does not have a formal role in petitions for H-1b visas or permanent residency.
Information resources related to petitioning for an H1-b visa:
Prevailing Wage Request through the Wisconsin Department of Workforce Development
Temporary Workers through the U.S. Department of State