During this time of year, we get many phone calls from physicians that either used a recruiting firm that did not know how to place J1 physicians (some of the largest recruiting firms are NOT the most knowledgeable because their main business is Americans and non visa related placements, also not all Attorneys (even immigration Attorneys) are the same) or they secured the opportunity themselves and did not have the knowledge to make a proper qualification.  After all they are doctors not placement and immigration specialists. 

This causes huge issues and puts the physician in a very precarious situation as many programs are closing throughout the US.  Some of these physicians will have to go home never getting their waiver.

We wanted to list the “main” requirements for a J1 candidate when accepting a job.  Keep in mind doesn’ even include the difficulty in just finding an appropriate practice opportunity.  The J1 Physician Network insures all of these items are met even before we allow a candidate go to a site visit.  Some physicians look for jobs on their own.  If you are one of them, then it is then your responsibility to insure that these are all met.  And there are obviously other requirements but these are the main ones that are most likely if not met disqualfy an opportunity for a waiver.

1.  Located in a HPSA or MUA - The place where you actually are performing services is in a HPSA or MUA (depending on the State - some only regard HPSA’s as qualifying areas, some use both and some utilize up to 5 Conrad State 30 slots at their discretion approving J1 waivers in non-underserved areas).  By the way, just because you have an office in an underserved area does not mean that the job qualifies if you perform services in non underserved areas.

2.  You must be employed.  An income guarentee is NOT a guarenteed income and does not indicate employment and will not be approved. 

3.  There can be no Non Compete clauses in your contract - A non compete clause is not allowed to be in the contract for a J1 waiver candidate.  Also, many states regard a Liquidated Damage clause to be a restritive covenant and is not allowed either (unless it is the ARC area which is mandated by law that it has to be included).

4.  100% of the prevailing wage has to be paid - This can be tricky, but an honest employer will pay the actual prevailing wage that he/she pays everyone else.  If an employer is trying to pay less, you should not work for them.

5.  The contract has to state that the employee will work 40 hours not including call - Otherwise it will not be considered a full time job by the State.

6.  No moonlighting - Not allowed by law.

7.  They facility has tried to hire an American - This usually takes the shape of the facility has at least advertised the opportunity nationally for at least 6 months.  Each state handles this differently and some are very strict and some are less strict, but all have this requirement.

Most physicians on a J1 only think of the Conrad State 30 program and sometimes the VA, but there are other ways to get a waiver.  The Delta Region Authority can give an unlimited amount of waivers and will accept specialties and sub specialties, and the ARC can also give an unlimited amount of waivers but only in primary care.

If you are a physician that suddenly finds themselves without a waiver and without a job at this late date, please take action.  You are running out of time.

And always remember, a Contract is not a Waiver.  And a Contract never guarantees a Waiver. 

Good luck.