J-1 Waiver | IGA for Physicians

Applicants eligible for the J-1 waiver IGA for Physicians are required to be foreign medical graduates who are willing to be employed in a medically underserved area. J-1 IGA Waivers are the second most common sought after waivers. Based on the terms of this waiver, the physician must have been extended a full-time position within a healthcare facility of the medically underserved area.

A “medically underserved area” is defined as having a shortage of health care professionals. These areas also include mental health professional shortage areas, medically underserved areas or population, and physician scarcity areas. If the physician accepts the waiver, the physician is required to start employment within 90 days of obtaining the waiver and is obligated to work in the designated facility for a total of 40 hours a week.

The potential candidate may be employed with this facility for a minimum of three years. If the physician qualifies under these requirements, he/she can then be eligible for sponsorship from an Interested Government Agency (IGA).

This is a method in which a U.S. Federal Executive Agency expresses interest in your work and wishes to sponsor your waiver to avoid the home residency requirement. This usually occurs if you are working on a federal project that would be disrupted if you were compelled to return to your home country. This means that you will need to demonstrate that your involvement is instrumental to the completion of your project. The more critical your role is, the greater your chances of acceptance.

A government agency, under certain circumstances, may still qualify as your sponsoring IGA even if the agency only funds your work. For example, if your cardiology program receives funds from the Department of Health, it might qualify as an IGA.

Alternatively, if you work in a Veterans Affairs hospital, the U.S. Department of Veterans Affairs can be your sponsoring agency and you do not need to work in a medically underserved area.

j-1 waiver iga for physicians

To successfully process your J-1 waiver for physicians, you will need to follow the following steps:

Find a Qualified Sponsoring Agency

The first thing you need to do is find a sponsoring government agency. This does not necessarily need to be the same agency that you worked for during your J-1 visa validity period. For example, if you are working on developing vaccinations for a private company, the U.S. Department of Health and Human Services may choose to sponsor you. However, it will usually be up to you to reach out to the agency.

Interested Government Agencies (IGAs) That Can Sponsor Your J-1 Waiver

When it comes to J-1 waiver sponsorship, any U.S. federal government agency can act as an IGA. However, for FMG sponsorship, some agencies have been more involved. They include the Department of Health and Human Services (HHS), the Department of Veterans Affairs (VA), the Appalachian Regional Commission (ARC), and the United States Department of Agriculture (USDA). In some cases, a state health department may also act as an IGA. This is known as the Conrad Program.

Any of the IGAs may request a waiver on your behalf by showing that your two-year absence from the U.S. would be detrimental to a certain activity of significant health importance or of official interest to the agency. In return for the sponsorship, you will need to submit a “no objection” statement from the government of your home country, have a full-time medical job offer, and agree to work in a medically underserved area for at least three years. You are also required to be in-status while completing the term and agree to start working within 90 days of receipt of the waiver. The following shows the process of getting a waiver via those IGAs.

HHS J-1 Waiver Program

The HHS is responsible for managing the J-1 visitor program as it relates to health research and clinical care. This explains why the HHS exchange visitor program accepts applications to request a J-1 waiver related to the following two types of work:

  • Research performed in an area of significant or priority interest to the HHS
  • Health care services in a Health Professional Shortage Area (HPSA) in the U.S. As a J-1 physician, you must agree to provide health care services for three years in a primary health or mental health care HPSA.

The HHS has different waiver requirements for each of the above programs. To apply under the research category, see the Research Waiver Request, Supplement A. And to get a waiver under the clinical care category, see Clinical Care Waiver Request Requirements, Supplement B. 

After submitting your application, the HHS will evaluate it and determine if the proposed research program or healthcare services have met the requirements of essential and quality participation. If yes, the HHS will submit its recommendation to approve the request to the Department of State.

Appalachian Regional Commission J-1 Waiver Program

The Appalachian Regional Commission (ARC) is committed to helping residents in the region have access to affordable, quality health care. The commission is a joint federal-state entity, established by Congress in 1965. The ARC is made up of all of West Virginia and parts of Alabama, Kentucky, Georgia, Maryland, South Carolina, New York, North Carolina, Mississippi, Ohio, Pennsylvania, Tennessee, and Virginia.

Your request for a waiver through the ARC must be sponsored by any of the above states. You will have to contact the designated official in the state where you intend to practice to know the required process. This webpage contains the contact information of all ARC states J-1 visa waiver program.

Delta Regional Authority J-1 Waiver Program

There are 240 county or parish areas under Delta Regional Authority in these states: Alabama, Kentucky, Arkansas, Louisiana, Illinois, Mississippi, Missouri, and Tennessee. You must agree to provide full-time primary health care services within the DRA region for at least three years. You will also need to follow all the DRA J-1 waiver program application guidelines and pay the required application processing fee. The DRA program has a liquidated damages clause that you must complete and sign. According to the clause, you must also agree to pay $250,000 to the sponsoring facility if you fail to fulfill any part of your own commitment to the employment contract or pay $6,945 per month for each month you fail to fulfill your requirement. 

Conrad State J-1 Waiver Program

The Conrad waiver program for states is similar to that of an IGA. However, the application requirements and program administration vary by state. Under the program, participating states are allowed to sponsor 30 J-1 waiver applications for foreign primary care physicians annually. 

To apply for a waiver under Conrad, you must fulfill both the general licensing requirements for physicians in the U.S. as well as the state-specific licensing in the state where you will practice. Your waiver request application must be sponsored by the state where you agree to practice medicine in a designated shortage area for a period of three to four years. You will have to contact the state department to know the required process.  

Complete the J-1 Waiver Application

The physician is required to complete the J-1 Visa Waiver Recommendation Application (Form DS-3035). The application is available online. The online DS-3035 is the only acceptable method for the application to be processed. When the physician has completed the online application, remember to print the given barcode and finished application. Make sure that the application indicates how the J-1 visa waiver will be in the nation’s best interest.

Mail Your Application to the Appropriate Address

Once the DS-3035 has been submitted online, the physician is required to mail 5 items to one of the listed addresses.

    1. The completed online application
    2. Application barcode
    3. Duplicates of every Certificate of Eligibility for Exchange Visitor Status (Form DS-2019) and IAP-66 obtained.
    4. Two self-addressed, stamped envelopes
    5. $215 application fee (be sure to submit this will the barcode or else it will be returned).
    6. You may also need to include recommendation letters from experts in your field. Work with your immigration attorney to determine candidates as authors for your letters.

Processing Time for J-1 IGA Waiver

The average processing time for a J-1 waiver for physicians based on a request from an IGA is six months, although there may be discrepancies from case to case.

Keep in mind that you will most likely not be permitted to self-petition for your IGA waiver. This means that you will need to get the approval and support from your manager and often a director or executive. These individuals, acting as your employer, will likely need to sign the application for the IGA and give the USCIS information about your work and the program that sponsored you for your J-1 visa.


Be sure to have your application, payments, and supporting documents sent to the right address to avoid any complications in your processing. Ask your immigration attorney if you should use the courier or regular service.

(Courier Service)

U.S Department of State

Waiver Review Division

Box 952137

1005 Convention Plaza

St. Louis, MO 63101-1200


(Regular Service)

U.S. Department of State

Waiver Review Division

Box 952137

St. Louis, MO 63195-2137

  1. The J-1 waiver IGA for physicians requires supplementary material.
  • Resume
  • Signed statement with the date. The statement must read:
    • “I, (Name of J-1 Visa Holder) hereby declare and certify, under penalty of the provisions of 18USC.1101, that: (1) I have sought or obtained the cooperation of (Name of Government Agency who is submitting IGA request); and (2) I do not now have pending nor will I submit another request to any U.S. Government department or agency or its equivalent, to act on my behalf in any matter relating to a waiver of my two year home residence requirement.”
    • The head of the sponsoring government agency must submit a letter of request stating the importance of removing the two-year foreign residency requirement.
    • A signed contract indicating that the physician will work a minimum of 3 years at 40 hours a week within the designated facility
    • Provide proof that the facility is qualified with the U.S. Department of Health and Human Services.
    • The head of the facility is obligated to sign a statement declaring that the facility is an HPSA or MUA. The statement must include that it delivers medical care to Medicaid and Medicare-eligible patients and uninsured patients. The statement is required to provide Information Processing Standards county code, census tract, block numbering area, or the 9 digit zip code of the facility’s area.
    • Proof of recruiting efforts in trying to obtain a qualified U.S. citizen for the physician position.
    • If the physician would like attorney representation, he/she is mandated to submit Form G-28 must be submitted.

Once the physician has completed the above steps, the Waiver Review Division will consider your case. The physician will have the ability to view the status of the waiver application.

Check Your Waiver Request Status and Update

After completing the above steps, you have completed your part of the waiver request application. However, it is important to follow up on the application so you can know the status at any given time. For instance, in some cases, the Waiver Review Division may need additional information from you. 

To check your application status, you will go to the J-1 Visa Waiver Online webpage and click on “Check the status.” Then enter your application case number. The system will let you know if the Department received your application and supporting documents. You will also know if any document is missing.

In addition, if you change your address, email address, or phone number after submitting the application, you can update the new information on the webpage. To do this, you can click on “Inform the Department of State of a change to personal data.”

NOTE: The Department of State advised that applicants allow approximately one month after submitting their application before checking their status. 

The Waiver Review Division may request additional information and documents. The Division will contact the physician using the information provided in the application (Form DS-3035).  If the physician wishes to request information or submit missing documents, all items should be sent to:

U.S. Department of State Visa Services

Waiver Review Division

2401 E. Street, NW

Washington, DC 20522-0106

Other J-1 Waiver Options for Foreign Physicians

Apart from requests through IGAs and state health departments, J-1 physicians may also explore other bases for a waiver. In all, there are five bases through which you can apply fora  J-1 waiver, according to the Department of State. The other three bases are:

If your application is denied on one basis, you may reapply under another basis if you think you qualify.

Learn all about J-1 visa and taxes

How VisaNation Law Group Immigration Lawyers Can Help

Getting around the J-1 visa home residency requirement is no easy task. Doing it alone can only increase the probability that your application will be denied. The best way to make sure that you are prepared for any issues or unforeseen obstacles is to have a qualified J-1 visa attorney in your corner.

VisaNation Law Group’s dedicated team of attorneys will take care of everything from filling out your application to helping you collect letters of recommendation and other supporting documents. We’ll also help you determine what qualifies as a medically underserved area so you can be sure that your case is rock solid.

To get in touch with a VisaNation Law Group immigration attorney, just fill out this simple contact form and schedule your consultation with our office today.