By Michael P. Broxterman and Terry Lane
The U. S. Department of Agriculture (USDA) announced that effective February 28, 2002, it has permanently closed its waiver program for foreign physicians who are in the US on a J-1 Visa. All applications currently pending are being returned. Across the country, communities have been left hanging while they wait to find out who will fill critically-needed physician openings.
According to the USDA website: “[The] USDA began an extensive review of these programs in light of increased security. The review revealed that USDA has been granted no special authority and no additional funding to sponsor Visas for scientists or to serve as an IGA supporting waiver applications. USDA has no specific authority to conduct adequate background checks on applicants or to rely upon other federal agencies to do so. Because of this, USDA has decided to discontinue its role as an IGA on behalf of foreign research scientists or physicians desiring a recommendation of a J-1 Visa waiver.”
J-1 Visa waivers are temporary visas that allow foreign physicians to remain in the United States after completing their residencies, instead of leaving for at least two years (as the J-1 Visa normally requires).
The J-1 Visa physicians must work in a medically-underserved rural area where physicians are desperately needed. Millions of Americans who live in rural areas would not have access to primary care without the J-1 Visa waiver program and the physicians who obtain them. To qualify for the waiver, the foreign physician must be offered a position in a sponsoring government agency and a rural HPSA (Health Professional Shortage Area) – the Dept. of Health and Human Services has identified nearly 1200 such areas in the United States.
Approximately 51 million Americans live in rural areas, and nearly 40% of these Americans live in areas that have a shortage of primary care doctors. American doctors do not generally want to locate to rural areas despite higher salary offers, bonuses, loan repayment plans, and other generous programs designed to attract them. The answer for rural communities has been to hire foreign medical school graduates who enter the US on J-1 Visas, coupled with the requirement that the physician leave the US for two years when the residency program ends. To get around this requirement and remain in the US, foreign physicians have found US government or state agencies to sponsor the physician via the waiver.
The USDA has sponsored more than 3,000 foreign physicians for work in rural areas since 1994 on the J-1 Visa waiver program. Most of these doctors have gone to work in clinics and hospitals in remote areas of Appalachia and the Deep South-treating primarily the elderly and the poor. Texas, California, Oregon, South Dakota, Kansas and Oklahoma have relied exclusively on the USDA program for the sponsorship of physicians working in their rural communities.
While a grassroots lobbying effort is in the works to seek a reversal of the closure, advocates are working to get bill §1259 passed – a bill that will double the number of physicians who can be sponsored in State 20 waiver programs, and would bring back a non-immigrant visa program for nurses.
While the loss of the USDA J-1 waiver program will certainly have an impact on the foreign physicians whose pending applications are being returned, there are other waiver programs available for many J-1 physicians and rural health care providers in 44 states. They are:
- The Appalachian Regional Commission
- The Conrad State 20 Program
- The Veterans Administration
- State Departments of Health
- The Department of Health and Human Services
Additionally, some J-1 physicians may be eligible for 0-1 Visa status (medical professionals with extraordinary ability), TN status (if Canadian) or a waiver-based on hardship or persecution. Information on alternative waiver programs can be found at: http://www.travel.state.gov/jvw.html.
Many thanks to the law firm of Ogletree, Deakins, Nash, Smoak & Stewart, P.C in Atlanta, GA. Their research and information regarding this critical issue was extremely helpful. Any further questions can be directed to Jay C. Ruby, Associate Attorney, at 404/881-1300 or jay.ruby@odnss.com