J-1 Visa Waivers & Physician National Interest Waivers

The State of Iowa is committed to improving access to health care in underserved areas of the state. The Conrad 30/J-1 Visa Waiver Program and the Physician National Interest Waiver Program are two ways to address the shortage of physicians in rural and urban areas.

J-1 Visa Waiver Program

The Conrad 30/J-1 visa waiver program, framed by Senator Kent Conrad of North Dakota in 1994 is a program that allows J-1 exchange visitors to apply for a waiver of the 2-year home residency requirement upon completion of their exchange program (see Section 214(l) of the Immigration Nationality Act (INA)). The Primary Care Office, within the Bureau of Policy and Workforce Services at the Iowa Department of Health and Human Services, receives requests and makes recommendations for waivers on behalf of physicians holding J-1 visas in accordance with the Conrad State 30 program.

Waiver requests are accepted for physicians who provide primary health care, mental health care, and specialty care. Recipients of a waiver agree to a service obligation in an underserved area of the state, as designated by the federal government. The program allows for 30 waiver spots per Federal Fiscal Year (October 1 – September 30), 10 of which are considered flex spots for physicians who agree to work in non-designated areas, yet still serve residents in underserved areas. J-1 visa waiver requests are accepted annually in the fall. Refer to the J-1 Visa Waiver Program Guidance for more details about submitting a request.

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J-1 Visa/Conrad 30 Waiver Cycle 2023-2024

Twenty-three viable applications have been received as of January 1, 2024, eight of which are flex slots. We anticipate providing recommendations for all of the 23 applications.

The application process will remain open for additional applicants until we reach the limit or until the end of the federal fiscal year. We will recommend future applicants on a first come, first serve basis as long as they meet the criteria for acceptance.

Physician National Interest Waiver Program

In accordance with the Nursing Relief for Disadvantaged Areas Act of 1999, national interest waivers were established for foreign national physicians seeking a Green Card via the second-preference employment category (EB-2). The EB-2 typically requires a job offer and labor certification. A PNIW allows that requirement to be waived, but the physician must agree to work full-time in a medically underserved area (Section 203(b)(2) of the Immigration Nationality Act (INA). PNIWs are issued by the United States Citizenship and Immigration Services.

The Primary Care Office, within the Bureau of Policy and Workforce Services at the Iowa Department of Public Health, receives requests and provides PNIW attestation letters throughout the year for primary care physicians (such as a general practitioner, family practice petitioner, general internist, pediatrician, obstetrician/gynecologist, or psychiatrist) or specialty physicians. Recipients of a waiver agree to a 5-year, full-time service obligation in either in a Health Professional Shortage Area (HPSA), Mental Health Professional Area (MHPSA – for psychiatrists only), a Medically Underserved Population (MUP), or a Medically Underserved Area (MUA).

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