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 waiver program, framed by Senator Kent Conrad of North Dakota in 1994, is one way to address the shortage of physicians in rural and urban areas. The Iowa Department of Health and Human Services, Division of Public Health, Primary Care Office receives requests and makes recommendations for waivers on behalf of physicians holding J-1 visas in accordance with the Conrad 30 waiver program.

Waiver requests are accepted for physicians who agree to a 3-year, full-time service commitment to provide primary care or specialty care in a designated primary care health professional shortage area, or a medically underserved area or population; or provide psychiatric care in a mental health professional shortage area. There are currently 30 available spots annually, 10 of which may be considered as “non-designated requests” for physicians who agree to work in non-designated areas yet still serve patients who reside in federally designated shortage area(s). The Iowa Department of Health and Human Services issues letters of recommendation to the U.S. Department of State. The U.S Citizenship and Immigration Services approves, and issues J-1 visa waivers. Refer to the J-1 Visa Waiver Program Guidance for more details about submitting a request for a letter of support.

PDF forms are no longer available. 

Online Forms

J-1 Visa/Conrad 30 Waiver Cycle 2024-2025

The agency submitted 30 applications to US Department of State. The agency will accept application for the 2025-2026 fiscal year starting September 2, 2025. 

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 designated underserved area [Section 203(b)(2) of the Immigration Nationality Act (INA)]. 

The State of Iowa is committed to improving access to health care in medically underserved areas of the state. The PNIW is one way to address the shortage of physicians in Iowa. The Primary Care Office, within the Division of Public Health at the Iowa HHS, receives requests for and provides PNIW attestation letters. PNIW requests can be submitted and processed at any time during the year.

A United States health care facility or legal counsel must submit documentation on behalf of a physician to the Iowa HHS to be considered for a PNIW attestation letter. The documentation is collected to determine the term of the PNIW service obligation in Iowa, as well as to substantiate physician qualifications and the claim that the work of the physician is in the public interest.

The Iowa HHS issues letters of attestation to the health care facility or legal counsel submitting a PNIW request on behalf of the physician. Once a letter of attestation is provided, the PNIW request is submitted by the healthcare facility or legal counsel to the U.S Citizenship and Immigration Services who approves and issues PNIWs. Refer to the Physician National Interest Waiver Guidance for more details about submitting a request for a letter of attestation.

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