In welcome news for foreign physicians/international medical graduates, and healthcare facilities in Upstate and Northern New York, the Northern Border Regional Commission (NBRC) has implemented a new J-1 Visa Waiver Program for physicians who commit to working in a medically underserved area within the NBRC’s jurisdiction. This blog first mentioned this possibility in September 2022, and the development of this new J-1 waiver program has been years in the making.

By way of background, one perpetual issue facing International Medical Graduates who come to the United States on J-1 exchange visas to engage in residency/fellowship training is the imposition of the two-year home residence requirement. This requirement attaches to all foreign physicians utilizing a J-1 visa to complete graduate medical education/training in the U.S., and there are only very limited options for obtaining a waiver of that requirement. See prior posts on this blog for an overview of the available J-1 waiver options, including a discussion of several physician-specific waiver categories that require a period of service to patients in a medically underserved area. Some of these options/programs, such as the Appalachian Regional Commission (ARC) waiver and the Delta Regional Authority (DRA) waiver, are geographically limited, and only available to healthcare facilities/physicians located in the geographic footprint of those particular regional commissions.

The Northern Border Regional Commission’s J-1 waiver program is the latest addition to this group. As part of its efforts to improve this workforce issue in some of the most rural and underserved areas in New York, Vermont, New Hampshire, and Maine, the NBRC will consider recommending a waiver of the two-year home-country physical presence requirement on behalf of eligible physicians holding J-1 Visas in Health Professional Shortage Areas (HPSA) and Medically Underserved Areas (MUA). Eligible physicians must agree to work at least three years and 40 hours per week within a U.S. Department of Health and Human Services-designated HPSA or MUA of the legislatively defined Northern Border Region. In New York, this includes the following counties: Cayuga, Clinton, Essex, Franklin, Fulton, Genesee, Greene, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Montgomery, Niagara, Oneida, Orleans, Oswego, Rensselaer, Saratoga, Schenectady, Seneca, St. Lawrence, Sullivan, Washington, Warren, Wayne, and Yates.

The NBRC’s J-1 waiver program is narrow in scope at this stage, limited for now to physicians who will practice primary medical care (including general or family practice, general internal medicine, pediatrics, or OB/GYN) or mental health. It is not yet available to specialists, though NBRC has indicated that they plan to expand the waiver program to include some specialty care applications in the “second phase” of their program rollout.

This is of particular significance to medical facilities in New York, a state where the allotment of 30 waivers through the Conrad State 30 waiver program is routinely insufficient, with New York State receiving anywhere from 50 to 100 requests for its 30 available waivers in recent years. Thus, the NBRC waiver program, once fully rolled out to specialty care physicians, will offer benefits not only for employers within the NBRC’s jurisdiction (who can apply directly to NBRC for J-1 waivers for qualifying physicians) but also for healthcare facilities throughout the State (reducing the competition for the coveted Conrad 30 slots).

Brendan Venter, of the Harris Beach immigration practice group and the Health Care industry team, is a member of the International Medical Graduate Taskforce, a small sub-set of immigration attorneys from throughout the country who focus their practice on healthcare immigration and who are dedicated to educating national and state policy makers, administrative officials, and the American public on the need for fair and reasonable laws for allowing international medical graduates to become licensed as physicians and to begin or continue their medical careers in the United States.

If you have questions about J-1 waiver options or issues relating to physician/healthcare immigration, contact Brendan or the Harris Beach immigration team to discuss the options that may be available to you. Our Immigration Law Practice Group includes immigration attorneys who work across New York State in our Albany, Buffalo, Ithaca, Long Island, New York City, Rochester and Syracuse offices. Our immigration lawyers focus on strategies – including immigrant visas for permanent U.S. resident status and temporary visas for foreign nationals – to ensure companies are able to hire, transfer, and retain the brightest and best non-U.S. talent.

This alert is not a substitute for advice of counsel on specific legal issues.

Harris Beach has offices throughout New York state, including Albany, Buffalo, Ithaca, Long Island, New York City, Rochester, Saratoga Springs, Syracuse and White Plains, as well as Washington D.C., New Haven, Connecticut and Newark, New Jersey.