Irrespective of the statutory basis on which you are applying for the waiver, make sure to read the common waiver application procedures first.
Even though foreign physicians are not the only ones who can request an Interested U.S. Federal Government Agency (IGA) waiver, it is the most common with foreign physicians, as they are subject to the two-year home-country physical presence requirement.
An Interested U.S. Federal Government Agency (IGA) waiver can be obtained in various ways:
- Regular
The interested U.S. federal government agency should send a letter, signed by the head of the agency, or their designee, directly to the Waiver Review Division (not through you) explaining why granting a waiver of the two-year home-country physical presence requirement is in the public interest of the U.S., and why it would be detrimental to the agency if you must return to your home country to fulfill the requirement.
Any U.S. federal government agency may request a waiver on this basis. - Serve in a Medically Under-Served Area
The interested U.S. Federal Government Agency, on behalf of a foreign physician who agrees to serve in a medically under-served area, should send the following documents directly to the Waiver Review Division and not through you.- Copies of all DS-2019/IAP-66 forms ever issued to you;
- Your resume (curriculum vitae)
- A signed contract between you and the facility where you will work for at least three years and 40 hours a week.
- Evidence that the clinic/facility is located in a U.S. Department of Health and Human Services designated Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA)
- Evidence of unsuccessful efforts made to recruit U.S. citizen physicians for the position. Such evidence may include medical journal advertisements, labor certification, or language in a cover letter.
- A statement signed and dated by you that reads exactly as follows: “I, ______________ (your name) hereby declare and certify, under penalty of the provisions of 18 USC.1101, that: (1) I have sought or obtained the cooperation of _______________ (enter the name of the U.S. Government agency which will submit/is submitting an Interested Government Agency Waiver request on your behalf to obtain a waiver of the two-year home-country physical presence requirement)); and (2) I do not currently 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.”.
- A letter of request from the head of the agency, or a designated official that includes the following:
- Stating why it is in the public interest that you be granted a waiver
- Stating the facility is located in a designated HPSA or MUA and provides medical care to both Medicaid- and Medicare-eligible patients and indigent uninsured patients.
- Include the Federal Information Processing Standards country code and census tract, block numbering area number (assigned by the Bureau of Census), or the 9-digit zip code of the area where the facility is located.
- Two self-addressed, stamped, legal-size envelopes
- Form G-28 or a letter from a law office, if you designated an attorney to represent you.
Only the following U.S. federal government agencies may request an IGA waiver on behalf of foreign physicians to practices in HPSA or MUA:- Appalachian and Delta Regional Commissions, Department of Health and Human Services
- Department of Interior for Indian Reservations
- Department of Veterans Affairs (VA). VA hospitals don’t have to be in underserved areas.
- Serve in a VA hospital
An Interested Government Agency Request from the Department of Veterans Affairs (VA), on behalf of an exchange visitor physician, to serve in a VA hospital must include a signed memorandum of agreement between the physician and the hospital in lieu of a three-year contract. VA hospitals do not have to be in an underserved area.
Support for Getting an IGA Waiver
Several factors affect whether you would be able to get the IGA waiver:
- Relationship:
In most cases, IGAs will accept a waiver application either from a current or prospective employer of the J1 holder and not directly. Therefore, in most cases, you can’t self-petition to IGA. That means, you will need the support of not only your immediate supervisor but also of higher administrative officers. Employers may also need to provide information about the project for which you are seeking employment, and about the recruitment efforts they have made. - Role/Involvement:
The more critical role you play in the project, the more likely is your employer to support your waiver application; then, the IGA is more likely to support it as well. You may show your critical role by showing your contributions, such as breakthrough achievement in research, publications, patents, etc. The stronger recommendation letters you can get from your supervisors, the better your chances are. If you can get recommendations from experts outside of your immediate project, that would help to establish that your accomplishments are well recognized in your field. - Timeline:
If you are deeply involved in the project, and if the project still has quite some time to get completed, your chances would be higher because you leaving will have a detrimental affect on the project. It would be best to show your involvement in the project for at least two years. However, you should start preparing for your application at least 6 months before your application would actually be submitted.
