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Preparing for Pennsylvania J-1 Waivers


In May 2024, the Pennsylvania Department of Health (DOH) provided an update on the upcoming J-1 Waiver application process.

International Medical Graduates (IMGs) who complete medical education through residency or fellowship programs in the United States on a J-1 Exchange Visitor visa are required to return to their home country to practice for at least two years before petitioning for re-entry to the United States. Through the Conrad 30 program, state health agencies can recommend the waiver of the two-year home residence requirement if the agency attests to the public health need for this physician. States may request up to 30 such waivers per federal fiscal year. Pennsylvania has historically used all 30 waiver slots.

This year, the application window will run from October 1, 2024 through December 13, 2024. The application review will take place starting in January through February and notifications to applicants will be sent out in March.

Prioritization of applications remains the same as in previous years:

  • Priority 1: Primary care physicians who will provide services at out-patient, ambulatory care sites located in HPSAs or MUA/Ps.
  • Priority 2: Applications for physicians (including specialists) who will be employed at the following practice sites where need for the physician is sufficiently documented:
    • Critical Access Hospitals
    • Small Rural Hospitals
    • Federally Qualified Health Centers (and Look Alikes)
    • Certified Rural Health Clinics
    • Primary care outpatient facilities not located in a HPSA or MUA/P [Flex 10]
  • Priority 3: Applications for specialty physicians located in an MUA/P or HPSA or for a Flex 10 slot will be considered based upon the availability of slots and need as documented in the application.

Other important reminders include ensuring that employers can document unsuccessful recruitment efforts within the last year. A recruitment report outlining the employer’s efforts to recruit U.S. physicians to the role will be required. Finally, the DOH will not make a final determination on a case until they receive either the IMG’s PA Medical License or official notice from the PA Board of Medicine verifying the only outstanding documentation required to issue a license is the completion of the final year of the physician’s training.

If you have physician recruiting needs and would like to explore the J-1 waiver and other recruitment options for international medical graduates, please contact an attorneys on the Healthcare Immigration Team below.

Please contact your Klasko Law attorney with any questions regarding this client alert.

The material contained in this alert does not constitute direct legal advice and is for informational purposes only. An attorney-client relationship is not presumed or intended by receipt or review of this presentation. The information provided should never replace informed counsel when specific immigration-related guidance is needed.

© 2024 Klasko Immigration Law Partners, LLP. All rights reserved. Information may not be reproduced, displayed, modified, or distributed without the express prior written permission of Klasko Immigration Law Partners, LLP. For permission, contact

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