Foreign physicians on J-1 visa can get bypass the two-year requirement via Interested Government Agency (IGA) waiver. In obtaining an IGA waiver, a foreign physician must choose either a clinical track or a research track. If a foreign physician chooses the clinical track, they must agree to practice in a Health Professional Shortage Area or a Medically Underserved Area for a minimum of three. If a foreign physician chooses the research track, their employer must file an application with the Department of Health and Human Services (HHS) Exchange Visitor Waiver Review Board detailing (with supporting documentation) the importance of the research, how the physician will contribute to the research, the foreign physician's credentials, and the adverse impact upon the research project should the foreign physician leave the United States for two years.
IGA waivers can be sponsored by a state's Department of Health, or a specific federal government agency. State-level sponsorship is known as the Conrad 30 Program. Most states participate, however each state varies in its rules and procedures in issuing the 30 waiver maximums available to each state per year. In some states, the Conrad 30 Program is limited to primary care physicians. Other states allow physicians who specialize in their practice. A period of recruitment is required to demonstrate that there are no available U.S. physicians. A foreign physician must remain at their medical facility in H-1B status for three years in order to fulfill waiver eligibility.