J1 waiver in pathology

[scam'ron]

Hi all,

Has anyone been in the position of pathology residency on J1 visa and can comment on the likelihood of a J1 visa waiver in pathology once residency is completed?

I have researched this on 3net and it seems J1 waivers are primarily for psych/family med - pathology jobs aren't even listed when I run a search! Is it unrealistic to expect to gain a j1 waiver after residency in this field?

Thanks in advance!

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[CrazyEBV]

J1 waiver in Pathology is a JOKE!!!! I have been searching for the past 8 months and there was only 1 (yes ONE) job advertised as j1 waiver. And even for that job in some rural montana town of 3 miles diameter with a population of 10,000 there was a ton of applications from US citizens. So think about it.

 

[scam'ron]

Thanks for the advice! Without being successful obtaining j1 waiver job or a fellowship, is the only option to go to home country for 2 years or are there other possibilities?

 

[The Baron]

Hi everyone, sorry to resurrect an old post.

I'm in the final few months of residency and will begin the job search soon, but I'm just wondering why J1 waiver jobs seem so difficult to get? It looks as though most states still have plenty of J1 spots available even in March. (March 2021 - Conrad 30 - J-1 Waiver Updates - Physician Immigration — Irvine Legal),

Is it really that difficult, or is it just easier now that the HHS visa waiver program has been expanded for primary care physicians? (HHS Expands Clinical Waiver Program to “All Facilities” in HPSA 07 or Higher | Berardi Immigration Law)

 

[Iceman24]

I'm just wondering why J1 waiver jobs seem so difficult to get?

The cost of waiver is ~13-15K for employer. So why someone would even bother if the market is oversaturated and there are tons of candidates without any visa problems after all.

 

[TrojanRaggy]

Thanks for the advice! Without being successful obtaining j1 waiver job or a fellowship, is the only option to go to home country for 2 years or are there other possibilities?

Unless you come from a war-torn or dictatorial country, going back to home country is not as bad. Waiver job salaries are as low as 100-120K and you have to do it for 3 years and you won't be able to file an application for green card during those 3 years. On the other hand, you can go back to your country, work and get paid as "a US returned" pathologist for two years, and come back after two years. This way you can get that green card application in an year earlier (assuming you want to immigrate). You would be losing some money but not as much as you think. If you don't get a job from home country, you can also do a second fellowship on H1b after coming back from home country and become relevant again.

If you are from the middle-east, you can always go to Dubai/Qatar who pay very good for a US trained specialist.

 

[Iceman24]

Unless you come from a war-torn or dictatorial country, going back to home country is not as bad. Waiver job salaries are as low as 100-120K and you have to do it for 3 years and you won't be able to file an application for green card during those 3 years. On the other hand, you can go back to your country, work and get paid as "a US returned" pathologist for two years, and come back after two years. This way you can get that green card application in an year earlier (assuming you want to immigrate). You would be losing some money but not as much as you think. If you don't get a job from home country, you can also do a second fellowship on H1b after coming back from home country and become relevant again.

If you are from the middle-east, you can always go to Dubai/Qatar who pay very good for a US trained specialist.

Kind of agree with everything you said, but have a few comments.

1) I wonder where this info about "waiver job salaries" is coming from. Neither have seen these jobs advertised, nor salaries posted. My guestimate is these salaries are no different with regard to visa sponsorship or its absence, at least, this is the case in clinical medicine (so seeing no reason why path would be much different).

2) Not every country would appreciate US postgraduate education by increasing the compensation, plus the process of recognition your credentials may take months, if not years.

3) Gulf is still very small market, like Qatar+UAE population is PA state size; also not a good place to be if you are a woman, to say at least.

 

[SetecAstronomy]

Kind of agree with everything you said, but have a few comments.

1) I wonder where this info about "waiver job salaries" is coming from. Neither have seen these jobs advertised, nor salaries posted. My guestimate is these salaries are no different with regard to visa sponsorship or its absence, at least, this is the case in clinical medicine (so seeing no reason why path would be much different).

Just an N=1, but my friend's husband didn't/couldn't go back home because of the wife and kids. He was practicing in a fairly rough neighborhood for way, way lower compensation than everyone else, and pretty long hours (although I guess that's normal for OB/Gyn). I want to say maybe $140k/yr?

 

[KeratinPearls]

Just an N=1, but my friend's husband didn't/couldn't go back home because of the wife and kids. He was practicing in a fairly rough neighborhood for way, way lower compensation than everyone else, and pretty long hours (although I guess that's normal for OB/Gyn). I want to say maybe $140k/yr?

140k for a OBGyn. If the demand and supply is there, employers will take advantage of you if they can to make a quick buck!

 

[TrojanRaggy]

Kind of agree with everything you said, but have a few comments.

1) I wonder where this info about "waiver job salaries" is coming from. Neither have seen these jobs advertised, nor salaries posted. My guestimate is these salaries are no different with regard to visa sponsorship or its absence, at least, this is the case in clinical medicine (so seeing no reason why path would be much different).

2) Not every country would appreciate US postgraduate education by increasing the compensation, plus the process of recognition your credentials may take months, if not years.

3) Gulf is still very small market, like Qatar+UAE population is PA state size; also not a good place to be if you are a woman, to say at least.

1) I used to believe they should not be different from other usual jobs until I saw an official J1 waiver job posting at a VA hospital. There could be exceptions but the bottom-line is that you are puppet at the hands of the employer.

2) I would imagine that most developing countries would. However, my experience is limited to the Indian subcontinent and South-east Asia.

3) UAE and Qatar seem to be different from Saudi Arabia as far as civil liberties are concerned but I may be wrong. One advantage for Asian immigrants is proximity from their homes. A big disadvantage is that there is no pathway to citizenship...

 

[The Baron]

The cost of waiver is ~13-15K for employer. So why someone would even bother if the market is oversaturated and there are tons of candidates without any visa problems after all.

Thanks Iceman, can I ask where you got these figures from? This is ~5x higher than the J1 waiver cost (application & processing fee) listed by most states.

As for why a hospital would choose someone with a J1-visa, I guess for the same reason as they'd choose any candidate; because they're the best fit for the job. I understand that the visa waiver is a drawback, but I don't see why somebody couldn't compensate for it. Particularly strong candidate; trained at prestigious institution(s), strong research background with multiple 1st author pubs and good references from well-known pathologists.

 

[Iceman24]

Thanks Iceman, can I ask where you got these figures from? This is ~5x higher than the J1 waiver cost (application & processing fee) listed by most states.

As for why a hospital would choose someone with a J1-visa, I guess for the same reason as they'd choose any candidate; because they're the best fit for the job. I understand that the visa waiver is a drawback, but I don't see why somebody couldn't compensate for it. Particularly strong candidate; trained at prestigious institution(s), strong research background with multiple 1st author pubs and good references from well-known pathologists.

I got these figures from people who are in the process of obtaining waiver right now and were obtaining it year or two ago; these numbers are stated in the contract. Apart from application and processing fees there are also legal fees incurred during this process.

The hypothetical scenario you described is pertinent to academic center, likely to a big academic center. However, there are certain requirements established by the federal government, and according to them the physical address of the work place should be in the so-called "medically underserved area" and vast majority of academic hospitals do not meet this criterion. Plus, certain states (CA, for instance) do not allow any specialist (all pathologists will fall under this category, as opposite to primary care) apply for a waiver at all.

 

[The Baron]

I got these figures from people who are in the process of obtaining waiver right now and were obtaining it year or two ago; these numbers are stated in the contract. Apart from application and processing fees there are also legal fees incurred during this process.

The hypothetical scenario you described is pertinent to academic center, likely to a big academic center. However, there are certain requirements established by the federal government, and according to them the physical address of the work place should be in the so-called "medically underserved area" and vast majority of academic hospitals do not meet this criterion. Plus, certain states (CA, for instance) do not allow any specialist (all pathologists will fall under this category, as opposite to primary care) apply for a waiver at all.

Hi Iceman, thanks for getting back to me.

I have seen the application fee alone range from $200-$3,000 depending on the state. I have no doubt that the figures you mention reflect the cost of obtaining a J1 waiver in some states but, from my research, I don't think that they represent all or even most states.

Regarding medically underserved areas (MUA), the work-place does not physically have to be in an MUA to be eligible, but at least 10% of the practice's patient population has to live in MUAs. For instance, the department of public health in Washington DC told me that all of their major academic hospitals are eligible to obtain J1 visa waivers.

You are correct regarding California. North Carolina doesn't accept waiver applications from specialists either, but they are the only two states that seem totally inaccessible as far as I know. The following may be useful to individuals seeking a waiver. It is a list of states in which it is plausible for someone to obtain a J1 Waiver, assuming of course that they have someone to sponsor them:

1. Very Likely: These states do not prioritize primary care over specialist physicians and don't tend to fill their waiver spots each year:
   1. Alabama Colorado DC Delaware Kansas Massachusetts Nebraska Nevada New Jersey Oregon S Dakota Vermont Washington
2. Likely: These states give priority to primary care, but also consider specialists. They don't tend to fill their spots for ~3-6 months though, so they're promising options:
   1. Connecticut Illinois Iowa New Hampshire Penn
3. Possible: These states prioritize primary care and fill up within 3-months, but most years they will issue at least some waivers to specialists.
   1. Arizona Arkansas Florida Georgia Kentucky Maryland Missouri New Mexico Ohio Rhode Island South Carolina Texas Utah Virginia
4. Possible: These states also offer pathologist waivers through the Delta Doctor's program:
   1. Alabama Louisiana Mississippi Tennessee

 

[The Baron]

Unless you come from a war-torn or dictatorial country, going back to home country is not as bad. Waiver job salaries are as low as 100-120K and you have to do it for 3 years and you won't be able to file an application for green card during those 3 years. On the other hand, you can go back to your country, work and get paid as "a US returned" pathologist for two years, and come back after two years. This way you can get that green card application in an year earlier (assuming you want to immigrate). You would be losing some money but not as much as you think. If you don't get a job from home country, you can also do a second fellowship on H1b after coming back from home country and become relevant again.

If you are from the middle-east, you can always go to Dubai/Qatar who pay very good for a US trained specialist.

Hi Trojan,

I agree with you and I would go home if I could!

I'm from a tiny country, however, and attending pathologist positions very rarely open up (maybe 3/4 each year and replacements are typically hired from within). I should have given it more thought before coming over here for training, but.... here I am, so....

 

[Iceman24]

Hi Iceman, thanks for getting back to me.

I have seen the application fee alone range from $200-$3,000 depending on the state. I have no doubt that the figures you mention reflect the cost of obtaining a J1 waiver in some states but, from my research, I don't think that they represent all or even most states.

Regarding medically underserved areas (MUA), the work-place does not physically have to be in an MUA to be eligible, but at least 10% of the practice's patient population has to live in MUAs. For instance, the department of public health in Washington DC told me that all of their major academic hospitals are eligible to obtain J1 visa waivers.

You are correct regarding California. North Carolina doesn't accept waiver applications from specialists either, but they are the only two states that seem totally inaccessible as far as I know. The following may be useful to individuals seeking a waiver. It is a list of states in which it is plausible for someone to obtain a J1 Waiver, assuming of course that they have someone to sponsor them:

1. Very Likely: These states do not prioritize primary care over specialist physicians and don't tend to fill their waiver spots each year:
   1. Alabama Colorado DC Delaware Kansas Massachusetts Nebraska Nevada New Jersey Oregon S Dakota Vermont Washington
2. Likely: These states give priority to primary care, but also consider specialists. They don't tend to fill their spots for ~3-6 months though, so they're promising options:
   1. Connecticut Illinois Iowa New Hampshire Penn
3. Possible: These states prioritize primary care and fill up within 3-months, but most years they will issue at least some waivers to specialists.
   1. Arizona Arkansas Florida Georgia Kentucky Maryland Missouri New Mexico Ohio Rhode Island South Carolina Texas Utah Virginia
4. Possible: These states also offer pathologist waivers through the Delta Doctor's program:
   1. Alabama Louisiana Mississippi Tennessee

The amount of application fee(s) is just the small portion of the waiver cost, you keep forgetting about the legal fees. The state does not matter here (may be it matters so that in one place it will cost 12K and 13K in another) and I've never heard of anyone who was able to get waiver without the assistance of an attorney.
Think about it, you are talking about 10% of the "practice population", so how are you going to convince the state officials, as well as DoS and USCIS that your employer satisfying all these (and many more) requirements?

I don't know where your list of states is coming from, but even I am able to see a lot of inaccuracies there:
North Carolina allocated 11 slots for specialists in 2019;
Connecticut filled all spots in 2019, some years they receive more then 30 applications, so they use lottery;
Illinois filled all spots in 2019 form applications received in October;
Florida does not prioritize primary care and they use lottery system;
etc.

 

[The Baron]

Iceman, this doesn't seem to be a discussion worth having with you. I have responded to your most recent post below but will not be responding further.

Should anybody who is (or will be) seeking a J1-visa waiver be interested in finding out more information about the process, you should do your own homework. Much of the required information is available through google, and the remainder can be obtained through speaking with the individuals coordinating the Conrad 30 program in each state. If there's any way that I can help, by sharing my research and my experience with you, feel free to send me a PM.

The amount of application fee(s) is just the small portion of the waiver cost, you keep forgetting about the legal fees. The state does not matter here (may be it matters so that in one place it will cost 12K and 13K in another) and I've never heard of anyone who was able to get waiver without the assistance of an attorney.
Think about it, you are talking about 10% of the "practice population", so how are you going to convince the state officials, as well as DoS and USCIS that your employer satisfying all these (and many more) requirements?

I don't know where your list of states is coming from, but even I am able to see a lot of inaccuracies there:
North Carolina allocated 11 slots for specialists in 2019;
Connecticut filled all spots in 2019, some years they receive more then 30 applications, so they use lottery;
Illinois filled all spots in 2019 form applications received in October;
Florida does not prioritize primary care and they use lottery system;
etc.

1. The amount of application fee(s) is just the small portion of the waiver cost, you keep forgetting about the legal fees. The state does not matter here (may be it matters so that in one place it will cost 12K and 13K in another) and I've never heard of anyone who was able to get waiver without the assistance of an attorney.
   1. Legal fees charged by attorneys range from ~$2k to 5k, not 13k. I'm basing that number on numerous phone call and email correspondences with attorneys. You can also get a feel for the figures by a quick google search, where some of the early hits quote legal fees as ~3.5k (J-1 – Exchange Visitor, Austin Immigration Attorneys | Law Office of William Jang, PLLC).
2. Think about it, you are talking about 10% of the "practice population", so how are you going to convince the state officials, as well as DoS and USCIS that your employer satisfying all these (and many more) requirements?
   1. Each state typically has an individual responsible for coordinating the Conrad-30 program. They are usually in the dept. of public health/ primary care/ rural health etc. You can get their contact information by googling the state's Conrad 30 waiver program or by phoning the relevant DoS. Most of the individuals are extremely helpful and, if you ask them nicely, many will help you identify eligible hospitals in their state.
3. I don't know where your list of states is coming from, but even I am able to see a lot of inaccuracies there:
   1. I emailed the department responsible for visa waivers (dept. of public health/ primary care/ rural health etc.) in over 40 states and compiled an excel sheet from their responses.
      1. North Carolina allocated 11 slots for specialists in 2019;
         1. Iceman is correct regarding North Carolina, there was a mix-up between two cells in my excel sheet.
            1. It is Louisiana that only accepts primary care physicians and does not accept pathologists into its Conrad30 visa waiver program. It does, however, offer pathologists visa waivers through the Delta Doctors program.
      2. Connecticut filled all spots in 2019, some years they receive more then 30 applications, so they use lottery;
         Illinois filled all spots in 2019 form applications received in October;
         1. This doesn't make my last post inaccurate. The number of applications received by a given state, and whether or not it fills its visa waiver quota obviously changes year to year based on the job market and the make up of applicants and probably other factors too. The states "tend to fill" or "tend not fill" as stated above. This information is from the individuals responsible for coordinating the Conrad 30 program in each of these states.

 

[Iceman24]

Iceman, this doesn't seem to be a discussion worth having with you. I have responded to your most recent post below but will not be responding further.

Should anybody who is (or will be) seeking a J1-visa waiver be interested in finding out more information about the process, you should do your own homework. Much of the required information is available through google, and the remainder can be obtained through speaking with the individuals coordinating the Conrad 30 program in each state. If there's any way that I can help, by sharing my research and my experience with you, feel free to send me a PM.

1. The amount of application fee(s) is just the small portion of the waiver cost, you keep forgetting about the legal fees. The state does not matter here (may be it matters so that in one place it will cost 12K and 13K in another) and I've never heard of anyone who was able to get waiver without the assistance of an attorney.
   1. Legal fees charged by attorneys range from ~$2k to 5k, not 13k. I'm basing that number on numerous phone call and email correspondences with attorneys. You can also get a feel for the figures by a quick google search, where some of the early hits quote legal fees as ~3.5k (J-1 – Exchange Visitor, Austin Immigration Attorneys | Law Office of William Jang, PLLC).
2. Think about it, you are talking about 10% of the "practice population", so how are you going to convince the state officials, as well as DoS and USCIS that your employer satisfying all these (and many more) requirements?
   1. Each state typically has an individual responsible for coordinating the Conrad-30 program. They are usually in the dept. of public health/ primary care/ rural health etc. You can get their contact information by googling the state's Conrad 30 waiver program or by phoning the relevant DoS. Most of the individuals are extremely helpful and, if you ask them nicely, many will help you identify eligible hospitals in their state.
3. I don't know where your list of states is coming from, but even I am able to see a lot of inaccuracies there:
   1. I emailed the department responsible for visa waivers (dept. of public health/ primary care/ rural health etc.) in over 40 states and compiled an excel sheet from their responses.
      1. North Carolina allocated 11 slots for specialists in 2
      2. Connecticut filled all spots in 2019, some years they receive more then 30 applications, so they use lottery;
         Illinois filled all spots in 2019 form applications received in October;
         1. This doesn't make my last post inaccurate. The number of applications received by a given state, and whether or not it fills its visa waiver quota obviously changes year to year based on the job market and the make up of applicants and probably other factors too. The states "tend to fill" or "tend not fill" as stated above. This information is from the individuals responsible for coordinating the Conrad 30 program in each of these states.

1. Sorry, but I never said that "legal fees [are] ... 13K". Instead, I was saying that the total cost of application is around 13K and that includes legal and government fees. I attached the contract quote from one of the law offices to this message, and that confirms what I am saying. However, this is a free country, and if someone is able to do all the paperwork himself, find an attorney who would do it for free, or kindly ask state representative to do that and this way will save all these money, I would be very happy for this person.

2. It is not the matter of "being helpful", it is about preparation of application for waiver petition and state representative will not do it for you.

3. What is the point to email state clerks if all this info is available online? I attached the PDF.

Also, what kind of experience are you talking about? Did you get a waiver yourself? Are you an attorney?

 

[Smoothbrain]

Is it difficult to get a J-1 waiver if you are into Forensic Pathology? They seem very short of that here in the U.S. Any suggestions?

 

[Iceman24]

Is it difficult to get a J-1 waiver if you are into Forensic Pathology? They seem very short of that here in the U.S. Any suggestions?

Sorry, still extremely difficult.
You can try to get in touch with the Chicago office, they mentioned H1 visa in their job ad (still unclear H1 or J1 waiver though).
Also, there are rumors that Detroit (UoM) may provide the sponsorship.

 

[Iceman24]

Just the expedited processing fee alone for H1B visa for waiver costs 2,500$.
And this is the only one fee out of many...
I don't get it, why people talk with so much confidence about things they have no clue about?
Rhetorical question though.

 

[Smoothbrain]

Thank you for the Chicago suggestion, I will look it up.