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North Dakota’s participation in the Conrad 30 Waiver Program is completely discretionary, voluntary, and may be modified or terminated at any time. In all instances, the NDPCO reserves the right to support or deny support for any request for a waiver.

Preference for J-1 visa waivers will be given to physicians in primary care (i.e., Family Practice, Pediatrics, Obstetrics & Gynecology, Internal Medicine, & Psychiatry) and specialists (i.e., Hospitalists, Geriatrics, General Radiology and General Surgery) who are willing to work full time (40 hours per week) for at least three years in a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or a Medically Underserved Population (MUP).

Non-Designated/Flex Waivers

The Conrad 30 Waiver Program policy objectives are to increase access to physicians by the medically underserved. Flexibility provisions require a qualifying physician to serve substantial numbers or percentages of the medically underserved population. These waivers are generally referred to as “flex 10” or “flex waivers”. North Dakota approves up to 10 flex waivers per fiscal year (October 1 to September 30). North Dakota flex waiver applications will only be accepted for specialist J-1 Physicians in non-designated areas. If by April 1 of each year, any of the 10 flex waivers are unused, applications will then be accepted from non-designated areas for any specialty, including primary care. In all flex waiver applications, facilities must provide a written statement of how the J-1 Physician will serve patients from HPSAs, MUAs, or MUPs. This statement can be included in the facility letter.

Special Consideration for Non-Designated Waivers

Facilities located in a non-designated area who wish to submit a waiver application for a J-1 Physician who is not a specialist may do so after April 1st if any of the 10 flex waivers remain. If extenuating circumstances require a special consideration, please contact the NDPCO J-1 representative, Stacy Kusler, at Special consideration may or may not be given depending on individual cases. Increasing access to quality health care services for those residing in HPSAs, MUAs, or MUPs will be considered first and foremost.

Waiver Request Eligibility and Guidelines

To be eligible for a J-1 visa waiver, a physician must:

  • Agree to be employed full time in H-1B nonimmigrant status at a healthcare facility located in an area designated by the U.S. Department of Health and Human Services (DHHS) as a HPSA, MUA, or MUP;
  • Have a signed employment contract for full time employment (40 hours/week), for a term of three years;
  • Agree to begin employment at the approved site within 90 days of receiving the J-1 visa waiver approval from U.S. Citizenship and Immigration Service (USCIS);
  • Provide documentation of completion and passing of the United States Medical Licensing Examination (USMLE) Steps 1, 2, and 3; and Educational Commission for Foreign Medical Graduates (ECFMG) Certifications;
  • Have a North Dakota medical license, or documentation that a North Dakota license application is in process; and
  • Include a “No Objection” letter from the home country, or a statement that the physician is not contractually obligated to return to the home country.

To be eligible, an employer/service site(s) must:

  • Be located in an area federally designated as a HPSA, MUA, or MUP. If you are applying for a flex waiver, describe how the J-1 Physician will serve patients from HPSAs, MUAs and/or MUPs.
  • Include a bona fide offer of employment in the form of a completed employment contract for a period of at least three years that is signed by the J-1 Physician and by the authorizing representative of the facility.
    • Include stipulations that the physician will be employed at least 40 hours per week.
    • Provide added detailed information if more than one service site is to be utilized by the physician to perform his/her required 40 hours per week.
  • Agree to provide NDPCO with the Arrival to Practice Report within 30 days of the start of employment at the service site(s).
  • Comply with federal and state program policies and guidelines. Failure, on the part of the sponsoring employer or the J-1 Physician - who has been granted a waiver, to comply with the rules and regulations of this program will result in a report of noncompliance to the USCIS and may, among other things, make the site ineligible for future placements for a period of time to be determined by the NDPCO.
  • Not change, by contractual amendment or otherwise, the essential terms of the employment contract presented to NDPCO, unless authorized by NDPCO.