Immigration Bill Lowers Hurdles for Foreign-Born Docs

John Commins, for HealthLeaders Media , June 10, 2013
  • Physicians who received J waivers would no longer be required to work in H-1B status, but could work in any immigration status for which employment is authorized. To prevent foreign-born physicians from being exploited, J waivers would not be granted unless the physician's employment contract contained the following clauses:

1. The amount of "on-call hours" per week and the compensation for such;
2. The amount of malpractice insurance provided to the physician and whether the employer will pay for this;
3. All work locations, and a statement that the employer will not add work locations without the approval of the  state or federal agency requesting the waiver;
4. The contract may not contain a "non-compete" clause.

  • If a physician's J waiver were denied under the Conrad program because the state had used up all of its slots for the year, the physician could obtain a six-month work permit if he or she agreed to seek a J waiver from a state which has not used all of its J waivers. After that, the physician could extend his or her work permit from the time that the employer in the new state filed a Conrad waiver until the DHS either granted a change of status or denied the waiver application.

The proposed law also provides that when the U.S. Citizenship and Immigration Service determines that "extenuating circumstances" exist, the physician could change employers during the three-year required period of employment in an underserved area.

"This is important because some employers have taken unfair advantage of physicians who they have sponsored for J waivers," Shusterman says. "For example, some employers have failed to pay a physician at the prevailing wage or have insisted that a physician work outside of the designated medically-underserved area for 40 hours per week. If the physician does not claim 'extenuating circumstances,' he or she needs not only to complete the 3-year period in a medically underserved area, but also an extra year for each termination."

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