Generally, if you are in the US in J-1 immigration status, received financial support from your home country government or directly from a US government agency, are from a country or have a skill on the US Department of State's "skills list," or have completed any medical training in the US sponsored by ECFMG as an "alien physician," you must return to your home country for two years before you can change immigration status in the US from J-1 to H-1B, or become a permanent resident. This is known as the "two-year home residence requirement" or sometimes "212e."

The only way around this requirement is to request a waiver, which must be approved by both the US Department of State and US Citizenship and Immigration Services (USCIS) before an employer can file an H-1B work authorization petition on your behalf.

Interested Government Agency Waiver for J-1 Physicians Sponsored by ECFMG

If you are currently completing your medical training in the US in J-1 status sponsored by ECFMG, you are automatically subject to the 212e requirement. UAB/HSF will work with you to obtain an "interested government agency" (IGA) waiver of the two-year home residence requirement. We sponsor waivers through the Conrad/State 30 program (generally 4-6 available per year), the Appalachian Regional Commission (ARC, unlimited and year-round), and the Southeast Crescent Regional Commission (unlimited and year-round, but for placement at physical work locations in Montgomery County ONLY). If you will be practicing in the field of primary care/family medicine, UAB/HSF can also sponsor waivers through the US Department of Health and Human Services (HHS).

All waiver applications are assembled, prepared, and filed by outside counsel — not the IFSIS office. IFSIS will work with your hiring department and outside counsel to identify the best waiver option for you according to timing and institutional need. Once a waiver program has been identified and you have signed an offer letter, you will work directly with outside counsel on the waiver process. IFSIS will work with you in parallel to collect documents needed for the H-1B process specifically and will file the UAB/HSF H-1B petitions for work authorization on your behalf after the waiver is approved. We will provide a flowchart to help set expectations for the J-1 waiver process and invite you to a webinar on Zoom for questions specifically about the process. Physicians who are sponsored for a waiver will receive an email calendar invitation to the webinar in early March.

IGA waivers require physicians to commit to working in an underserved area or with an underserved medical population for a minimum of three years before applying to become a permanent resident. You cannot apply for more than one IGA waiver at the same time. Due to uncertain processing times with the various federal agencies, IFSIS strongly recommends that you extend your DS-2019 for boards by filing a request with ECFMG on their website to allow the waiver process the maximum time to conclude. Please consult your current institution's ECFMG Training Program Liaison (TPL) or ECFMG directly with questions about the DS-2019 extension process. IFSIS cannot assist.

If it appears that your waiver will not be approved in time to preserve the anticipated start date for your employment with UAB/HSF, and in consultation with your department about timelines, IFSIS can evaluate your CV for potential O-1 work authorization. O-1 sponsorship will be evaluated on a case-by-case basis and is not guaranteed. Read more about the O-1 process here: https://www.uab.edu/global/faculty-staff/international-faculty-staff/o-1-work-authorization

Clinical Faculty Completing Third Year of J-1 Waiver Service Who Are Eligible for Permanent Residence

IFSIS strives to outline a permanent residence strategy for each clinical faculty member to be completed by the end of the third year of J-1 waiver service. This could be in the EB-2 PERM category (for those without a tenure-track appointment with UAB) or the EB-1B category (for those with a tenure-track appointment at UAB). IFSIS is acutely aware of the green card backlog in the EB-2 category for individuals born in China and India and welcomes questions about this policy. If your priority date will be current, a couple of months before completing your third year of J-1 waiver employment in H-1B status, begin planning to file your Form I-485 (personal application for permanent residence). You are not eligible to file a Form I-485 to apply for permanent residence unless you have BOTH an approved Form I-140 AND a current priority date in the Department of State's monthly visa bulletin. See the Permanent Residence section of our website at https://www.uab.edu/global/faculty-staff/international-faculty-staff/permanent-residence for more information.

There are three important next steps to prepare for the permanent residence process:

  1. Review, obtain signatures, and be ready to email a waiver completion form to the federal agency that sponsored your J-1 waiver.

For waivers sponsored by the Delta Regional Authority (DRA), you will need to provide TWO forms downloadable from the DRA website here:

Completion Request Form: https://dra.gov/images/uploads/content_files/12._Completion_Request_Form_2.pdf (requires BOTH your signature and your supervisor’s signature)

Physician Compliance Closing Survey: https://dra.gov/images/uploads/content_files/11a._Physician_Compliance_Closing_Survey.pdf (requires only YOUR signature)

If your J-1 waiver was sponsored by the Conrad State 30 program managed by the Alabama Office of Primary Care and Rural Health (formerly managed by the Alabama Department of Public Health), you will need to provide a waiver service completion form from the Conrad 30 website here: https://www.alabamapublichealth.gov/ruralhealth/assets/state-30-phys-status-rpt-07-10-2014-.2-fillable-form-.pdf

Please ask your department administrator the exact date of your three-year service (i.e., three years from the date you began working specifically for the waiver-sponsoring employer, which could be either UAB or HSF depending on your specific waiver situation).

Please consult outside counsel for all questions concerning waiver completion documents that must be submitted. Outside counsel must review all waiver service forms before you email them to the agency. Outside counsel handles all aspects of the waiver process. Please email outside counsel directly with questions about waiver forms. IFSIS cannot assist.. 

        2. Review the I-485 Checklist carefully and assemble documents necessary for your personal green card application.

Email This email address is being protected from spambots. You need JavaScript enabled to view it. for a checklist a couple of months before completing your third year of J-1 waiver employment in H-1B status.

        3. Request a Form I-485 Supplement J from This email address is being protected from spambots. You need JavaScript enabled to view it. AFTER reading the I-485 Checklist carefully.

Please email This email address is being protected from spambots. You need JavaScript enabled to view it. when you are ready for the Form I-485 Supplement J described on the checklist. We will provide this document AFTER the day you complete your full three years of J-1 waiver service—not before—and will email you when it’s ready (usually within 24 hours). You can pick it up at our office without an appointment any time between 8:15 AM and 5:00 PM Monday-Friday (except federal/university holidays).

Waiver for J-1 Research Scholars or Others Funded by Their Home Government

If you are currently in J-1 Research Scholar, Short-Term Scholar, Professor, Specialist, or other relevant J-1 category, you will need to consult the initial Form DS-2019 stamped by a US Consular Officer at your J-1 visa interview and the physical J-1 visa stamp placed into your passport to see if either or both of them are marked "subject to 212," "two-year home residency applies," or "Section 212e applies." If so, or if there is conflicting information between the DS-2019 and the visa, you have two options:

  1. write to the Department of State and request an advisory opinion asking them to clarify whether you are, in fact, subject to the two-year home residence requirement, or
  2. assume that USCIS will rely on the document indicating that you are subject to 212e, cut your losses, and begin the process of applying for a "no objection" waiver of this requirement.

The no-objection waiver process requires you to obtain a letter from your home country government, submit it to the US Department of State, and wait for USCIS approval of the waiver. More information can be found on the Department of State website. IFSIS cannot assist with no-objection waiver applications, since they do not require express employer sponsorship and are a matter between you, your home country, and the US Department of State.

J-1 Immigration Advisors with the UAB Office of International Student and Scholar Services (This email address is being protected from spambots. You need JavaScript enabled to view it.) may be able to answer common questions about the advisory opinion and no-objection waiver processes.

Other Types of Waivers

Some individuals will qualify for a waiver of the 212e requirement based on hardship to a US citizen or permanent resident spouse or child (a "hardship" waiver) or a credible fear of persecution if you had to return to your home country (a "persecution" waiver). IFSIS cannot assist with hardship and persecution waiver applications, since they do not require express employer sponsorship and are purely personal matters between you, your family, your home country, and the US Department of State. IFSIS strongly recommends that you consult your own immigration attorney to strategize about your chances of success in either of these two waiver categories.