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Vermont Department of Health - Rural Health and Primary Care and 2 more... less...

Health Care Quality

Healthcare Workforce Development

% of J-1 waiver applications reviewed within 21 days for foreign medical graduates

Current Value


Q4 2019


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Story Behind the Curve

In 2019 the state office of Rural Health reviewed and recommended seven J-1 applications, including six specialists and one primary care physician. 

While the annual volume of applications to process is totally dependent on vacancies, recruiting and hiring decisions of hospitals and clinics, we were able to process all eligible applications within 21 days.

We usually receive a total of 2-5 applications per year out of 30 potential slots for foreign born physicians practicing primary care, psychiatry or other medical specialties. This means that we have an average of 1 application per quarter, and a delay in submission causes a swing between 100%, 50% and 0%. It is not uncommon to receive no applications for 1-2 quarters each year.


VDH State Office of Rural Health & Primary Care

Vermont hospitals and specialty outpatient practices;

Vermont Primary care practices (FQHCs, RHCs & private practices);

Vermont Mental health agencies.

What Works

Recruiting and hiring foreign medical graduate (FMG) physicians can be an important option to fill open positions when US physicians cannot be hired. FMG physicians on J-1 visas can apply to states to waive their 2 year home country residence obligation in exchange for employment for at least 3 years at a facility serving under-served areas. States are allowed up to 30 waivers each year and have a great deal of latitude to design the program to their own priorities and needs. Vermont typically uses about 5 waivers per year.

Sharing contact information of inquiring J-1 psychiatrists with recruiters at all VT mental health agencies should increase direct contact between candidates and employers with openings.

Promoting the J-1 program, priorities and procedures to health facility recruiters with skilled immigration lawyers has increased knowledge of and confidence in the J-1 program.

Action Plan

Develop a follow-up procedure with placed physicians and employers to monitor satisfaction, and possibility of continuation beyond initial 3 year obligation to extend retention of physicians within under-served areas.

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