Physician National Interest Waiver in an underserved area

Under a Physician National Interest Waiver a qualifying foreign national physician must commit to working for five years in clinical practice in an underserved area or in a Veterans Affairs (VA) facility.

The Physician NIW is normally utilized by primary care physicians (such as general practitioners, family medicine doctors, general internists, pediatricians, obstetricians/gynecologists, and psychiatrists), but specialty physicians are also included.

The U.S. Department of Health and Human Services (HHS) keeps an updated list of underserved areas eligible for an alien practitioner under this subtype of NIW. These include:

Eligibility Criteria:

You must agree to work full-time in a clinical practice. For most physician NIW cases, the required period of service is 5 years.

You must work in a primary care (such as a general practitioner, family practice petitioner, general internist, pediatrician, obstetrician/gynecologist, or psychiatrist) or be a specialty physician.

You must serve either in a Health Professional Shortage Area (HPSA), Mental Health Professional Area (MHPSA – for psychiatrists only), a Medically Underserved Area (MUA), or a Veterans Affairs facility, or for specialists in a Physician Scarcity Area (PSA).

Attestation Letter:

The foreign national Physician must obtain the attestation letter from either a state department of health (if the physician will be working in a shortage area) or from the Department of Veterans Affairs demonstrating how the work is in the national interest.

A physician applying through the Department of Veterans Affairs should apply through the VA facility where he or she is or will be employed.

A physician who will be employed in a shortage area must contact the state department of health in the state where the practice site is located. Each state has its own procedures for applying for the letter.

Required Documentation:

1. A full-time employment contract (issued and dated within 6 months prior to the date the petition is filed) for the required period of clinical medical practice (5 or 3 years, depending on the date the application is filed), or an employment commitment letter from a Veterans Affairs (VA) facility.

2. If the physician will establish his or her own practice, the physician must submit a sworn statement committing to the full-time practice of clinical medicine for the required period, and describing the steps the physician has taken or intends to actually take to establish the practice.

3. Evidence that the physician will provide full-time clinical medical service:

a. In a geographical area or areas designated by the Secretary of HHS as having a shortage of health care professionals and in a medical specialty that is within the scope of the Secretary’s designation for the geographical area or areas; or

b. In a facility under the jurisdiction of the Secretary of VA.

4. Attestation letter (see above) (issued and dated within 6 months prior to the date on which the petition is filed) from the Department of Veterans Affairs or a state department of health attesting that the physician’s work is or will be in the public interest.

5. Evidence that the physician has passed a U.S. medical licensing examination and is competent in oral and written English.

6. If the physician was a J-1 nonimmigrant who received medical training in the United States , he or she must also provide a copy of the USCIS approval notice of the J-1 visa waiver.


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