Chapter 21 Immigration and the Locum Tenens

• Jurisdiction: United States

Most physicians and physician employers assume that locum tenens positions are not appropriate for International Medical Graduates (IMGs) because of immigration requirements. But there are times where IMGs can, in fact, work in locum opportunities, especially given recent changes in immigration policy.

IMGs seem ideally suited for locum opportunities. First, they typically do not have strong family ties anywhere in the United States and have more flexibility in choosing a work location. Second, because they have been willing to move abroad and have been able to succeed requires the traits of adaptability and adventurousness that locum physicians must possess.

Finally, IMGs may be open-minded about potentially less attractive work situations as they “pay their dues” on the way to permanent status in the United Status. Locum positions in hard-to-fill communities may be the route to take for a physician seeking a way to remain in the United States permanently.

This chapter is intended to briefly explain immigration rules for physicians and how locum tenens companies can navigate the immigration system and sponsor international physicians.

Can physicians satisfy their J-1 waiver requirements in a locum tenens position?

For most physicians, the only way to obtain a J-1 waiver is via sponsorship by an interested government agency. This would include sponsorship by a state health department under the Conrad 30 program or sponsorship by a federal agency, such as the Department of Health and Human Services, the Appalachian Regional Commission, the Department of Veterans Affairs, and the Delta Regional Authority.

With the exception of the Department of Veterans Affairs, all of the waiver programs generally require that a physician work in a geographic area recognized by the U.S. Department of Health and Human Services (HHS) as being “medically underserved.” In other words, the facility in which the physician works must be located within one of these HHS-designated areas. State waiver programs are permitted to sponsor up to 10 doctors per year to work outside of shortage areas if those locations still serve patients coming from shortage areas.

See Chapters 6 and 7 to learn more about Conrad 30 and sponsorship by interested government agencies.

Physicians also are required to work 40 hours per week in a shortage area and sponsors must demonstrate that a facility or employer has been unsuccessful in its recruitment of a qualified American physician. Finally, federal...