J-1 Visa Waiver Program

The Washington J-1 Physician Visa Waiver program increases the number of physicians available to work in rural and underserved areas of the state. The program is a secondary recruitment tool, used when efforts to recruit a U.S. trained physician have been unsuccessful for an extended period.

Washington state sponsors up to 30 waivers per federal fiscal year (October 1 through September 30). Primary care J-1 physicians are encouraged to use the s hiring primary care J-1 physicians are encouraged to use the U.S. Department of Health and Human Services J-1 Visa Waiver Program for Clinical Care.

J-1 Physician Visa Waiver program background and overview information fact sheet

2025-2026 J-1 Visa Waiver Program Application Cycle

Updates

All waiver slots have been filled for the 2026 Application Cycle. We are not accepting anymore applications.

2026 Application Cycle Dashboard

Waiver Slots Available

Number of Applications Received

0 Open for applications now

30

Last updated on March 13, 2026.

 

Application Review Periods

The department will only be receiving applications during the following review periods.

First Application Review Period (October 1 – October 15)

  • We only accept complete applications. Incomplete applications will be returned and will not be considered for this review period. 
  • Applications are scored according to a scoring rubric: J-1 Waiver Scoring Criteria (PDF). Waivers are distributed based on ranking.
  • Applicants can submit 2 waivers per practice location, and 3 waivers total.

Second Application Review Period (November 15 – September 1)

  • This review period will only open if there are available waiver slots. The Application Cycle Dashboard will be updated to show the number of waiver slots available.
  • Applications will be reviewed in the order they are received and will not be scored.
  • Limits to the number of waivers per applicant are lifted. 
  • Flex (or non-HPSA) waiver applications are accepted beginning January 1 if waiver slots are available.
     

Application Requirements

Please review the J-1 Visa Waiver Application Checklist for a list of required documentation. Refer to the Washington State J-1 Visa Waiver Manual for a detailed breakdown of the application process and documentation.

As a reminder: 

Applications and Forms

Please use the forms below for waiver applications.

Applications

Resources

Eligibility Requirements

Full requirements for the applicant employer and physician can be found in the Washington Administrative Code 246-562: Rules governing J-1 physician waiver process. A summary is below.
 

Employer Eligibility Requirements

Employers can be for-profit, non-profit, or government organizations. Employees must meet the following to be eligible:

  • Operational Status: The health care facility where the job will be must have been operating legally in Washington for at least 12 consecutive months before applying.
  • Serving Underserved Patients: At least 15% of patients at the job site over the past 12 months must have been uninsured, enrolled in Medicaid, or people with low incomes. This must remain true throughout the whole time the physician is on the J-1 Visa Waiver.
  • Sliding Fees: You must offer a sliding fee discount schedule based on family income and size for all patients, whether or not they have insurance. This policy must:
    • Be written in English and all languages spoken by more than 10% of the population in the service area.
    • Be posted publicly in patient waiting areas and on your facility’s website.
    • Be distributed to all patients upon request or intake. 
  • Recruitment Efforts: You must be able to show evidence that you tried to fill the position for at least 6 months before the physician on the J-1 Visa Waiver signs an employment contract.
  • Employment Contract: You must have a written employment contract that meets state and federal requirements, as described here.
  • Compensation: You must pay the physician at least the prevailing wage for their specialty and county. You can find prevailing wages on the U.S. Department of Labor website.

J-1 Physician Eligibility Requirements

Physicians must meet the following to be eligible: 

  • Exclusive Application: The physician must not have an open J-1 waiver application anywhere else.
  • Residency/Fellowship Status: The physician must have either completed a residency or fellowship, or be in the final year of their program.
  • License Requirements: The physician must have an active or pending medical license in Washington under RCW 18.71 (MDs) or RCW 18.57 (DOs). The physician also must not have any pending enforcement actions or disciplinary restrictions.
  • Board Certification: The physician must be an active candidate for board certification by the start date of the job.
  • Primary Care vs. Specialty Care: Physicians with additional specialization (except for geriatrics, obstetrics, and psychiatry) are not eligible for primary care waivers. They must apply as a specialist, even if they will only be providing primary care.

Requests for Letters of Attestation

Employers or physicians may request a letter of attestation from DOH to support a Physician National Interest Waiver (PNIW) petition or a U.S. Department of Health and Human Services (HHS) Waiver.

You can request letters of attestation from DOH by emailing J-1 Visa staff members.

  • Requests must include a letter from the employer and an employment contract. Review the Washington State J-1 Visa Waiver Manual for additional criteria.
  • At the time of the request, the physician must have an active Washington medical license with no restrictions or enforcement actions. Exceptions may be made if their license is still being processed.
  • Practice locations included in the request must be in a HPSA designation (or mental health HPSA if the physician is a psychiatrist).

For additional information, email the J-1 Visa Waiver Program Manager.