Health and Human Services Clinical Care Waiver Request

Requesting a letter of support from the Minnesota Department of Health.

The U.S. Department of Health and Human Services (HHS) manages the U.S. Exchange Visitor Program as it relates to research and clinical care. The program accepts applications to request a waiver of the two-year foreign residency requirement related to health care services needed in a Health Professional Shortage Area (HPSA) in the U.S. Physicians with J-1 visas must agree to deliver health care services for three years in a mental health or primary care HPSA.

An application to HHS for a Clinical Care Waiver must be accompanied by a letter of support from the state health department in the state where the IMG will practice, confirming that the applicant fills a community need for services.

MDH accepts requests for letters of support for Clinical Care Waiver applications year-round.

For more information on this federal program, visit HHS Exchange Visitor Program. Note that this program is similar to, but distinct from the J-1 Visa Waiver Program.

Physician eligibility

MDH will provide a support letter for a physician who will practice in a primary care field (family medicine, general internal medicine, general pediatrics, obstetrics and gynecology) or general psychiatry, and who has completed their primary care or psychiatric residency training program no more than 12 months before the date of commencement of employment under the contract.

Facility eligibility

To focus on communities and populations with the greatest need for primary care and mental health services, HHS will only process an application for a Clinical Care Waiver from a facility in an area with a Health Professional Shortage Area (HPSA) score of 7 or higher.

For more information on HPSA Designations please refer to HRSA: What Is Shortage Designation?.

Required supplemental information

When requesting a letter of support from MDH, please submit the following:

1. Current curriculum vitae (CV). Do not include your Social Security number.
2. Credentials (diplomas, licenses / license application) showing completion of a residency in one of the following: family medicine, general internal medicine, general pediatrics, obstetrics and gynecology, or general psychiatry. Credentials must show that the physician is board certified or board eligible in a primary care discipline in the last 12 months.
3. Copy of the executed contract signed by the head of the medical facility and the physician, dated, and notarized. Contract must:
   • be of three years’ duration,
   • obligate the physician to begin work within the first three months of receiving the waiver approval,
   • obligate the physician to work 40 hours per week providing primary care (family practice, general internal medicine, general pediatrics, or obstetrics and gynecology) or general psychiatric services,
   • specify the site in which the physician will work (if more than one, all sites must be located in designated HPSAs with a score of 7 or higher, and HPSA identifier numbers must be provided), and
   • include a clause that the contract can only be terminated for cause until completion of the three-year commitment (note that the contract may not contain a non-compete clause or restrictive covenant).
4. Send your request for a letter of support to MN_Health.J1NHW@state.mn.us.

Other resources for internationally trained physicians

Please see below for other programs permitting internationally trained physicians to work in the U.S.

• Minnesota J-1 Visa Waiver Program
• Physician National Interest Waiver Petition