U.S. Citizenship and Immigration Services issued temporary policy changes regarding the full-time work requirement for foreign medical graduates and the provision of telehealth services by those foreign medical graduates in light of the evolving COVID-19 pandemic.

Foreign medical graduates who are present in the United States as J-1 exchange visitors are subject to a two-year foreign residence requirement under the Immigration and Nationality Act. The law requires them to return to their home country for at least two years in the aggregate before being eligible to apply for an immigrant visa (permanent residence) or certain nonimmigrant visas (e.g., H-1B). 

The purpose of the requirement is to ensure that exchange visitors adhere to the nature of the exchange program and return home to share the knowledge gained in the U.S. with their home country. However, provisions are available for waivers of the two-year foreign residence requirement, including but not limited to foreign medical graduates who consent to work full-time for at least three years in a shortage area designated by the U.S. Department of Health and Human Services (HHS) with a recommendation from an IGA or state agency of public health or its equivalent, or with the Department of Veterans Affairs (VA).

Full-Time Work Requirement

The failure of a foreign medical graduate to work full-time (40 hours per week) with the health facility or health care organization named in their waiver application will generally result in the re-imposition of the two-year home residence requirement. 

USCIS announced that effective Jan. 27 through the end of the Public Health Emergency, USCIS officers will not consider a failure to work full-time to be a failure to fulfill the terms of the waiver contract, as a matter of policy. This policy is only applicable to foreign medical graduates' eligibility to apply for future immigration benefits that would be affected by the two-year residency requirement.