My five cents on stages #1 and #2 of the process
Ok, here are my five cents on the first two steps in the process: Maybe the moderator can make this a 'sticky' so that it can grow to something useful.
As for the nittty-gritty of what to file, when and where, there is a series of pretty good articles on the website of Siskind&Susser
http://www.visalaw.com/abcs.html
Look in the 'non immigrant visa' section under 'J-1 Flowchart Part VIII: J-1 IGA physician waivers'
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IMHO, the first two steps are:
#1 Make sure that the Conrad30 program stays with us
And here is how you can help with that:
- Go to a friend who is a US citizen or permanent resident
- have them take out their checkbook
- write on a check:
1st line: Friends of Kent Conrad $100
2nd line: one hundred
3rd line: Campaign 2006 *their signature*
- write a note with their name, employer, address and nationality or immigration status
- put both in an envelope with a 37c stamp
- mail to:
Friends of Kent Conrad
Attn: Pat Ness, Treasurer
P.O. Box 812
Bismarck, ND 58502
- Send your friends to dinner to a good restaurant and pick up their check. Of course, there can be NO causal connection between dinner and check ;-) because this would violate the federal election commission rules...
The continuation of the Conrad30 progam depdends on one thing: Sen Kent Conrad to stay in the Senate. He is a democratic senator from a state that voted with 60+% for George Bush in the last election. Now, he is sort of a conservative on many issues and therefore less likely to be targeted by the Karl Roves right wing associates, but still, he is potentially vulnerable. He is up for reelection in 2006.
(As you all might have realized by now, elections in the US are not decided on the base of issues, but rather on the base of $$$$. In South Dakota, s^)$loads of money from the national republican party (GOP) managed to unseat Tom Daschle, the local democratic senator in the 2004 election. So, lets make sure that this doesn't happen 200miles further north, in ND. )
In the past, some of our specialty colleges have contributed to his campaigns($1000 each).
Individual contributions are key, look at the Dean campaign. He was swimming in cash until he killed his campaign in Iowa..
I am thinking about 'inspiring' some citizen friends to register a 'political action committee' with the Secretary of States office in Bismark and the FEC for this purpose. It allows to collect and funnel contributions with a particular agenda in hand. And money opens doors in US politics.
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#2 Find a 'Waiver' Job
Disclaimer:
These are some of the things I have assembled on this. Part of it is out of my own quest, part of it is stuff I gleaned from talking to: other residents, my attorney, friends, colleagues....
I posted this in another thread before, so bear with me. I will try to add links and websites over time to make it a bit more authoritative.
Ok, step #2 has a couple of substeps which you will have to repeat multiple times
2.1. find some leads towards potential job opportunities
2.2 check whether they might qualify for a waiver based on location (HPSA/MUA)
2.3 check which programs might apply for this location (state/ARC/DRA)
A couple of warnings right at the beginning:
-- Be very careful that you don't get taken advantage of. There are a couple of unscrupulous agencies charging residents 25k for getting a waiver job. Anytime, somebody makes you put down money before they can look for a job for you it is a fraud (I am not talking about legit lawyers fees once you have a job offer, I am talking about agencies 'guaranteeing' a waiver job if you pay them a 5k deposit.)
-- BE VERY AFRAID OF YOUR OWN COUNTRYMEN WHO OWN SMALL PRACTICES. THE FRIENDLY COLLEAGUE FROM YOUR HOME COUNTRY WHO OFFERS TO 'HELP YOU OUT' MIGHT TURN OUT TO BE A RUTHLESS SLAVEDRIVER. MANY J1 DOCS ARE BEEING TAKEN ADVANTAGE OF IN SMALL PRACTICES, THEY ARE FORCED TO TAKE ALL THE CALL FOR THE OWNER, ARE NOT PAID THEIR OFFICIAL SALARY ETC.
2.1 let's get started. Finding 'leads'
-- Look for job postings on the websites of large multispecialty practices in the midwest. They frequently have clinics in rural areas they need to staff, many rural locations are also MUA/HPSA.
-- Look for 'community health centers' or 'CHC look-alikes'. Most of them are in underserved locations or qualify for waiver physicians even if they are not in a HPSA.
-- Check out
www.3rnet.org Many of the job postings are hopelessly out of date, but it can give you contacts to CHC's and rural practices that have looked for docs in the past.
-- DON'T look in JAMA or NEJM. Practices who post jobs there are innundated with CV's from J1 docs and run them through the shredder the moment they get the impression that you need a waiver.
-- Commercial recruiters are usually a dead end. They are in for the quick money, hassles such as a J1 waiver don't fit into their plan. The moment they find out that you need a waiver, they will shun you like you have leprosy. The few recruiters specializing (-->preying) on J1 docs, are for the greater part crooks.
-- Try to look for clinics/hospitals with 'in house' employed recruiters. They actually have a long-term perspective and far more accessible for you purposes.
2.2 Checking the location for HPSA/MUA status
Once you have located a potential job go through the following steps:
-- try to find the EXACT location of the practice. Not the address of the recruiter, not the address of the hospital, no the EXACT geographic location of the office in which you would be working.
-- then go to the website of the US census website
www.census.gov
click on the 'census2000' logo
smack in the middle, click on 'enter a street address to find census2000 data'
enter the street address with town and state
click on the 'go' button
It will spit out a table/list out of which you can extract the following geographic information:
the 'county subdivision' or 'MCD' (minor civil division),
county
'census tract' (most important)
-- now, go to the website of the 'bureau for primary health care ' of the department of health and human services.
http://bphc.hrsa.gov/
go to their 'databases' section
go to the 'HPSA database'
enter the state and county and put the filters on 'designated'
run a query
check whether the geography (county, MCD, census tract) for the job you are looking at is considered a HPSA
If yes: BINGO, you found a potential waiver job.
If no:
go back to the databases screen
now go to the 'MUA/MUP' database
enter state and county
check the geography
If yes: BINGO
If no: move on
2.3 What program does apply
State Conrad30 programs (your best bet)
Check on the website of the department of health for that state what their policy for waiver jobs is. Some are pretty lenient, others are outright bizarre. As a rule of thumb:
- Stay away from FL, NY, CA, IL, TX (the equation 30/population=X is the worst there)
- the south and the coasts seem to be more difficult than the midwest and plains.
- Look at places like ME, ND, SD, RI, NE.
Appalachian Regional commission
www.arc.gov
for parts of the states that have the Appalachian mountains runnign through them.
(only primary care, very restrictive)
Delta Regional Authority
www.dra.gov
for parts of the states that the Missisipi river runs through.
The DRA program was drafted with the input of attorney Siskind. As a result it is a bit less restrictive than the ARC for example. On Siskinds website there is a little article with an outline on the program.
http://www.visalaw.com/04may4/2may404.html
After you have run through 2.1-2.3 successfully you are approximately already 1% of the way there

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The tricky part is to convince a practice that wasn't looking for a waiver job to go through the hassles of sponsoring you. But once you explain to them that by sponsoring you they are assured that you will stay for 3-5 years, they usually warm up.
to be continued..