• Employer - Not required
• Labor Certification - Not required

Qualified alien physicians who will be practicing medicine in a Health and Human Services Department (HHS) - designed underserved area or a Department of Veterans Affairs (VA) facility may be relieved from the labor certification process due to national interest waiver.

A petitioner can request a national interest waiver on behalf of a qualified alien physician or an alien physician can self-petition for this classification. Either way, an alien physician must meet all eligibility requirements for EB2 immigrant classification in order to be eligible for the national interest waiver.

Along with the documents for Form I-140, following documents must be submitted:

• Difference evidence is required based on whether the physician will be an employee or will establish his/her own practice.
  • Employee:
    • A full-time employment contract (issued and dated within six months prior to the date the petition is filed), or
      
      
    • an employment commitment letter from a VA facility.
      
      
  • Own practice: The physician's sworn statement committing to the full-time practice of clinical medicine for the required period, and describing the step the physician has taken or intends to actually take to establish the practice.
    
    
• Evidence that the physician will provide full-time clinical medical service:
  • In a geographical area or areas designated by the Secretary of HHS as having a shortage of health care professionals and in a medical specialty that is within the scope of the Secretary's designation for the geographical area or areas; or
    
    
  • In a facility under the jurisdiction of the Secretary of VA.
    
    
• A letter (issued and dated within six months prior to the date on which the petition is filed) from a Federal agency or the department of public health (or equivalent) of a State (including territories of the US and the District of Columbia) attesting that the alien physician's work is or will be in the public interest
  • Any attestation from a Federal agency must reflect the agency's knowledge of the alien's qualifications and the agency's background in making determinations on matters involving medical affairs so as to substantiate the finding that the alien's work is or will be in the public interest.
    
    
  • An attestation from the public health department of a State, United States territory, or the District of Columbia must reflect that the agency has jurisdiction over the place where the alien physician intends to practice clinical medicine. If the alien physician intends to practice clinical medicine in more than one underserved area, attestations from each intended area of practice must be included. Attestation from the public health department of a State, United States territory, or the District of Columbia that does not have jurisdiction over the place in which the alien physician intends to practice clinical medicine will not be accepted.
    
    
• Evidence that the alien physician meets the admissibility requirements established by section 212(a)(5)(B) of the Act.
  
  
• If applicable, evidence of the Service-issued waiver of the requirements of section 212(e) of the Act, if the alien physician has been a J-1 nonimmigrant receiving medical training within the US.
  
  

For physicians planning to divide the practice of full-time clinical medicine between more than one underserved area, the above evidence must be submitted for each area of intended practice.

• If the physician already has authorization to accept employment (other than as J-1 exchange alien), the beneficiary physician must complete an aggregate 5 years of qualifying full-time clinical practice during the 6 year period beginning the date of approval of the Form I-140.
  
  
• If the physician must obtain authorization to accept employment before the physician may lawfully begin working, the physician must complete the aggregate 5 years of qualifying full-time clinical practice during the 6 year period beginning on the date the Service issues the necessary employment authorization document.
  
  

J-1 visa waiver means that the J-1 visa holder may change his visa status or adjust the status to permanent resident without returning home to live for two years returning to the US.

J-1 visa waiver and National Interest Waiver are two different things. A J-1 visa waiver is an application to waive the two-year home country residency requirement. National interest waiver is a waiver of job offer and labor certification requirement for an immigrant petition.

Even if your NIW petition gets approved, you are still subject to the two-year requirement. You will need to obtain a J-1 visa waiver or satisfy the two year requirement before you may file for adjustment of status or go through consular processing.

J-1 visa waiver may be requested by an interested US government agency in the "public interest". "National interest" and "public interest" essentially mean the same thing.

Appalachian Regional Commission, the Department of Housing and Urban Development(HUD), the Department of Agriculture and the Department of Veterans Affairs sponsors waiver requests for physicians who will be engaged in clinical practice. The Department of Health and Human Services (HHS), the Department of Defense, and the Department of Education process requests for scholars and researchers.

The requesting agency must send the J-1 visa waiver request with

• Copy of the contract between J-1 alien physician and the healthcare provider for two to fours years depending upon the sponsoring agency.
  
  
• Proof of J-1 alien physician's satisfactory qualifications and strong recommendations.
  
  
• Evidence that the physician will practice in a "health professionals shortage area" or a "medically underserved area", as determined by the US Public Health Service of HHS.
  
  
• Evidence that the extensive attempts to recruit US citizen or permanent residents physician were unsuccessful for the position being sought by J-1 alien physician.