MD / DO Physician H-1B Visa Guide (2026)

J-1 waiver paths, cap-exempt hospital sponsorship, HPSA requirements, and prevailing wages for physicians seeking H-1B.

$240,000
Median Physician LCA
$200,000
Primary Care (Level II)
$350,000+
Surgical Specialist
~8,000/yr
Annual LCA Filings
SOC Codes29-1210 to 29-1299
J-1 Waiver ProgramConrad 30 / IGA / VA
Cap-Exempt AvailableYes (nonprofit hospitals, VA)
HPSA Required (Conrad 30)Yes \u2014 3-year service commitment

J-1 Waiver Paths for Physicians

Conrad 30 (State)
Practice 3 yrs in HPSA/MUA. 30 slots/state/yr. Most common path.
Timeline: 8–14 months
IGA (Federal Agency)
VA, NIH, DoD sponsor waiver. High approval rate.
Timeline: 10–18 months
VA Hospital Waiver
Dedicated IGA pathway for VA physicians. Fastest federal route.
Timeline: 6–12 months
No Objection Statement
Home government waives objection. Rarely approved for MDs.
Timeline: 12–24 months

Cap-Exempt H-1B for Physicians

Physicians at qualifying nonprofit hospitals, academic medical centers, and VA facilities can be sponsored outside the annual lottery cap. Year-round filing, no lottery risk. Academic medical centers affiliated with universities (UCSF, Hopkins, Mass General Brigham, NYU Langone) qualify. VA hospitals qualify as government agencies. The Conrad 30 commitment alone does not grant cap-exempt status \u2014 the employer must independently qualify.

Frequently Asked Questions

Can physicians get H-1B without J-1 first?

Yes. Physicians on F-1 OPT or already in valid nonimmigrant status can petition directly. However, most foreign medical graduates enter residency on J-1, making the J-1 waiver the dominant path. Direct H-1B avoids Conrad 30 geographic constraints but requires winning the lottery.

What is the Conrad 30 waiver?

Conrad 30 allows J-1 physicians to waive the two-year home residence requirement by committing to 3 years in a Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA). Each state receives 30 Conrad slots per federal fiscal year. File through the state health department.

What do physicians earn on H-1B?

DOL prevailing wages (SOC 29-1210 to 29-1299) range from $200,000 for primary care (Level II) to $350,000+ for surgical specialists (Level IV). Hospitalists in shortage areas earn $220,000–$280,000. Specialist physicians command $300,000–$500,000.

Which hospitals sponsor H-1B for physicians?

Top sponsors: Mayo Clinic, Cleveland Clinic, UCSF Health, Johns Hopkins Medicine, Mass General Brigham, NYU Langone, Mount Sinai. Community and Critical Access Hospitals in rural areas sponsor heavily via Conrad 30. VA hospitals sponsor via IGA waiver.

Is J-1 waiver faster than direct H-1B?

J-1 waiver is a prerequisite for physicians subject to 212(e) — not an alternative to H-1B. Without a waiver, you cannot change to H-1B. Physicians not subject to 212(e) can file H-1B directly and skip Conrad 30 geographic constraints.