The most consequential aspect of entering the United States on a J-1 visa for graduate medical training is the two-year J-1 residency requirement. The purpose of the J-1 visa is for participants to return to their home countries with specific skills and a better understanding of the U.S.‌ This article will answer key questions about the J-1 residency requirement and is a shortened excerpt of Chapter 5 of The Physician Immigration Handbook.

Introduction to the J-1 Home Residence Requirement

Show Them The Money

The J-1 home-residency requirement for physicians is found in §212(e) of the Immigration and Nationality Act (INA). Under the J-1 residency requirement:

  • Doctors coming to the U.S. on J-1 visas to pursue graduate medical education or training are subject to the requirement;
  • Anyone subject to the requirement must reside and be physically present in their home country for a total of two years;
  • If a physician is subject to the home residence requirement, he or she is barred from getting an H or L visa at a U.S. consular post, is barred from changing nonimmigrant status in the U.S. or becoming a permanent resident;
  • The requirement may be waived if the U.S. government determines a waiver would be in the public interest; and
  • Physicians may seek waivers based on the request of a U.S. government agency or state health agency, or based on an exceptional hardship or persecution.

Despite the restrictions of the J-1 residency requirement, subject physicians are not barred from starting the green card process or from seeking visas other than Hs and Ls at U.S. consulates abroad, such as an O-1, if they are eligible for the alternate status.

Are J-2 family members subject to INA §212(e)?

Though §212(e) does not specifically mention family members, the U.S. government takes the position that J-2 spouses and children are subject to the home residence requirement. If the J-1 doctor obtains a waiver of the requirement, then the spouse or child also are no longer subject to §212(e). That said, if the J-1 physician returns home for two years but the J-2 dependent does not, the J-2 is still considered subject to §212(e) and must independently satisfy the home residence requirement.

Where must the home residence requirement be satisfied?

INA §212(e) mandates that the J-1 physician return to the country of citizenship or last permanent residence. Merely leaving the United States is not enough.

When must the return requirement be satisfied?

Trips back to the home country only begin to count toward the J-1 physician's home-residency requirement after the exchange visitor has ended his or her participation in the J-1 program. The two years do not have to be uninterrupted. The exchange visitor can aggregate two years of residence in the home country over any time period. Note, however, that the burden is on the exchange visitor to document that the requirement has been satisfied by showing that they resided in the home country, as required.

How do you prove the return requirement has been satisfied?

The U.S. government has no specific rules on how to prove compliance with the J-1 home residence requirement. Some types of documents that may be presented include:

  • Paystubs and payroll records;
  • Tax records;
  • Banking and ATM receipts;
  • Utility bills;
  • Rent or mortgage bills;
  • Receipts for purchases;
  • Social media records with tags documenting the location of the person making the post;
  • Airline and other transportation records; and
  • Affidavits.


Siskind Susser PC

Siskind Susser PC is one of the largest immigration law firms in North America and our attorneys have experience handling all aspects of American and Canadian immigration and nationality law.

We constantly monitor developments in immigration law and use state-of-the-art technology for research, client communications and case management. We have offices in each of the following cities: Memphis & Nashville.