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National Interest Waiver Letters of Support Information Sheet

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National Interest Waiver Letters of Support

A National Interest Waiver (NIW) exempts a foreign physician from the labor certification process administered by the U.S. Department of Labor and is granted by the U.S. Citizenship and Immigration Services in the Department of Homeland Security. The Ohio Department of Health (ODH) may issue a letter of support for a physician who is pursuing the NIW in cases in which ODH determines that the physician has served or will serve the public interest in Ohio.     
The NIW requires an aggregate of five years of full-time clinical care in an underserved area. In Ohio, time spent in residency or fellowship training is not counted toward the five-year requirement and underserved areas are defined as health professional shortage areas (HPSAs). An exception to Ohio’s HPSA requirement may be made for physicians who are currently serving or who have satisfactorily completed their Ohio State 30 J-1 Visa Waiver Program service obligation in a medically underserved area/population (MUA/P). Letters of support for the NIW will include years of service in Ohio only.     
Letters of support will be considered upon review of information submitted as outlined on the checklist below. Please note that ODH may request additional information or documentation as part of its review.  

1.         Signed request letter to director of health:

  • List physician’s name, specialty, and practice site location(s) name(s) and address(es).
  • Describe how this request will/has address(ed) an unmet need in the practice site’s service area, specifically for the medical specialty of the physician.

2.         Signed copy of the employment agreement.

3.         Evidence of HPSA designation status (or MUA/P designation status for current or previous Ohio State 30 J-1 Visa Waiver Program participants only): Find shortage areas by address on the HRSA website.

4.         Evidence of physician’s active medical license.

5.         Current and previous participants of Ohio State 30 J-1 Visa Waiver Program:

  • Semiannual patient activity reports from start of J-1 visa waiver obligation period (if not already submitted). Report can be found on our Activity Report download page.
  • Verification of Employment Form and copy of requested approval notices (if not already submitted). Form can be found on our Employment Form download page.