The effect of the physician J-1 visa waiver on rural Wisconsin.
BACKGROUND
One strategy to increase the number of physicians in rural and other underserved areas grants a waiver to foreign physicians in this country on a J-1 education visa allowing them to stay in the United States if they practice in designated underserved areas.


OBJECTIVE
The goal of this study is to evaluate the retention and acceptance of the J-1 Visa Waiver physicians in rural Wisconsin.


METHODS
Sites in Wisconsin at which physicians with a J-1 Visa Waiver practiced between 1996 and 2002 were identified. A 12-item survey that assessed the acceptance and retention of these physicians was sent to leaders of institutions that had participated in this program. Retention of J-1 Visa Waiver physicians was compared to other physicians recruited to rural Wisconsin practices by the Wisconsin Office of Rural Health during the same time period.


RESULTS
While there was a general perception that the communities were well satisfied with the care provided and the physicians worked well with the medical community, there was a lower satisfaction with physician integration into the community-at-large. This was found to correlate with the poor retention rate of physicians with a J-1 Visa Waiver. Physicians participating in a placement program without J-1 Visa Waivers entering practice in rural communities had a significantly higher retention rate.


CONCLUSIONS
Physicians with J-1 Visa Waivers appear to provide good care and work well in health care environments while fulfilling the waiver requirements. To keep these physicians practicing in these communities, successful integration into the community is important.
Crouse
Byron J
BJ
University of Wisconsin School of Medicine and Public Health, 4117 HSLC, 750 Highland Ave, Madison, WI 53705, USA. bjcrouse@wisc.edu
Munson
Randy L
RL
D005260:Female; D005550:Foreign Medical Graduates; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D010560:Personnel Selection; D010563:Personnel Turnover; D019035:Rural Health Services; D014922:Wisconsin; D000078329:Workforce