Updated: Dec. 1, 2025
Under federal law P.L. 106-95, eligible foreign physicians can apply for a National Interest Waiver (NIW), which allows them to obtain a U.S. visa to practice medicine in designated shortage areas. This pathway can ultimately lead to permanent residency.
As part of the NIW application to U.S. Citizenship and Immigration Services (USCIS), a physician must include a support letter from a state health department or federal agency confirming the following:
- the physician holds a valid license,
- they will practice in a designated shortage area, and
- the waiver is in the public interest.
The Primary Care Office (PCO) may issue a NIW Support Letter for qualified physicians upon receipt of the following documents, submitted to neelyk@dph.sc.gov:
- Employment Agreement must include:
- Signatures of both the physician and the employer
- The physician’s job title and specialty
- The name and physical address of each practice location
- A minimum five-year service commitment, including a specified start date
- Confirmation of at least 40 hours per week of direct patient care
- Employee Letter must include:
- The date the physician began employment with the organization
- A statement confirming the physician is in good standing
- A statement acknowledging that, upon receiving the National Interest Waiver and completing the three-year J-1 Waiver obligation (if applicable), the physician may accept another practice opportunity without needing to demonstrate extenuating circumstances
- A copy of the physician’s valid South Carolina Medical License
- Physician’s current Curriculum Vitae (CV)
- H-1B Petition Approval Notice
For more information about the NIW permanent residency petition process, please visit the USCIS website.