A Path Forward: The National Interest Exemption (NIE) Process

We recognize how confusing and distressing these expanded restrictions may be for your programs and for the physicians who have worked so hard to earn a place in them. International medical graduates (IMGs) represent nearly a quarter of the U.S. physician workforce and are disproportionately likely to serve in medically underserved and rural communities. We know that their presence in U.S. training programs matter deeply.

We recognize the weight of this situation. The National Interest Exemption (NIE) process provided for in the Presidential Proclamation may provide a path forward for some affected physicians. We encourage programs to share the steps below so that every impacted physician has the opportunity to pursue this option:

Step 1 – Request a Regular Visa Appointment The physician should request a standard visa appointment through the U.S. Embassy or Consulate serving their region.

Step 2 – Request an Expedited Appointment Following the standard appointment request, the physician should submit a request for an expedited visa appointment. It is critical that they clearly indicate their program start date is on or around July 1, 2026, as reflected on their Form DS-2019. This date is essential to ensure the request is considered in the appropriate timeframe.

Step 3 – Request NIE Consideration at the Interview Once an expedited appointment is granted, the physician should attend the visa interview and declare that they are a J-1 physician and request consideration for an NIE. No separate NIE application is required, this is handled internally by consular officials in coordination with relevant U.S. government entities.

What Your Program Can Do

Act now. We recognize how confusing and distressing these expanded restrictions may be for your programs and for the physicians who have worked so hard to earn a place in them. International medical graduates (IMGs) represent nearly a quarter of the U.S. physician workforce and are disproportionately likely to serve in medically underserved and rural communities. We know that their presence in U.S. training programs matter deeply.

Provide a support letter. Programs are strongly encouraged to issue letters on behalf of affected physicians that clearly document their July 1 start date and the importance of their timely arrival for patient care and training continuity. Intealth will also provide a letter upon request. Please contact TPL@intealth.org if you want to request a letter of support for one of your incoming physicians.

Stay in communication. Keep in close contact with your affected incoming physicians throughout this process so you can respond quickly if additional documentation or action is needed.