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This Hospitalist had experienced a number of hardships in her personal life that made finishing the three year requirement in her original place of employment a near impossibility. After an initial consult with the Hospitalist, we determined that her situation provided a strong argument for extenuating circumstances that would allow the doctor to pursue a J-1 Waiver Transfer.

This Hospitalist was engaged to a fellow physician who was serving their J-1 Waiver time across the country. This long distance resulted in a serious strain on the Hospitalist's time and energy through frequent travel. The stresses resulting from this were further compounded by the ongoing Covid-19 pandemic, resulting in additional risks around frequent travel. Additionally, the Hospitalist became pregnant, and due to the stresses and requirements of the work and distance, it became increasingly difficult for her to maintain her busy schedule in a healthy manner without any family or loved ones nearby to provide support.


Due to this increased stress, and the Doctor being alone during this vulnerable time, physical and mental consequences increasingly manifested making it nearly impossible for her to continue performing her job without pursuing a J-1 Waiver Transfer. Additionally, due to the demands of her work, and the distance of her fiancé, she was unable to provide adequate prenatal care. The Hospitalist was forced to make the difficult decision to end the pregnancy since she had no support system in place and there was no healthy way for her to carry the baby to term, care for the infant, and maintain her work obligations without any support system nearby. She also suffered post-traumatic stress disorder from the termination of the pregnancy and situation as a whole.

We argued that these points backed by evidence that the Hospitalist's mental health was steadily declining through the use of a psychologist's notes and recommendations that the Hospitalist be closer to her fiancé. Further, we utilized a note from the Hospitalist's OBGYN stating that further work under these extreme conditions could lead to future infertility related to an ongoing medical condition. We also utilized a statement from the Doctor which we adapted into a structured signed declaration describing her difficult situation caused by the physician being tied to her original J-1 Waiver stipulated workplace. These arguments were presented as culminating in a situation that should be considered untenable within the extenuating circumstances standard, and thus, the Hospitalist should be granted a J-1 Waiver Transfer to another eligible facility closer to her fiancé. The transfer request was approved without RFE related to the specifics of the J-1 Waiver transfer.

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