This may be possible if:

1. the person’s participation in an exchange program was funded by the United States Government, the participant’s own government, or an international organization;
2. the education, training, or skill the participant is pursuing in an exchange program appears on the Exchange Visitor Skills List (1997 Amendment) for participant’s country;
3. the participant acquired J-1 status on or after January 10, 1977, for the purpose of receiving graduate medical education or training.

If an individual is subject to the two-year foreign residence requirement, he/she may not change status to that of H, L, or K, or to immigrant or legal permanent status until he/she has fulfilled the two-year foreign residence requirement by going back to their home country or receiving a waiver of this requirement.

If however the individual subject to the two-year foreign residence requirement qualifies for a waiver, that individual may change status or become a permanent resident without returning to his or her country. There are five grounds to obtain waivers under INA 212(e):

1. No Objection Letter
   The participant’s home country government issue a No Objection Letter through its Embassy in Washington, DC directly to the Waiver Review Division that it has no objection to the participant not returning to the home country to satisfy the INA 212(e) two-year foreign residence requirement and does not object to the possibility of the participant becoming a resident of the U.S. The No Objection Letter may also be issued by a designated ministry of the participant’s home government. The law bars the use of this option by foreign medical physicians, who acquired J-1 status for the reasons of receiving graduate medical education or training.
    
2. Request by an interested government agency
   If an exchange visitor is working on a project for or of interest to a U.S. Federal Government agency, and that agency has determined that the visitor's departure for two years to fulfill the INA 212(e) requirement will be detrimental to its interest, that agency may request an interested government agency waiver on behalf of the participant for sake of public interest. For the applications on behalf of foreign physicians, who agree to serve in medically underserved areas, there may be other set of rules that apply.
    
3. Persecution
   If an exchange visitor believes that he or she will be persecuted based on his/her race, religion, or political opinion if he/she were to return to his/her home country, the participant may apply for a persecution waiver. The Form I-612, Application for Waiver of the Foreign Residence Requirement of Section 212(e) of the Immigration and Nationality Act, must be filed directly to the United States Citizenship and Immigration Services (CIS), within Department of Homeland Security. Only if CIS makes a finding of persecution will the Waiver Review Division proceed with the waiver case under this basis. Once CIS makes a decision, it will forward directly to the Waiver Review Division its decision on Form I-613.
    
4. Exceptional hardship to a United States citizen (or legal permanent resident) spouse or child of an exchange visitor
   If an exchange visitor can demonstrate that his or her departure from the United States would cause exceptional hardship to his or her U.S. citizen or legal permanent resident spouse or child, he or she may apply for an exceptional hardship waiver. This waiver basis requires that the participant to submit Form I-612, Application for Waiver of the Foreign Residence Requirement of Section 212(e) of the Immigration and Nationality Act, directly to the United States Citizenship and Immigration Services (CIS), within the Department of Homeland Security. Only if CIS makes a finding of exceptional hardship will the Waiver Review Division proceed with the waiver case under this basis. CIS will forward its decision directly to the Waiver Review Division on Form I-613.
    
5. Request by a designated State Department of Public Health or its equivalent, CONRAD
   Pursuant to the requirements of Public Law 103-416, a foreign medical graduate who has an offer of full-time employment at a health care facility in a designated health care professional shortage area or at a health care facility which serves patients from such a designated area, and agrees to begin employment at that facility within 90 days of receiving such a waiver, and who signs a contract to continue to work at that health care facility for a total of 40 hours per week and for not less than three years, may apply for a waiver under this basis.