With more than two decades of experience at the University of Kentucky, Michelle Zupancic has become the go-to person for all things related to recruiting and retaining international physicians at the University of Kentucky College of Medicine and UK HealthCare.
She serves as a faculty resource consultant within the UK College of Medicine Office of Visitor Information Services (OVIS). More specifically, she supports international medical graduates (IMGs) as they join the UK College of Medicine, with special regard to immigration and visa services.
Why Michelle's work is instrumental
To practice medicine in the U.S., IMGs must go through several processes at the federal and state level. The first of which, most often, is receiving a J-1 training visa and completing a residency or fellowship program in the U.S. Following the completion of their J-1 exchange program, IMGs typically must return to their home country for two years.
There are, however, a few exceptions to returning home. Though several waiver types exist, Zupancic and her team most often work with the Conrad 30 Waiver Program. This program allows J-1 IMGs to apply for a waiver of the two-year foreign residency requirement upon completion of the J-1 exchange program. In simpler terms, the Conrad waiver allows IMGS to remain in the U.S. to continue to practice uninterrupted, without being required to leave the country for two years.
Through this program, each state in the U.S. is granted 30 waivers per calendar year. Those waivers are reviewed and initially supported by each state based on several factors and guidelines. Zupancic shared that in the early years, she was able to complete around two waivers per year. Now, her team usually submits around 10—but that doesn’t come close to meeting the demand.
“It’s very competitive, and in a way that I don’t want it to be,” Zupancic said. “The majority of these individuals are sub-specialists or sub-sub-specialists. These are physicians whose specialties are very difficult to find and recruit, so when we can offer someone a waiver, it is a really big deal for our college and the University.”
Zupancic recalls completing her first waiver for the college in the division of cardiology while working under the leadership of David Moliterno, MD, then-chair of internal medicine. Soon thereafter, requests started coming from other clinical departments looking to recruit specialists and subspecialists.
“There was a need for it,” said Zupancic. “It was definitely enough work for a full-time position then, but, over time, it became too much for just one person. Now, years later, we have a dedicated visa and immigration services group within the dean’s office.” The OVIS team has expanded its services to include support to UK HealthCare international staff as well.
Zupancic and her small team regularly liaise with immigration attorney firms, the state medical licensure board, the University of Kentucky International Center, clinical department administrators, and the Office of Graduate Medical Education, to name a few.
Expertise that "instilled confidence"
Rupin Sharma, MD, is an assistant professor of pediatrics specializing in neonatology. Hailing from New Delhi, India, Dr. Sharma completed visiting rotations at hospitals near Washington D.C., where her mother was stationed as an Indian diplomat, and at Boston Children’s Hospital.
She leaned on Zupancic and her team when joining the UK College of Medicine, noting “what is so amazing about Michelle is her communication. It’s always very empathetic, very positive, but also very realistic at the same time.”
After nine years in her role as a faculty consultant, Zupancic has a pretty good idea of what makes a strong application. She leverages that expertise to help applicants put forth their best efforts when applying. Dr. Sharma added that “she's very, very cognizant of the timeline and of all the hurdles that people have to face, especially getting paperwork from your home country and those things.”
“When I compare that experience with some of my friends who started residency with me, also from India, there was a huge difference,” Dr. Sharma said. “Some places did not know how to file for waivers, they had no clue how the process worked, so the onus of knowing that fell solely on the candidate and caused massive delays.”
Naureen Narula, MD, an assistant professor of lung transplant in the division of cardiothoracic surgery, had a similar experience working with Zupancic.
“Michelle ensured that I began the process at the right time and connected me with the appropriate resources and people who could assist me along the way,” shared Dr. Narula. “Her expertise and encouragement eased my apprehensions and instilled confidence in me as I embarked on this new chapter.”
Promoting a commitment to treat underserved patients
One component of the Conrad waiver requires recipients to work, at least part-time, in a medically underserved area. The Albert B. Chandler and Good Samaritan Hospitals do not qualify, but less than a block away is the UK Specialty Care Clinic at Maxwell. This clinic, and its practice manager, Holly Dye, are essential to our physicians completing the waiver process. For the three-year duration of the Conrad waiver, IMG physicians see patients at the specialty clinic in addition to their other clinical and academic duties.
Over her tenure, Zupancic has supported more than 100 physicians through the Conrad waiver program. Her office also supports IMGs navigating the immigration process, most commonly by way of the PERM, NIW, and EB1B pathways.
Sayee Alagusundaramoorthy, MD, an assistant professor of medicine, is a nephrologist by training and currently has an H-1B visa. He shared that the process for receiving and renewing his H-1B visa was much easier with the help of Zupancic and her team.
“They helped me so much, every step of the way, to figure the process out,” he shared.
Dr. Alagusundaramoorthy joined the UK College of Medicine at the peak of COVID-19 in 2020 and quickly got to work seeing patients. Before his arrival, the position was vacant for 15 years. Dr. Alagusundaramoorthy also developed an interventional nephrology program, completing close to 3,000 procedures over the last three years.
An important service to the Commonwealth
Amidst increasing demand and the evolving complexities surrounding immigration, Zupancic’s leadership has been pivotal in this space. She has been able to streamline the process, noting her gratitude for the opportunity over the last decade. “This program is important to UK, to the Commonwealth, and to the United States,” said Zupancic.
“These physicians could have extraordinary abilities, but straight out of training, or even still in the middle of it, they have to worry about getting a waiver, securing a visa…it’s always something at the back of their mind, whether they’re in the middle of a surgery or seeing a new patient. I hope my work helps ease that stress a little and that they know we’re here to support them.”
The College of Medicine is grateful to Zupancic and her team for all the amazing work they do to support our physicians and our larger mission of providing excellence in education, equitable health care, and transformative research to improve the health and wellness of Kentuckians and beyond.