Scores of novice doctors attended a job fair in late September in Manhattan that featured chamber of commerce brochures from small towns and rural areas throughout New York state. Many of the doctors had come from abroad on visas, including the restrictive J-1 exchange visa, which requires them to return home for two years once they finish their studies unless they can get a waiver to work in a medically underserved area. New York state recommends about 30 doctors for J-1 visa waivers annually, and typically half of the visas go to doctors working in urban neighborhoods and half to upstate communities that do not have enough physicians.