; and (II) the head of such agency determines that— (aa) the alien physician’s work is in the public interest; and (bb) the grant of such waiver would not cause the number of the waivers granted on behalf of aliens for such State for a fiscal year (within the limitation in subparagraph (B) and subject to paragraph (6)) in accordance with the conditions of this clause to exceed 3. . 5. Amendments to the procedures, definitions, and other provisions related to physician immigration (a) Visa eligibility Not later than 90 days after the date of the enactment of this Act, the Secretary of State shall amend guidance in the Foreign Affairs Manual to clarify that the expression of a future intention to seek a waiver under section 214(l) of the Immigration and Nationality Act ( 8 U.S.C. 1184(l) ) by an alien coming to the United States to receive graduate medical education or training, as described in section 212(j) of such Act ( 8 U.S.C. 1182(j) ), or to take examinations required to receive such graduate medical education or training, shall not, by itself, constitute evidence of an intention to abandon a foreign residence for purposes of obtaining a visa as a nonimmigrant or otherwise obtaining or maintaining the status of a nonimmigrant. (b) Applicability of section 212(e) to spouses and children of J–1 exchange visitors Section 212(e) of the Immigration and Nationality Act ( 8 U.S.C. 1182(e) ) is amended— (1) by inserting (1) after (e) ; and (2) by adding at the end the following (2) A spouse or child of an exchange visitor described in section 101(a)(15)(J) shall not be subject to the requirements under this subsection solely on account of such spouse or child’s derivative nonimmigrant status to an exchange visitor who is subject to the requirements under this subsection. .