New legislation impacting international medical graduates would extend the Conrad State 30 program until 2021, improve the process for obtaining a visa, and allow for additional slots if certain thresholds are met. The bill would also allow the spouses of doctors to work and provide worker protections to prevent the doctors from being mistreated by employers.

On March 28, 2019, a bipartisan bill called The Conrad State 30 & Physician Access Act was introduced by Senators Amy Klobuchar (D-Minn), Susan Collins (R-Maine), Jacky Rosen (D-Nev) and Chuck Grassley (R-Iowa) to improve and extend the Conrad State 30 Program until 2021. The Conrad State 30 Program allows state health departments to request J-1 visa waivers for up to 30 international medical graduates who complete their medical residency training in the United States as long as they agree to work in a federally designated Health Professions Shortage Areas (HPSAs) or Medically Underserved Areas (MUAs).

 Among the improvements this bill proposes is increasing the number of waivers to 35 in states where the demand exceeds the limit. This will impact the waiver program in New York state, where the demand is currently more than double the allotted 30 waivers per year.

IMGs need waivers for two-year home residency requirement

In most cases, an International Medical Graduate (IMG) must have a waiver of the two-year home residency requirement in order to stay and work in the United States after completing his or her medical training program. The two-year home residency requirement attaches to all J-1 physicians and is a mandatory return to the individual’s home country at the end of his/her J-1 program. The IMG may not change status to another nonimmigrant work visa status, may not obtain an H or L visa, and may not adjust status to lawful Permanent Resident (“green card”) unless he or she gets a waiver of the two-year home residency requirement first.

Why the Conrad State 30 Program impacts the U.S. physician shortage

According to the Association of American Medical Colleges the U.S. faces an unprecedented shortage of up to 121, 000 physicians by 2030. Rural and underserved communities need access to quality medical care and will feel the physician shortages more acutely than other communities as they routinely struggle to find qualified physicians willing to serve in those areas.

IMGs in turn struggle to make use of their training and expertise in the United States after completing years of residency. They have invested time and money: often building careers, connections and community relationships, only to be left without any good options to stay and build their practice.

The Conrad State 30 program has been highly successful in getting primary care and specialty physicians into the underserved communities that most need their expertise.