Senator Kent Conrad (D-ND), the original sponsor of the Conrad 30 J-1 program, has introduced S. 628, a bill that would make a number of changes to the physician immigration system. The bill’s text can be found at http://www.thomas.gov/cgi-bin/query/z?c111:S.628:. The following is a summary of the bill’s major components: 

The Conrad State 30 program allows foreign doctors on J-1 visas to obtain a waiver of the J-1 requirement to return to their home country for two years, if they agree to serve for 3 years in an underserved area in the U.S.  Each state is allowed 30 such waivers.  In recent years, almost 1000 additional doctors annually have begun practicing in underserved communities in all 50 states as a result of the Conrad 30 program.  The Conrad State 30 Improvement Act would make this successful program permanent and implement various reforms intended to increase the number of the doctors in underserved areas.  Below is a section-by-section summary of the bill. 

Section 1.  Title – Conrad State 30 Improvement Act 

Section 2.  Permanent Authorization - Make the Conrad 30 program permanent.  Since its inception in 1994, the program has been repeatedly reauthorized on a temporary basis. 

Section 3.  H-1B Participation & Increase in Per State Allotment 

H-1B Participation – Allow doctors who come to the U.S. on an H-1B visa to obtain a Conrad 30 waiver slot, but not in a “flex” slot which allows doctors to practice outside of underserved areas, as long as they treat patients from underserved areas.  Currently, only J-1 doctors are eligible for the program.  There would be no new slots created initially; the H-1B doctors would simply be incorporated into the current 30 waiver per state system.  H-1B doctors do not have a requirement to return home, so in return for their 3 years of service in the Conrad 30 program, these doctors would receive an exemption from:

a) H-1B caps (helpful for those doctors who originally obtained an H-1B visa through a cap-exempt employer, but wish to stay in the U.S. when their employment with such employer terminates, and would thus be subject to the H-1B caps if seeking employment with a non-exempt employer);

b) the 6-year limit on H-1B visas (though their visa would be capped at 6 additional years); and

c) green card caps (see Section 4 below).  

Increase in Per State Allotment – If 90% percent of the nationwide waivers are filled in given year, the number of waivers allowed per state would increase to 35.  Then if 90% of the adjusted total of nationwide waivers were filled, the per state allotment would increase to 40, and so on indefinitely.  Only states that received at least 5 waivers in any of the three previous years would be included when calculating the 90% threshold.   

Section 4.  Green Card Cap Exemption – Green card cap exemptions for doctors who have completed the Conrad 30 program.  Due to current caps, many doctors face extremely long waits to obtain green cards, because a very high percentage of doctors come from heavily oversubscribed countries, such as India.  A cap exemption would provide an important incentive for doctors to practice in underserved communities.

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