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The Conrad State 30 J1 Waiver Program


In 1994, Senator Kent Conrad ( North Dakota ) addressed the issue of physician shortages in rural and urban areas of the United States by formulating the Conrad J1 visa waiver program. The Conrad program allowed each State's Department of Health to sponsor up to a certain number (initially 20, and now 30) international medical graduates (IMGs) each year for waiver of the two-year home residency requirement of the physician's J1 visa. The approved Conrad J1 waiver applicants would be required to serve in federally designated shortage area (either rural or urban).

The program generally targeted physicians who fulfilled a U.S. residency training program in family medicine, general obstetrics, general pediatrics, general internal medicine, and general psychiatry. In 2003 the Conrad program was reauthorized and increased the number of state sponsored waivers to 30, thus the name Conrad 30. Later, Congress enabled States to accept specialist physicians for waiver consideration, if the State chose to do so..

Background & Requirements

In addition to each of the 50 States, the District of Columbia, Puerto Rico, and Guam offer the Conrad 30 program where they can sponsor up to 30 IMGs each year for a J1 waiver. There are both general and State-specific requirements in order to qualify for the Conrad 30 program. Standard requirements include the following:

  • IMG's must have received a full-time offer of employment (40 hours/week) in a federally designated HPSA.
  • The IMG must serve for a period of no less than 3 years.
  • States may fill up to 10 “flex slots,” where physicians may be selected to work in an area that is not a HPSA or Medically Underserved Area (MUA), yet still serves residents in underserved areas.
  • The program may be applied to specialists, as long as, the service area has a shortage of physicians practicing that specialty.
  • The IMG must be under written contract with the employer.
  • The IMG must begin serving within 90 days of the waiver's approval.
  • The IMG must not apply for another Conrad 30 waiver in another state.
  • If the IMG's home country funded their medical education, a no-objection letter from the home country must be submitted.
  • IMG must sign a statement agreeing that they understand program policies and will comply with them and that all information they have submitted is correct.
  • The practice area must demonstrate evidence of failed attempts to recruit an American citizen for the vacancy.

States vary in their specific requirements for acceptance/consideration in their specific Conrad

30 program. Hence, it is very important to review a State's particular requirements prior to accepting a position in a particular State.

Reauthorization of Conrad 30 program

On February 27, 2008, Senator Conrad introduced a reauthorization bill called the “Conrad State 30 Improvement Act.” Its purpose was to make the Conrad 30 program permanent, while amending the Immigration and Nationality Technical Corrections Act of 1994. The Conrad State 30 Improvement Act put numerous reforms into effect in order to designate more physicians to underserved areas. Congress approved the Conrad 30 extension program on September 27, 2008.

States are now able, as well, to offer up to 10 FLEX waiver spots, for physicians agreeing to work in areas which are not designated as underserved, but that serve individuals residing in neighboring underserved communities.

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