Advocacy Update

March 10, 2023: Advocacy Update spotlight on Conrad 30 legislation


With the United States facing an ongoing shortage of physicians, especially in rural and underserved areas, and an underlying need to diversify the workforce, Senators Amy Klobuchar (D-MN) and Susan Collins (R-ME), along with a bipartisan group of 18 senators, introduced S. 665, the Conrad State 30 and Physician Access Reauthorization Act, on March 6. Absent congressional activity, the Conrad 30 program expires on Oct. 1. Senator Klobuchar previewed the introduction of S. 665 to reauthorize the program for three years last month when she addressed the AMA’s National Advocacy Conference (PDF). 

Currently, physicians from other countries working in the United States on J-1 visas are required to return to their country of origin upon conclusion of their residency for two years before they can apply for another visa or a green card. Under the Conrad 30 program, each individual state is granted 30 waivers to allocate to physicians permitting them to forgo the requirement to return to their country of origin so long as they are willing to work in a medically underserved community for three years.   

“The physician workforce crisis, exacerbated by the COVID-19 pandemic and other sources of burnout, threatens patient access to care, especially in rural and underserved communities. One way to address this problem is through smart, targeted immigration reforms,” said AMA President Jack Resneck Jr., MD.  “The Conrad 30 program remains an innovative way to achieve two major goals: facilitate greater patient access to physicians and diversify the physician workforce. The American Medical Association applauds Senators Klobuchar and Collins for their leadership on this bipartisan bill that seeks to expand and improve the Conrad 30 program. The Senate should expeditiously pass this legislation.” 

In addition to reauthorizing the program for an additional three years, the Conrad State 30 and Physician Access Reauthorization Act outlines a process to gradually increase the total number of waivers per state, mandates additional transparency in employment contract terms, permits greater immigration flexibilities for spouses and children of participating physicians, and requires an annual report from the U.S. Citizenship and Immigration Services to the Department of Health and Human Services on the annual utilization of the waivers in hopes of better informing rural states how to make full use of the program. To ease the current per country backlog, the legislation also authorizes physicians who practice in underserved areas or Veteran’s Affairs facilities for five years to receive priority access within the green card system. The AMA was joined by the Federation of American Hospitals, National Rural Health Association and Association of American Medical Colleges, as proud supporters of this bipartisan legislation.