The Conrad 30 program, which recently celebrated its thirtieth anniversary in May, is a testament to success. This program has significantly bolstered the physician workforce, emerging as the largest supplier of physicians to shortage areas, with over 20,000 international medical graduates (IMGs) across the country. The success of Conrad 30 offers a win-win solution for migrants and the U.S.: rural healthcare centers receive much-needed staffing, and migrants can bypass the requirement to return to their home country, enabling them to begin pursuing U.S. permanent residency earlier.
The Conrad 30 Waiver Program enables J-1 IMGs to waive the 2-year foreign residence requirement if they agree to practice medicine for three years in the U.S. at a facility in a designated Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or for a Medically Underserved Population (MUP). Each state’s Department of Health can sponsor up to 30 IMGs annually.
The J-1 visa also allows trainees to participate in sectors with significant shortages in the U.S., like agriculture, construction, healthcare, hospitality, industrial occupations, and STEM. Trainees must have an associate’s degree or higher and at least one year of work experience, or have at least five years of professional work experience. After finishing, all visa holders must return home for two years before seeking another type of visa that allows them to return to the U.S.
By replicating a Conrad 30 waiver for trainees, we could incentivize skilled occupation professionals to stay in the U.S. Currently, the trainee category is underutilized, with just 10,645 trainees working at 91 participating employers in 24 states. A waiver program—for, say, 100 trainees per state—could help incentivize more uptake in the program, fill roles in shortage occupations, and, with conversion to the H-1B visa, allow for a pathway to permanent residence for skilled migrants who otherwise lack legal pathways into the U.S.
By limiting the waiver to trainees who work in specific geographical areas, the program could incentivize roles in rural areas, opportunity zones, or distressed communities. Moreover, applying waivers specifically to trainees would allow companies to train and evaluate would-be employees for up to 18 months before deciding whether to sponsor their H-1B petition.
The Conrad 30 Waiver was designed by Senator Kent Conrad (D-ND) with bipartisan support to address physician shortages in rural areas. Thirty years later, there are still calls for Congress to quickly address labor shortages nationwide and increase legal migration pathways for skilled workers. Congress should create a waiver program for J-1 trainees that could fill shortages in specific sectors and regions while creating permanent legal pathways for migrant workers in occupations that don’t fall into existing visa categories.
There is already precedent for such a proposal. In May, Senators Thune, Heinrich, Rounds, and Luján introduced S.4301, which seeks to grant states and Indian Tribes the authority to waive the 2-year foreign residence requirement for educators in rural and Tribal areas. Their proposal allows for waiving the foreign residence requirement in exchange for three years of employment at a school in a rural, underserved, or tribal area.
Similarly, expanding a waiver to include all J-1 trainees could help fill some of America’s critical labor gaps, like construction, semiconductor manufacturing, the green energy transition, and hospitality. Tying the waiver to a specific location would guarantee migrants are filling shortages where they are most acute while giving states and Tribes the ability to select candidates that best meet their needs.