Affordable and accessible healthcare has long been a national priority. However, for decades the United States has experienced a critical shortage of physicians. The addition of millions more insured Americans to the healthcare rolls under the Affordable Care Act has heightened the problem. In fact, the Association of Medical Colleges predicts the US will face a shortage of 46,000 – 90,000 physicians by the year 2025.[1] While the US is now graduating more medical students than ever before, the number of graduate medical education residency and fellowship training programs has remained static.[2] With American physicians increasingly choosing hospital-based medical specialties over primary care positions,[3] millions of vulnerable Americans are left without primary healthcare.
Fortunately, US immigration law provides an incentive to attract US-trained international medical graduates (IMGs) to parts of the country not fully served by American physicians. Since its inception in 1994, state Departments of Health across the country have used the Conrad State 30 J-1 waiver program (“Conrad 30”) to place over 12,000 IMGs in medically underserved communities where they have provided healthcare to millions of our country’s neediest citizens.
Here’s how Conrad 30 works: The majority of IMGs who complete graduate medical education in the US do so in J-1 nonimmigrant status, which carries a requirement to return to the home country for an aggregate of 2 years following completion of training before becoming eligible for an H or L visa or a green card. Named for former Senator Kent Conrad who created the program in 1994, the Conrad 30 program creates a waiver of the 2-year home residency requirement permitting each state to recommend up to 30 IMGs each year for a J-1 waiver in exchange for a commitment to work for at least 3 years treating medically underserved populations within the state. It’s the ultimate win-win: the IMG gets to stay in the US and underserved Americans get healthcare that would otherwise be denied them.
Conrad 30 has been operating as a renewable “pilot program” for over 20 years and is currently set to expire on September 30, 2015. Senators Amy Klobuchar (D-MN) and Heidi Heitkamp (D-ND) have proposed legislation to permanently reauthorize Conrad 30, the “Conrad State 30 and Physician Access Act,” S.1189. Thus far, the bill has not moved in Congress. It is critical that we engage with our Congressional representatives to encourage passage of this bill before the current program expires.
Conrad 30 won’t single-handedly solve the US healthcare crisis, but for 20 years it has proven a successful tool in alleviating physician shortages among minority, rural and low-income urban populations that would otherwise not have access to medical care. In light of the acknowledged nation-wide shortage of physicians, it only makes sense to use every possible tool we have at our disposal to care for underserved Americans.
Conrad 30 works. Don’t let it die. Contact your Senator today to express your support for the extension of the Conrad 30 program. (https://www.opencongress.org/people/zipcodelookup).
Written by Sarah Peterson Stensrud, Member of AILA’s Healthcare Professionals Committee and Jennifer Minear, AILA National Secretary
[1] https://www.aamc.org/advocacy/campaigns_and_coalitions/fixdocshortage/
[2] https://www.aamc.org/newsroom/newsreleases/411636/10282014.html
[3] http://www.theatlantic.com/health/archive/2012/03/the-doctor-is-out-young-talent-is-turning-away-from-primary-care/254221/
