Conrad 30 waiver

Doctors who train in the US on a J-1 visa must normally spend 2 years in their home country before they can get an H-1B or a green card. USCIS says the Conrad 30 program allows J-1 foreign medical graduates to apply for a waiver of that requirement, and that it addresses the shortage of qualified doctors in medically underserved areas.

The USCIS Policy Manual says the number of these waivers is limited to 30 per state in each fiscal year. States may use up to 10 of these as flex slots for doctors working outside designated shortage areas who still serve patients from underserved areas.

It is for physicians who completed, or are completing, graduate medical training on a J-1 and want to stay in the US. USCIS says the doctor must:

• have a bona fide offer of full-time employment at a health care facility in an area designated by the Department of Health and Human Services as a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA) or Medically Underserved Population (MUP), except for flex slots
• agree to work there in H-1B status for at least 3 years; the State Department treats full-time as 40 hours a week
• begin work within 90 days of receiving the waiver
• obtain a no objection statement from the home government if contractually obliged to return home

1. Find an employer in an eligible area and sign a 3-year contract.
2. Apply to the state health department, or its equivalent, for sponsorship. Each state sets its own application window and criteria.
3. Complete the State Department's online J-1 waiver application (Form DS-3035).
4. The state sends the request to the State Department's Waiver Review Division for a recommendation.
5. USCIS makes the final decision. The employer then files an H-1B petition on Form I-129 with the favourable recommendation.

USCIS says that after completing the 3-year commitment, the doctor becomes eligible to apply for an immigrant visa, adjustment of status, or other H or L status. The waiver is conditional on meeting the terms of the commitment.

The program's legal authority is time-limited and has to be extended by Congress. USCIS has warned that, unless Congress extends it, people who are admitted in or acquire J-1 status on or after the sunset date will not be eligible for a Conrad 30 waiver. Bills to reauthorise it have been introduced in the 119th Congress. Check the current USCIS page before relying on the program.

• Slots filling quickly in popular states.
• Missed start date beyond 90 days.
• Changing employer during the 3 years without meeting the rules.

Other waivers exist. The USCIS Policy Manual says that if an interested federal agency requests the waiver to employ the doctor full time in clinical medicine, the doctor can meet the obligation by working for that agency for at least 3 years. See our USMLE guide.