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Reauthorizes and reforms the Conrad State 30 J‑1 physician waiver program and makes multiple changes to immigration and work rules for foreign physicians. It allows some physicians (and certain family members) earlier filing of immigrant petitions, creates new employment-contract protections and short work-authority extensions, adjusts how waiver slots are allotted to States (including provisions for academic medical centers), clarifies dual‑intent and national‑interest treatment for physicians, and requires annual USCIS reporting of admissions under the program by State. The bill is written so parts of the reauthorization are treated as retroactive to September 30, 2018.
Amends Section 220(c) of the Immigration and Nationality Technical Corrections Act of 1994 by striking the words "September 30, 2015" and inserting the words "Conrad State 30 and Physician Access Reauthorization Act."
Specifies that the amendment made by subsection (a) takes effect as if enacted on September 30, 2018.
Adds a new subparagraph (F) to 8 U.S.C. 1151(b)(1) covering "alien physicians who have completed service requirements of a waiver requested under section 203(b)(2)(B)(ii)."
Explicitly includes (I) alien physicians who completed such waiver service before the date of enactment and (II) the spouse or children of an alien physician described in subclause (I).
States that nothing in the new subparagraph prevents these alien physicians from filing a petition under section 204(a) or an application for adjustment of status under section 245 before the date the physician completes the service in section 214(l) or before the physician has worked full-time for an aggregate of 5 years at the location identified in the section 214(l) waiver or in HHS-designated shortage areas.
Primary affected groups:
Foreign physicians on J‑1 visas and recent graduates of U.S. residency programs: The legislation eases administrative barriers by allowing earlier filing of immigrant petitions in some cases, clarifies dual‑intent treatment during training, extends short periods of work authorization in transition, and protects physicians from onerous employment terms (e.g., non‑compete bans, limits on on‑call hours). For physicians who have already completed waiver service, the bill permits surviving spouses/children to file earlier in limited cases.
Families of J‑1 waiver physicians: The bill provides filing and waiver‑related clarifications that can help spouses and dependent children obtain or preserve lawful status, including limited exemptions from section 212(e) in certain cases.
Hospitals, clinics, especially in underserved areas, and academic medical centers: Changes to State allotment rules and a special academic center rule may increase available waiver slots or change how centers qualify, affecting recruitment and staffing. Contract protections may require employers to revise hiring agreements and scheduling practices.
State health agencies and governors: States maintain a central role in requesting and allocating Conrad slots; revised allotment formulas and utilization thresholds mean state agencies may gain or lose slots based on demand and reported usage. States may need to update administrative processes to comply with new criteria for academic medical center requests.
Federal agencies (DHS/USCIS, HHS): USCIS and DHS will implement the new filing/approval sequencing, adjudicate the updated waiver and status rules, and produce annual State‑by‑State admissions reports. HHS interacts operationally because of health‑workforce impacts and academic medical center provisions.
Patients and underserved communities: If the changes increase the supply or retention of foreign physicians in shortage areas, patients in rural and underserved areas may see improved access to care. Conversely, if allotments tighten in some States, some localities could face recruitment challenges.
Administrative and legal impacts:
Overall effect: The legislation reduces some immigration and employment barriers for foreign physicians, strengthens worker protections in the physician waiver context, and reshapes how waiver slots are allocated and reported — likely increasing flexibility for hiring institutions while imposing new administrative responsibilities on States and federal agencies.
Strikes an existing parenthetical exception in section 214(b) and inserts language adding an exception for aliens coming to the United States to receive graduate medical education or training described in section 212(j) or to take examinations required for such training.
Strikes items (aa) and (bb) in the specified subclause and inserts replacement text (new inserted text not shown in the provided section).
Adjusts the formatting/positioning of subclauses (II), (III), and (IV) and inserts additional text into subclause (II) (specific inserted text not shown in the provided section).
Adds a clarifying sentence stating that an alien physician holding a foreign medical degree deemed sufficient for acceptance by an accredited U.S. medical residency or fellowship program is to be treated as a member of the professions holding an advanced degree or its equivalent.
Provides that a spouse or child of an exchange visitor described in section 101(a)(15)(J) shall not be subject to the requirements under section 212(e).
Adds a new paragraph (9) to 8 U.S.C. 1184(l) establishing rules for nationwide allotment increases and decreases of waivers (including thresholds of 35, 45, percentage-usage triggers, and a floor of 30) and adds clause (iv) to 214(l)(1)(D) to permit interested State agency determinations regarding practice or faculty placement at academic medical centers (defined by the cited CFR provision).
Adds a new subparagraph (F) to subsection (b)(1) providing rules for alien physicians who have completed service requirements of a waiver requested under section 203(b)(2)(B)(ii), including those who completed such service before enactment and their spouse or children; permits filing of certain petitions/applications before completion of service or 5 years of full-time work but prohibits granting until waiver requirements are satisfied.
Amends Section 220(c) of the Immigration and Nationality Technical Corrections Act of 1994 by striking the date 'September 30, 2015' and inserting the text 'Conrad State 30 and Physician Access Reauthorization Act'.
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Referred to the House Committee on the Judiciary.
Introduced February 25, 2025 by David G. Valadao · Last progress February 25, 2025
Referred to the House Committee on the Judiciary.
Introduced in House