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Carl Shusterman's Immigration Update

Bill Would Help Supply Doctors To Rural and Inner City America

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On December 13, Senators Kent Conrad (D-ND) and Jerry Moran (R-KS) introduced the S.1979, the "Conrad State 30 Improvement Act".

This bipartisan bill would make it easier for physicians educated in other countries to obtain temporary visas and permanent residence in the U.S. if they obtain offers of employment in medically-underserved areas of this country.

Senator Conrad, who has announced that he will retire from the Senate in 2012, sponsored a law that was enacted back in 1994 which, for the first time, permitted states to sponsor up to 20 physicians annually for J waivers if these doctors found employment in such areas. The number of waivers available to each state was increased to 30 in 2002.

For the past 17 years, the Conrad program has permitted states to sponsor over 9,000 foreign-born physicians to work in underserved areas. However, this program is not a permanent part of the law. It must be renewed every 2 or 3 years. Also, since the early 1990s, more and more physicians have obtained H-1B status, rather than J status, in order to pursue their medical residencies and fellowships in the U.S. These physicians lack a legal incentive to work in underserved areas.

Among other things, S.1979 would do the following:


  • Make the Conrad program a permanent part of the law;
  • Allow physicians who work in underserved areas to immigrate under the EB-1 category rather than the EB-2 category;
  • Allow physicians who pursue their medical residencies in H-1B status and agree to work in underserved areas to restart the maximum 6-year duration of their H-1B status;
  • Increase the number of physicians that states can sponsor annually to 35 under certain circumstances; and
  • Make it easier for physicians in H-1B status who are work in underserved areas to change employers.


The passage of this legislation would be a boon for rural and inner city America since over 20% of our country suffers from a shortage of physicians. This shortage is slated to rise to over 200,000 by 2020.

Since the EB-1 category is "current" for all countries, the bill would aid Indian and Chinese physicians who are presently disadvantaged by backlogs in the EB-2 category.

Also, the bill would, for the first time, aid physicians who complete their medical residencies and fellowships in H-1B status. This is important because the number of J-1 medical residents and fellows who are eligible to participate in the Conrad State 30 program has been steadily decreasing, much to the disadvantage of rural and inner city America. Typically, because of the 6-year maximum duration of H-1B status (with limited exceptions under AC-21), these physicians must scrabble to attempt to secure permanent residence in the U.S. before their H-1B status can no longer be extended. S.1979 would solve this problem for those physicians who work in underserved areas.

As Senator Moran stated in his press release, "S. 1979 provides additional incentives for more doctors to participate in the program. Also, the bill provides a method for states to increase the number of waivers available to work in underserved communities."

We will follow the progress of S.1979 as it moves through the legislative process.

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Updated 12-02-2013 at 06:41 PM by CShusterman

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