Reports show that there is a serious shortage of doctors in America today. While it may not be obvious in big cities, the lack of physicians has become strongly felt in poor and rural areas. By year 2020, the doctor shortage is expected to reach 200,000 because of the aging baby boom generation.
A bipartisan bill was recently introduced in the Senate to make it easier for foreign doctors to obtain temporary visas and permanent residence in the U.S. and thereby address the shortage.
The bill, also known as the “Conrad State 30 Improvement Act” (S.1979), seeks to make permanent a program allowing states to recommend J-1 waivers for physicians who work in medically underserved communities. Currently, the program needs to be renewed every 2 or 3 years. The number of doctors that can be sponsored by each state annually would also be increased from the current 30.
It would also allow doctors on H-1B status to restart the 6-year maximum period if they agree to work in underserved areas. The doctors would also find it easier to change employers.
Additionally, doctors who work in underserved areas would be able to immigrate under the EB-1 category, instead of the EB-2 category. This would greatly benefit physicians from China and India who would otherwise face lengthy visa backlogs under EB-2.
The doctor deficit is in part due to the economic recession but also in some part a result of the immigration restrictions on foreign medical graduates.
The immigration of foreign doctors is a complex matter governed by different sets of rules. Foreign doctors usually come to the U.S. either on an H-1B visa, which allows temporary employment, or J-1 visa, which permits them to undergo graduate medical education or training.
Most of the time, hospitals and medical schools offer only the J-1 option because of the lower level of responsibility required of them. Because H-1B visas are subject to annual limits, when the cap is reached the J-1 is sometimes the only option.
Upon the expiration of their J-1 visa, doctors must return to their home country for two years before they can apply for permanent residence. They may apply for a J-1 visa waiver to be exempt from this home residence requirement. One of the ways to get a waiver is through the state or the Conrad State 30 program, which is named after Sen. Kent Conrad (D-North Dakota) who sponsored the bill back in 1994 and which is the subject of the S.1979.
Many doctors, however, are unwilling to go through the waiver process and instead choose to go back to their home countries or elsewhere to work. Even doctors on H-1B status who lack options for permanent residence sometimes just give up upon reaching the 6-year maximum H-1B period.
Although the specific requirements vary by state, the Conrad State 30 program allowed states to sponsor a certain number of foreign-born, U.S.-trained physicians per year for the J waiver, as long as they agreed to practice in underserved communities for at least 3 years. It was seen as a win-win situation: the doctor was able to remain in the U.S. and the community had a doctor.
The program has allowed 9,000 doctors to work in rural and underserved communities. However, the number of foreign doctors participating in the program has gone down over the years, further limiting the access to healthcare of the people who perhaps need it the most.