More than three dozen healthcare associations and organizations penned a letter this week calling on House and Senate leaders for action on a bill bolstering foreign-born physician recruitment to underserved regions.
The letters—which include the American Medical Association, the American Hospital Association and the Association of American Medical Colleges as signatories—speak to the Conrad 30 Waiver Program and its role in alleviating the nation’s worsening clinical workforce shortage.
It allows foreign students who come to the U.S. for medical training to immediately begin practicing in the U.S. by forgoing visa requirements that would force them to return to their home country for at least two years. In exchange, program participants are required to work full-time for at least three years in a medically underserved community.
Over the past three decades, the program has helped place about 20,000 physicians, the groups wrote in their letters, and has helped retain participating doctors in the U.S. beyond their three-year commitment.
“However, misaligned incentives and outdated policies are jeopardizing the future success of the program,” they wrote.
A pair of bills introduced in the House and Senate late last month and referred to their respective judiciary committees would reauthorize and “make necessary updates to strengthen the program,” the groups said.
For starters, the bill would ramp up the number of waivers allotted per state per year if a certain percentage was used during the prior year. This would begin with an increase from the 30-waiver cap to 35 should 90% have been used the prior year, with an additional five waivers being allocated for each subsequent year with 90% use until the threshold is increased to 95% at 45 waivers. Those increases would be in place indefinitely until there is a 5% drop in granted waivers, at which point the total is reduced by five waivers.
Outside of capacity, the bills include waiver process clarifications and other provisions related to foreign-born doctors’ immigration status and employment—“commonsense changes” that the organizations said would help physician applicants and their employers alike.
“One of the strengths of the Conrad 30 program is its flexible design, which allows each state to tailor the program to meet its specific healthcare needs,” the groups wrote. “This reauthorization will reinforce that flexibility while providing needed clarity and incentives to attract and retain more highly qualified physicians. As workforce shortages worsen, Congress must act with urgency to advance this legislation and strengthen one of the most successful programs for addressing healthcare workforce shortages.”
Many of the letters’ signatories and several other healthcare groups had, in 2022, similarly thrown their weight behind a prior bill that outlined many of the same updates and clarifications, though that attempt did not make it out of committee.
The workforce issues of then are still weighing down on the healthcare industry, particularly in light of the aging baby boomer generation both increasing demand for care and its retiring physicians reducing the supply of clinicians. The Association of American Medical colleges has estimated the country will be short by as many as 86,000 physicians by 2036.
In this week’s letter, the groups also pointed to “reimbursement challenges in Medicare” as a constraint of the physician training pipeline. They stressed that the issue is worse among the rural and underserved communities served by the Conrad program and that more than 80 million Americans currently have limited access to primary care.