A new analysis suggests that many states aren’t fully taking advantage of a federal program intended to alleviate physician shortages.
The Conrad 30 Waiver Program lets each state recommend 30 visa waivers a year to international medical graduates who want to stay in the U.S. after residency training. Between 2001 and 2020, 18,000 doctors were hired through the program. Most are required to practice in underserved communities for at least three years.
“That's the largest physician recruitment program in this country,” said Hao Yu, an associate professor of health policy at Harvard Medical School who led the analysis published in Health Affairs Scholar this month.
While the report showed that an increasing number of states are filling all of their visa slots, it also found that about half are not.
In the Mountain West, the program's usage varies. Between 2001 and 2020, Arizona used more than 90% of its visa allowance, Colorado filled a third, and Idaho just 4%.
“That's really a minimum level — almost doing nothing,” Yu said.
The analysis also noted that in Utah only 6% of Conrad physicians were hired in rural areas, despite those counties often having more significant doctor shortages.
Yu said some of the low rates of uptake are surprising because the program could be a tool for solving physician shortages. He added that states can do more to recruit doctors through Conrad.
But states might not be taking full advantage of the program for a number of reasons, the report said, including a lack of funding or staff to manage the visa waiver application process.
Jonathan Wolfson, the chief legal officer at the Cicero Institute, said it could also be due to the requirement that most visa waiver recipients, just exiting residency, practice in underserved areas where they might be isolated.
“They may prefer those doctors have additional years of experience before putting them in that sort of setting,” he said.
Wolfson was not involved with the Conrad visa analysis, but advocates for other efforts to expand opportunities for international doctors to practice in the U.S. In the past couple of years, several states have passed such legislation, including Idaho.
This year, the Idaho legislature passed a bill creating a pathway to licensure for qualified doctors with international training. Similarly, in 2022, the Colorado legislature passed a bill mandating that the state board create a pathway for international doctors to practice.
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Nevada Public Radio, Boise State Public Radio in Idaho, KUNR in Nevada, KUNC in Colorado and KANW in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.
