Many international physicians complete U.S. residency or fellowship training on a J-1 visa, which often includes a two-year home residency requirement. The rule is designed to encourage physicians to return their skills to their home countries after completing U.S. training.

In practice, however, it often becomes a barrier for doctors who want to continue working in the U.S. Before they can move forward with long-term employment or a Green Card, they must first obtain a waiver of that requirement. The Conrad 30 program is the most common waiver pathway.

What is a J-1 waiver?

A J-1 waiver allows certain physicians to avoid the two-year home residency requirement under section 212(e). Without the waiver, many J-1 exchange visitors have to return to their home country for two years before becoming eligible for certain U.S. immigration benefits, including H-1B status and permanent residence.

Most waivers are granted based on specific qualifying grounds and often require government agency sponsorship. The most common pathway for physicians is the Conrad 30 program. 

What is the Conrad 30 waiver program?

The Conrad 30 program allows each U.S. state to sponsor up to 30 foreign physicians per year for a J-1 waiver of the two-year home residency requirement. In exchange, the physicians must agree to work full-time for at least three years in a federally designated underserved area. If the requirements are satisfied, the state health department recommends a waiver of the home residency obligation to the federal government.

Eligible Conrad 30 positions are typically located in:

• Rural communities
• Urban medically underserved areas (MUAs)
• Federally designated Health Professional Shortage Areas (HPSAs)

Because the program is administered at the state level, requirements, timelines, and specialty priorities vary significantly by jurisdiction.

Who qualifies for a J-1 waiver through Conrad 30?

To qualify for a Conrad 30 waiver, physicians generally must:

• Complete or be in the final stages of  a J-1 residency or fellowship program in the U.S.
• Have a full-time job offer in a federally designated Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or other qualifying underserved location. 
• Agree to work for at least three years in the approved position. 
• Practice in a specialty needed by the sponsoring state or underserved community determined by state health authorities.
• Receive support from both a state health department and a qualifying employer.

Is the Conrad 30 program available in June 2026?

As of June 2026, the Conrad 30 program’s status remains uncertain after its statutory authorization expired on September 30, 2025.

USCIS may continue processing certain pending cases, but new eligibility depends on congressional reauthorization.

A bipartisan bill called “Conrad State 30 and Physician Access Reauthorization Act” is currently pending in Congress. If passed, the program would be extended for three years and adjust annual waiver limits for states.

Other ways to get a J-1 waiver

While Conrad 30 is the most common option, it is not the only pathway for physicians to get a J-1 waiver. Some physicians may also qualify through:

• Interested Government Agency (IGA) waivers: granted through sponsorship by a U.S. federal agency, such as the Department of Health and Human Services or the Department of Veterans Affairs. These waivers are not subject to a numerical cap. 
• Hardship waivers: This is an option if you have a U.S. citizen or permanent resident spouse or child, and they would suffer extreme hardship if you were required to leave the U.S.
• Persecution-based waivers: You must demonstrate a credible fear of persecution in your home country based on a protected group.

Each of these options has different eligibility standards and is less frequently used than Conrad 30 in physician cases. 

How to apply for a Conrad 30 J-1 waiver

The Conrad 30 process involves both a state health department and the federal government, and the steps generally run in this order:

1. Secure a qualifying job. You will need a full time employment offer in a federally designated Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or an area serving a significant underserved population The employer must agree to a binding contract for at least the three year service obligation. 
2. Complete Form DS-3035. This is the J-1 Visa Waiver Application. You’ll also need to provide a number of documents to prove you hold a valid immigration status and meet program eligibility.
3. Apply through your state health department. Each state sets its own application window, checklist, and review timeline. It’s reasonable to budget two to three months for the state review process. Having a contingency plan in case of denial is also worth considering.
4. Wait through application review. If the state health department approves the request, it forwards a recommendation to the U.S. The Department of State, the DOS then makes a final recommendation to USCIS to either grant or deny the waiver. 
5. Change of status to H-1B. Once the waiver is approved, you can change from J-1 to H-1B or an equivalent visa status.
6. Complete your service requirement. You must complete at least three years of continuous full-time employment in the approved position at the designated underserved location.

Planning for a J-1 waiver and beyond

A J-1 waiver can shape your immigration options for years to come, so it’s important to think beyond the waiver itself. After completing your three-year service commitment, you may have more flexibility to change employers, relocate, or change your practice focus. You can also pursue other work visas, like the H-1B, or long-term immigration options by transitioning from a J-1 to a Green Card.

Manifest Law helps physicians navigate every stage of this journey, from J-1 waiver applications and H-1B transitions to long-term Green Card planning. Whether you’re evaluating Conrad 30 opportunities or are already in the process of applying, our team can help you build a strategy tailored to your personal and career goals.

👉 If you’re ready to explore your options, request a consultation with Manifest Law’s immigration attorneys today.

FAQs about J-1 waivers for physicians

What’s the difference between Conrad 30 waivers and IGA waivers?

Conrad 30 waivers are state sponsored J-1 waivers administered by state health departments and generally limited to 30 physicians per state per year. Interested Government Agency ( IGA) waivers are sponsored by a qualifying federal agency—usually, the U.S. Department of Health and Human Services (HHS) or the Appalachian Regional Commission (ARC). These don’t have an annual cap. 

Does a J-1 waiver automatically lead to a Green Card?

No, a J-1 waiver doesn’t guarantee a Green Card. It only removes the two-year home-residency requirement, allowing you to pursue other visas and permanent residence. Any Green Card process, such as the EB-1 or EB-2, requires a separate application that needs to meet that visa eligibility criteria.

Can a physician’s spouse and children stay in the U.S. during Conrad 30 service?

Yes. Spouses and children can receive J-2 or H-4 status, depending on the physician’s status. Their status generally ends with the physician’s service period.

Is Conrad 30 currently available to all J-1 physicians?

Not necessarily. The Conrad 30 program’s statutory authorization expired on Oct. 1, 2025.  USCIS continues to process J-1 applications for physicians who previously held J-1 status prior to October 1, 2025. Physicians who entered J-1 status before that date remain eligible, however   USCIS is not currently processing new petitions pending congressional reauthorization of the program.