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The United States is a relatively new country. However, the nation’s population is older than it has ever been, which has meaningful and important impacts on how we ensure the provision of healthcare.
Healthcare shortages across the country
The shortage of doctors and support staff in the U.S., including nurses and allied healthcare workers, is well documented and will only continue to grow. By 2034, the country will face a shortage up to 124,000 doctors! Currently, more than 95 million people in the U.S.—a third of the country’s population—live in healthcare shortage areas.
This shortage means people must travel further distances to receive care, particularly in rural areas, or wait substantially longer to be seen for care. Though there is not a singular “quick fix” to the healthcare shortage the country is facing, immigration reform is a surefire, short-term mechanism to help alleviate the issue and to begin ensuring that all Americans can secure timely and accessible healthcare.
Addressing the shortage through legislation
This shortage of access to healthcare in the U.S. is not new. In 1994, to address the staggering physician shortages in North Dakota, Senator Kent Conrad championed what became what we now know as the “Conrad State 20” J-1 waiver legislation.
Senator Conrad saw an opportunity to enhance the country’s medical system using U.S.-trained foreign national physicians by placing them into rural and urban underserved communities. Since its inception, the Conrad program has placed nearly 20,000 physicians in underserved rural and urban communities across the country.
Further, data confirms that these U.S.-trained foreign national physicians stay in underserved areas longer than their U.S. counterparts – in other words, they become part of the fabric of these underserved communities.
Yet, nearly 30 years later, the only modernization Congress has enacted to this program was to increase the limit to 30 international medicine graduates per state in 2002 (now known as the “Conrad State 30”). Due to lack of change across our immigration programs in more than 20 years, more than half of the U.S. Conrad state programs need well over 30 waivers to meet the growing underserved demands in their states.
Recent developments
Understanding the need for swift action to address this ongoing issue, members of Congress continue to advance smart reform. On March 10, 2023, Senator Amy Klobuchar reintroduced the Conrad State 30 and Physician Access Reauthorization Act (S.665) with 20 co-sponsors.
Additionally, on July 25, 2023, Representative Brad Schneider reintroduced the companion Conrad State 30 and Physician Access Reauthorization Act (H.R. 4942) with 51 co-sponsors.
Through this bill, Congress would modernize our existing Conrad program and give each state the ability to ensure that U.S.-trained foreign national physicians remain in the U.S. after their residency and fellowship training if they agree to work in underserved rural or urban areas.
Need to know more?
Lack of access to equitable healthcare is a national emergency, and effectuating smart immigration reform allows U.S.-trained foreign national doctors to immediately help address the country’s ongoing shortage of access to medical care.
For questions regarding efforts to address this healthcare shortage or how Fragomen can help through immigration solutions, please contact Partner Sarah Peterson at [email protected].
This blog was published on August 23, 2023, and due to the circumstances, there are frequent changes. To keep up to date with all the latest updates on global immigration, please subscribe to our alerts and follow us on LinkedIn, Twitter, Facebook and Instagram.
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The Montreal office has added Partner Julie Lessard and Counsel Elsa Agostinho and Sophia Khanzadian to strengthen its immigration services.
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Blog post
Latin America & the Caribbean Managing Partner Leonor Echeverria, Senior Associates Sarah Blackmore and Sonya Cole and Senior Regional Knowledge Manager Laura Weingort examine renewed energy interest in Venezuela and outline key immigration pathways, procedural constraints and strategic considerations for compliant talent deployment.
Media mentions
Senior Manager Andreia Ghimis highlights how the EU’s new migration strategy could create opportunities for employers while increasing compliance requirements.
Awards
Partner Julia Onslow-Cole is recognised in the Spears 500 guide to leading private client advisers, reflecting her experience advising high-net-worth individuals, families and global businesses on complex UK and European immigration and mobility strategies.
Media mentions
Partner Abeer Al Husseini discusses increased scrutiny of Saudi business visas in AGBI, highlighting stricter review of short-term entry used for operational work and the implications for regional employers.
Awards
Australia and New Zealand Managing Partner Teresa Liu, Partner Charles Johanes, Practice Leaders Hedvika and Leader Ben Lear and Senior Associate Hannah Scanlan are recognized in the 2026 edition of Doyle’s Guide as leading immigration practitioners in Australia.
Awards
Fragomen is ranked Band 1 for Immigration: Business in the Chambers Global 2026 Guide, marking two decades of recognition since 2006. The firm is also the only firm ranked Band 1 in the Global: Multi-Jurisdictional Immigration category and receives additional individual recognitions in the USA: Business Immigration rankings.
Media mentions
Partner Rick Lamanna provides insight to Buffalo Toronto Public Media on potential IRCC processing challenges as Canada prepares for increased visa demand ahead of the 2026 FIFA World Cup.
Blog post
Immigration Director Deirdre Murray explores the impact of upcoming employment permit changes on employers and workforce planning in Ireland.


