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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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Explore more at Fragomen
Awards
Fragomen is recognized with multiple honors at the 2026 FEM Americas EMMAs, including Outstanding Agility & Crisis Management as a Service Provider and Thought Leadership – Best Survey or Research Study of the Year for the Worldwide Immigration Trends Report 2026.
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Fragomen and Papaya Global announce a strategic partnership combining workforce technology and immigration capabilities to help organizations simplify global mobility, enhance compliance and manage cross-border workforces through a more integrated, technology-enabled approach.
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Media mentions
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Media mentions
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Senior Associate Tuğba Özyakup outlines how Europe’s Entry and Exit System (EES) introduces digital tracking of non-EU short-stay travel across the Schengen Area, requiring more proactive planning, accurate record-keeping and awareness of increased border processing times to avoid delays and overstay risks.
Awards
Fragomen is recognized with multiple honors at the 2026 FEM Americas EMMAs, including Outstanding Agility & Crisis Management as a Service Provider and Thought Leadership – Best Survey or Research Study of the Year for the Worldwide Immigration Trends Report 2026.
Blog post
Destination Services Director Christine Sperr examines how housing market reforms, rent stabilization measures and cost-of-living dynamics in Saudi Arabia are influencing workforce mobility, compensation planning and long-term settlement strategies under Vision 2030.
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Manager Dr. Adela Schmidt explains how German authorities assess past travel and business activities and why suspected unauthorized work during prior visits can lead to visa refusals and temporary entry bans.
Podcast
Partner Cosmina Morariu and Senior Director Leah Rogal discuss the mission of Fragomen’s Center for Strategy and Applied Insights and how it helps organizations and governments navigate evolving immigration policy and global talent mobility challenges.
Fragomen news
Fragomen and Papaya Global announce a strategic partnership combining workforce technology and immigration capabilities to help organizations simplify global mobility, enhance compliance and manage cross-border workforces through a more integrated, technology-enabled approach.
Video
Latin America & the Caribbean Managing Partner Leonor Echeverria explores how Latin America’s evolving immigration landscape offers accessible and flexible residence pathways for foreign nationals, highlighting key visa options, regional trends and the growing role of digital modernization across the region.
Podcast
Senior Associate Stephanie Weaver and Associate Julia Manacher continue their discussion on immigration law in popular culture, examining how television and media portray immigration processes and the realities behind common immigration storylines.
Media mentions
Partner Kevin Miner discusses how proposed H-1B salary threshold increases may raise employer costs and influence hiring strategies for specialized talent across industries.
Video
In this Mobility Minute, Manager Pierangelo D’Errico discusses Portugal’s newly approved nationality law changes and the potential impact on Golden Visa applicants and other foreign residents.
Media mentions
Partner Rajiv Naik highlights the importance of transparency, clear guidance and human oversight as AI use expands in UK immigration tribunals.
Video
Senior Associate Tuğba Özyakup outlines how Europe’s Entry and Exit System (EES) introduces digital tracking of non-EU short-stay travel across the Schengen Area, requiring more proactive planning, accurate record-keeping and awareness of increased border processing times to avoid delays and overstay risks.


