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Conrad 30 Program for J-1 Physicians: How It Works in 2026

October 27, 2026

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October 27, 2026

GWP IMMIGRATION LAW

Three years in an underserved community, in exchange for staying in the U.S.

How the Conrad 30 waiver lets a J-1 doctor skip the two-year home residency rule, and what it costs in commitment.

The Conrad 30 program for J-1 physicians is still running in 2026, but only on short-term extensions from Congress. Each state still has 30 waivers per fiscal year, not the 35 that a pending bill would allow.

Updated October 27, 2026 · GWP Law · Las Vegas, NV

THE CONTEXT

What Is the Conrad 30 Program for J-1 Physicians?

It is a state-sponsored waiver that lets a J-1 doctor stay in the U.S. on an H-1B by working 3 years in an underserved area.

The Conrad 30 program for J-1 physicians exists because most foreign medical graduates who train in the U.S. on a J-1 visa must return home for two years before they can get an H-1B, an L visa or a green card. INA § 212(e), 8 U.S.C. § 1182(e)

Doctors who came for graduate medical education cannot use the usual “no objection” waiver from their home country. The Conrad 30 program, created by INA § 214(l), gives them another way out. INA § 214(l), 8 U.S.C. § 1184(l)

Each state health department may request up to 30 waivers per federal fiscal year, which runs from October 1 to September 30. In exchange, the doctor agrees to practice where the state has a shortage of physicians. USCIS, Conrad 30 Waiver Program

Is the Conrad 30 Program Still Active in 2026?

Yes. Congress extended it through December 11, 2026, and states are accepting applications, but it needs another extension after that.

The program’s authority comes with an expiration date that Congress must renew. In 2025 and 2026 it was renewed through short-term funding laws instead of a long-term reauthorization.

The current extension is the Continuing Appropriations and Extensions Act, 2027, signed on September 2, 2026, which keeps the program running through December 11, 2026. Public Law 119-103

The Congressional Budget Office confirmed that this law extends “the Conrad-30 waiver program” through that date. CBO, Cost Estimate for the Continuing Appropriations and Extensions Act, 2027

You may read online that the program now has 35 slots per state, bans non-compete clauses and gives doctors new job protections. Those changes come from the Conrad State 30 and Physician Access Reauthorization Act, which has not become law. S. 709, 119th Congress

Until that bill or a similar one passes, the statute still caps each state at 30 waivers. Some states, such as Texas and Florida, already ban non-compete clauses in their own program rules.

THE REQUIREMENTS

Who Qualifies and What You Must Commit To

The waiver is a contract with the government. These are the federal minimums; each state may add its own.

Requirement

What the law requires

Who can apply

A foreign medical graduate who received J-1 status to pursue graduate medical education or training

Sponsor

The public health department of a U.S. state or territory, plus a health facility with a bona fide job offer

Work schedule

Full-time, at least 40 hours per week, for at least 3 years

Start date

Employment must begin within 90 days of the waiver approval

Location

A Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA) or a facility serving a Medically Underserved Population (MUP)

“Flex” slots

Up to 10 of the 30 waivers may go to facilities outside a shortage area that serve patients who live in one, if the state uses them

Status during service

The 3 years must be served in H-1B status, which is exempt from the H-1B cap and lottery

Home-country funding

If your home government funded your exchange program, it must send a No Objection Statement

Source: INA § 214(l); 8 CFR § 212.7(c)(9); U.S. Department of State, How to Apply for a Waiver.

THE PROCESS

How the Conrad 30 Waiver Process Works, Step by Step

Most doctors start looking for a qualifying job 12 to 15 months before their residency or fellowship ends. The state deadline, not your graduation date, sets the pace.

Step 1 · Job offerFind an employer in a designated shortage area willing to sponsor the waiver and the H-1B, and sign a 3-year, 40-hour contract that meets federal and state rules.

Step 2 · DS-3035Complete the online J visa waiver recommendation application, get your case number and pay the $120 State Department fee.

Step 3 · State applicationSubmit the state’s packet during its application window, with the contract, the employer’s letter and proof of the shortage designation.

Step 4 · State DepartmentIf the state approves, it sends its letter to the State Department’s Waiver Review Division, which reviews the case and sends its recommendation to USCIS.

Step 5 · USCIS decisionUSCIS is the final waiver authority and issues the approval notice.

Step 6 · H-1BThe employer files Form I-129 for a cap-exempt H-1B, and your J-2 family members file to change to H-4.

Source: U.S. Department of State, Waiver Processing Fee; USCIS, Form I-129; USCIS, Form I-539.

The State Department estimates 6 to 10 weeks from the moment its Waiver Review Division receives a complete package. USCIS time is added on top of that.

The timing that catches most doctors is the state window. Texas held its priority window from September 1 to 15, 2026, with a $3,000 state fee. Texas DSHS, FY2027 Conrad 30 Policy Manual

California’s cycle runs from October 1 to October 31, 2026, gives priority to rural sites and does not offer flex slots. California HCAI, J-1 Visa Waiver Program

Our guide to Conrad 30 slots by state compares the most competitive states with those that usually have room.

One more point on the H-1B: a change of status from J-1 to H-1B inside the U.S. is not subject to the $100,000 H-1B payment created by a 2025 presidential proclamation, according to USCIS guidance. Federal courts have also blocked that payment while litigation continues.

THE RISKS

Common Mistakes That Can Cost You the Waiver

Without a plan

With a plan

Starting the job search in the final months of residency and missing the state window

Securing an offer 12 to 15 months ahead and filing on the first day the state opens

Signing a contract missing the 40-hour, 3-year or 90-day terms

Reviewing the contract against federal rules and the state’s checklist before signing

Assuming the employer’s site is in a shortage area

Confirming the HPSA, MUA or MUP designation for the exact practice address

Letting J-1 status lapse while waiting for USCIS

Timing the H-1B petition so you remain in valid status until the change takes effect

Treating the waiver as a green card

Planning the permanent residence strategy from year one

Source: 8 CFR § 212.7(c)(9); U.S. Department of State, How to Apply for a Waiver.

A REAL CASE

The Contract That Almost Sank the Application

A second-year internal medicine fellow came to me with a signed offer from a clinic two months before her state’s window opened.

The contract said she would work “approximately 40 hours per week” and allowed either side to end it with 90 days’ notice, for any reason.

Both terms conflicted with the state’s rules. Her state required at least 40 hours a week and allowed termination only for cause.

We had the employer sign a corrected contract, confirmed the clinic’s HPSA designation and filed on the day the window opened. Her waiver and H-1B were approved before her fellowship ended.

Before You Apply

Check whether your exchange program was funded by your home government; if so, plan for a No Objection Statement.

Make a calendar of the application windows in every state where you would accept a job.

Confirm the shortage designation of the exact practice address, not just the employer’s main office.

Have the contract reviewed for the 3-year term, 40 hours a week, the 90-day start and any state-specific clauses.

Complete the DS-3035 early, since the state packet usually asks for the case number.

Plan the change from J-2 to H-4 for your spouse and children at the same time as your H-1B.

THE PATH FORWARD

The Waiver Is the First Step, Not the Last

The Conrad 30 program for J-1 physicians removes the two-year home residency barrier, but it does not give you permanent residence. That requires a separate process.

Read how the 3 years of service connect to residence in our guide on the Conrad 30 green card path.

If something goes wrong with your employer during those 3 years, our article on Conrad 30 extenuating circumstances explains how a transfer works.

Because the program’s authority now runs only through December 11, 2026, check its status again before you file. A lapse can affect doctors who acquired J-1 status after the cutoff set by Congress.

References

Planning a Conrad 30 waiver?

We review your contract, map the state deadlines and coordinate the waiver with your H-1B and your family’s status.

Book a Consultation →

(702) 737-7717 info@gwp.law www.gwp.law

This article is for informational purposes only and does not constitute legal advice. Consult a qualified immigration attorney before taking any action. · Last verified: October 14, 2026 · Reviewed by: Kathia Quirós, Immigration Attorney · GWP Immigration Law

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