69–006 

110TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 110–646 

TO EXTEND FOR 5 YEARS THE PROGRAM RELATING TO WAIVER OF THE 

FOREIGN COUNTRY RESIDENCE REQUIREMENT WITH RESPECT TO 

INTERNATIONAL MEDICAL GRADUATES 

MAY 15, 2008.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. CONYERS, from the Committee on the Judiciary, 

submitted the following 

R E P O R T 

[To accompany H.R. 5571] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on the Judiciary, to whom was referred the bill 

(H.R. 5571) to extend for 5 years the program relating to waiver 

of the foreign country residence requirement with respect to international medical graduates, having considered the same, reports 

favorably thereon without amendment and recommends that the 

bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 1 

Background and Need for the Legislation ............................................................. 2 

Hearings ................................................................................................................... 2 

Committee Consideration ........................................................................................ 2 

Committee Votes ...................................................................................................... 2 

Committee Oversight Findings ............................................................................... 3 

New Budget Authority and Tax Expenditures ...................................................... 3 

Congressional Budget Office Cost Estimate .......................................................... 3 

Performance Goals and Objectives ......................................................................... 4 

Constitutional Authority Statement ...................................................................... 4 

Advisory on Earmarks ............................................................................................. 4 

Section-by-Section Analysis .................................................................................... 4 

Changes in Existing Law Made by the Bill, as Reported ..................................... 4 

PURPOSE AND SUMMARY

H.R. 5571 reauthorizes the Conrad 30 J Waiver Program and extends the waiver provision for 5 years to ensure that States can 

recommend such a waiver for areas with a shortage of doctors. The 

Conrad 30 J Waiver Program allows States to ensure medically underserved areas can hire physicians who receive medical training 


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in the United States on a J-1 visa for 3 years where there is no 

other doctor available to fill the position. 

BACKGROUND AND NEED FOR THE LEGISLATION

The Immigration and Nationality Act allows for foreign doctors 

to train in the United States under the ‘‘J-1’’ visa program, otherwise known as nonimmigrants in the Exchange Visitor Program. 

This Exchange Visitor Program seeks to promote peaceful relations 

and mutual understanding with other countries through educational and cultural exchange programs. Accordingly, many exchange visitors, including doctors in training, are subject to a requirement that they must return to their home country to share 

with their countrymen the knowledge, experience, and impressions 

gained during their stay in the United States. Unless U.S. Citizenship and Immigration Services (USCIS) approves a waiver of this 

requirement in those cases, the exchange visitors must depart from 

the United States and live in their home country for 2 years before 

they are allowed to apply to return to the United States. 

A waiver of the 2-year foreign residency requirement (commonly 

referred to as the ‘‘Conrad 30 J Waiver Program’’) is available for 

doctors who have trained in the United States under the J-1 visa 

if a State or an interested government agency sponsors the physician exchange visitor to work in a health manpower shortage area 

for 3 years as a nonimmigrant in H-1B status (temporary worker 

in a specialty occupation). The Secretary of Health and Human 

Services determines which areas have a health manpower shortage. 

The current authorization for the Conrad 30 J Waiver Program 

will sunset on June 1, 2008. H.R. 5571 would extend this waiver 

for 5 years to ensure that States can recommend such a waiver for 

areas with a shortage of doctors. The Conrad 30 J Waiver Program 

allows States to ensure medically underserved areas can hire physicians who received medical training in the United States on a J1 visa for 3 years where there is no other doctor available to fill 

the position. 

HEARINGS

The Committee on the Judiciary held no hearings on H.R. 5571. 

COMMITTEE CONSIDERATION

On March 12, 2008, the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law met in 

open session and ordered the bill, H.R. 5571, favorably reported, 

without amendment, by voice vote, a quorum being present. On 

April 2, 2008, the Committee met in open session and ordered the 

bill, H.R. 5571, favorably reported without amendment, by voice 

vote, a quorum being present. 

COMMITTEE VOTES

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that there were 

no recorded votes during the Committee’s consideration of H.R. 

5571. 


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COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that the findings 

and recommendations of the Committee, based on oversight activities under clause 2(b)(1) of rule X of the Rules of the House of Representatives, are incorporated in the descriptive portions of this report. 

NEW BUDGET AUTHORITY AND TAX EXPENDITURES

Clause 3(c)(2) of rule XIII of the Rules of the House of Representatives is inapplicable because this legislation does not provide new 

budgetary authority or increased tax expenditures. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

In compliance with clause 3(c)(3) of rule XIII of the Rules of the 

House of Representatives, the Committee sets forth, with respect to 

the bill, H.R. 5571, the following estimate and comparison prepared 

by the Director of the Congressional Budget Office under section 

402 of the Congressional Budget Act of 1974: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, April 14, 2008. 

Hon. JOHN CONYERS, Jr., Chairman, 

Committee on the Judiciary, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 5571, a bill to extend for 

5 years the program relating to waiver of the foreign country residence requirement with respect to international medical graduates. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Mark Grabowicz, who 

can be reached at 226–2860. 

Sincerely, 

PETER R. ORSZAG, 

DIRECTOR. 

Enclosure 

cc: 

Honorable Lamar S. Smith. 

Ranking Member 

H.R. 5571—A bill to extend for 5 years the program relating to 

waiver of the foreign country residence requirement with respect 

to international medical graduates. 

CBO estimates that implementing H.R. 5571 would result in no 

significant net cost to the Federal Government. The bill would affect direct spending, but we estimate that any effects would be insignificant. Enacting the bill would not affect revenues. 

H.R. 5571 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would 

not affect the budgets of State, local, or tribal governments. 

Current law permits foreign students attending medical school in 

the United States to remain after graduation if they agree to work 


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for at least 3 years in certain regions of the country considered to 

be underserved by physicians or if they accept employment with 

certain Federal agencies. The program is scheduled to expire on 

June 1, 2008; H.R. 5771 would extend it through June 1, 2013. 

Based on the participation of foreign medical students in the targeted regions or Federal agencies in recent years, CBO expects that 

the bill’s provisions would affect fewer than 2,000 persons annually. The Department of Homeland Security (DHS) would collect 

fees to provide work permits for those individuals. Those fees are 

classified as offsetting receipts (a credit against direct spending). 

The department is authorized to spend such fees without further 

appropriation, so the net impact on DHS spending would be insignificant for each year. 

The CBO staff contact for this estimate is Mark Grabowicz. This 

estimate was approved by Theresa Gullo, Deputy Assistant Director for Budget Analysis. 

PERFORMANCE GOALS AND OBJECTIVES

The Committee states that pursuant to clause 3(c)(4) of rule XIII 

of the Rules of the House of Representatives, H.R. 5571, will extend the program relating to waiver of the foreign country residence requirement with respect to international medical graduates 

(the Conrad 30 J Waiver Program) for 5 years, to continue promoting delivery of critically needed medical services to people in 

the United States lacking adequate access to physician care, including vulnerable populations in low-income and impoverished 

communities, or in communities with high infant mortality rates or 

exhibiting other signs of a lack of necessary physician services. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds the authority for this legislation in article I, section 8, clause 4 of the Constitution. 

ADVISORY ON EARMARKS

In accordance with clause 9 of rule XXI of the Rules of the House 

of Representatives, H.R. 5571 does not contain any congressional 

earmarks, limited tax benefits, or limited tariff benefits as defined 

in clause 9(d), 9(e), or 9(f) of Rule XXI. 

SECTION-BY-SECTION ANALYSIS

The following discussion describes the bill as reported by the 

Committee. 

Sec. 1. Extension of Waiver Program. This section extends the 

Conrad 30 J Waiver Program for 5 years, until June 1, 2013. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 


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IMMIGRATION AND NATIONALITY TECHNICAL 

CORRECTIONS ACT OF 1994 

* * * * * * * 

TITLE II—TECHNICAL CORRECTIONS 

OF IMMIGRATION LAWS 

* * * * * * * 

SEC. 220. WAIVER OF FOREIGN COUNTRY RESIDENCE REQUIREMENT 

WITH RESPECT TO INTERNATIONAL MEDICAL GRADUATES. 

(a) * * * 

* * * * * * * 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall apply to aliens admitted to the United States under section 

101(a)(15)(J) of the Immigration and Nationality Act, or acquiring 

such status after admission to the United States, before, on, or 

after the date of enactment of this Act and before øJune 1, 2008¿ 

June 1, 2013. 

* * * * * * * 

Æ 


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