suant to section 101(a)(15)(J) because the State has re-
quested the maximum number of waivers permitted for 
that fiscal year, the physician’s nonimmigrant status shall 
be extended for up to 6 months if the physician agrees 
to seek a waiver under this subsection (except for para-
graph (1)(D)(ii)) to work for an employer described in 
paragraph (1)(C) in a State that has not yet requested 
the maximum number of waivers. 
‘‘(B) Such physician shall be authorized to work only 
for the employer referred to in subparagraph (A) during 
the period beginning on the date on which a new waiver 
application is filed with such State and ending on the ear-
lier of— 
‘‘(i) the date on which the Secretary of Home-
land Security denies such waiver; or 
‘‘(ii) the date on which the Secretary approves 
an application for change of status under paragraph 
(2)(A) pursuant to the approval of such waiver.’’. 
(e) CONTRACT REQUIREMENTS.—Section 214(l) of 
such Act, as amended by this section, is further amended 
by adding at the end the following: 
‘‘(5) An alien granted a waiver under paragraph 
(1)(C) shall enter into an employment agreement with the 
contracting health facility or health care organization 
that— 
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‘‘(A) specifies the maximum number of on-call 
hours per week (which may be a monthly average) 
that the alien will be expected to be available and 
the compensation the alien will receive for on-call 
time; 
‘‘(B) specifies— 
‘‘(i) whether the contracting facility or or-
ganization— 
‘‘(I) has secured medical malpractice 
liability protection for the alien under sec-
tion 224(g) of the Public Health Service 
Act (42 U.S.C. 233(g)); or 
‘‘(II) will pay the alien’s malpractice 
insurance premiums; 
‘‘(ii) whether the employer will provide 
malpractice insurance for the alien; and 
‘‘(iii) the amount of such liability protec-
tion that will be provided; 
‘‘(C) describes all of the work locations that the 
alien will work and includes a statement that the 
contracting facility or organization will not add addi-
tional work locations without the approval of the 
Federal agency or State agency that requested the 
waiver; and 
‘‘(D) does not include a non-compete provision. 
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‘‘(6) An alien granted a waiver under this subsection 
whose employment relationship with a health facility or 
health care organization terminates under paragraph 
(1)(C)(ii) during the 3-year service period required under 
paragraph (1) shall be considered to be maintaining lawful 
status in an authorized period of stay during the 120-day 
period referred to in items (aa) and (bb) of subclause (III) 
of paragraph (1)(C)(ii) or the 45-day period referred to 
in subclause (III)(cc) of such paragraph.’’. 
(f) RECAPTURING WAIVER SLOTS LOST TO OTHER 
STATES.—Section 214(l) of such Act, as amended by this 
section, is further amended by adding at the end the fol-
lowing: 
‘‘(7) If a recipient of a waiver under this subsection 
terminates the recipient’s employment with a health facil-
ity or health care organization pursuant to paragraph 
(1)(C)(ii), including termination of employment because of 
circumstances described in paragraph (1)(C)(ii)(III), and 
accepts new employment with such a facility or organiza-
tion in a different State, the State from which the alien 
is departing may be accorded an additional waiver by the 
Secretary of State for use in the fiscal year in which the 
alien’s employment was terminated.’’. 
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(g) EXCEPTION TO 3-YEAR WORK REQUIREMENT.— 
Section 214(l) of such Act, as amended by this section, 
is further amended by adding at the end the following: 
‘‘(8) The 3-year work requirement set forth in sub-
paragraphs (C) and (D) of paragraph (1) shall not apply 
if— 
‘‘(A)(i) the Secretary of Homeland Security de-
termines that extenuating circumstances, including 
violations by the employer of the employment agree-
ment with the alien or of labor and employment 
laws, exist that justify a lesser period of employment 
at such facility or organization; and 
‘‘(ii) the alien demonstrates, not later than 120 
days after the employment termination date (unless 
the Secretary determines that extenuating cir-
cumstances would justify an extension), another 
bona fide offer of employment at a health facility or 
health care organization in a geographic area or 
areas which are designated by the Secretary of 
Health and Human Services as having a shortage of 
health care professionals, for the remainder of such 
3-year period; 
‘‘(B)(i) the interested State agency that re-
quested the waiver attests that extenuating cir-
cumstances, including violations by the employer of 
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the employment agreement with the alien or of labor 
and employment laws, exist that justify a lesser pe-
riod of employment at such facility or organization; 
and 
‘‘(ii) the alien demonstrates, not later than 120 
days after the employment termination date (unless 
the Secretary determines that extenuating cir-
cumstances would justify an extension), another 
bona fide offer of employment at a health facility or 
health care organization in a geographic area or 
areas which are designated by the Secretary of 
Health and Human Services as having a shortage of 
health care professionals, for the remainder of such 
3-year period; or 
‘‘(C) the alien— 
‘‘(i) elects not to pursue a determination of 
extenuating circumstances pursuant to sub-
clause (A) or (B); 
‘‘(ii) terminates the alien’s employment re-
lationship with the health facility or health care 
organization at which the alien was employed; 
‘‘(iii) demonstrates, not later than 45 days 
after the employment termination date, another 
bona fide offer of employment at a health facil-
ity or health care organization in a geographic 
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area or areas, in the State that requested the 
alien’s waiver, which are designated by the Sec-
retary of Health and Human Services as having 
a shortage of health care professionals; and 
‘‘(iv) agrees to be employed for the remain-
der of such 3-year period, and 1 additional year 
for each termination under clause (ii).’’. 
SEC. 5. ALLOTMENT OF CONRAD 30 WAIVERS. 
(a) IN GENERAL.—Section 214(l) of the Immigration 
and Nationality Act (8 U.S.C. 1184(l)), as amended by 
section 4, is further amended by adding at the end the 
following: 
‘‘(9)(A)(i) All States shall be allotted a total of 35 
waivers under paragraph (1)(B) for a fiscal year if 90 per-
cent of the waivers available to the States receiving at 
least 5 waivers were used in the previous fiscal year. 
‘‘(ii) When an allotment occurs under clause (i), all 
States shall be allotted an additional 5 waivers under 
paragraph (1)(B) for each subsequent fiscal year if 90 
percent of the waivers available to the States receiving at 
least 5 waivers were used in the previous fiscal year. If 
the States are allotted 45 or more waivers for a fiscal year, 
the States will only receive an additional increase of 5 
waivers the following fiscal year if 95 percent of the waiv-
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tionality Act (8 U.S.C. 1153(b)(2)(B)(ii)(I)) is 
amended by striking items (aa) and (bb) and insert-
ing the following: 
‘‘(aa) the alien physician agrees to 
work on a full-time basis practicing pri-
mary care, specialty medicine, or a com-
bination thereof, in an area or areas des-
ignated by the Secretary of Health and 
Human Services as having a shortage of 
health care professionals, or at a health 
care facility under the jurisdiction of the 
Secretary of Veterans Affairs; or 
‘‘(bb) the alien physician is pursuing 
such waiver based upon service at a facility 
or facilities that serve patients who reside 
in a geographic area or areas designated 
by the Secretary of Health and Human 
Services as having a shortage of health 
care professionals (without regard to 
whether such facility or facilities are lo-
cated within such an area) and a Federal 
agency, or a local, county, regional, or 
State department of public health deter-
mines the alien physician’s work was or 
will be in the public interest.’’. 
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(2) FIVE-YEAR SERVICE REQUIREMENT.—Sec-
tion 203(b)(2)(B)(ii) of the Immigration and Na-
tionality Act (8 U.S.C. 1153(B)(ii)) is amended— 
(A) by moving subclauses (II), (III), and 
(IV) 4 ems to the left; and 
(B) in subclause (II)— 
(i) by inserting ‘‘(aa)’’ after ‘‘(II)’’; 
and 
(ii) by adding at the end the fol-
lowing: 
‘‘(bb) The 5-year service requirement 
under item (aa) shall begin on the date on 
which the alien physician begins work in 
the shortage area in any legal status and 
not on the date on which an immigrant 
visa petition is filed or approved. Such 
service shall be aggregated without regard 
to when such service began and without re-
gard to whether such service began during 
or in conjunction with a course of graduate 
medical education. 
‘‘(cc) An alien physician shall not be 
required to submit an employment contract 
with a term exceeding the balance of the 5- 
year commitment yet to be served or an 
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employment contract dated within a min-
imum time period before filing a visa peti-
tion under this subsection. 
‘‘(dd) An alien physician shall not be 
required to file additional immigrant visa 
petitions upon a change of work location 
from the location approved in the original 
national interest immigrant petition.’’. 
(c) TECHNICAL CLARIFICATION REGARDING AD-
VANCED
DEGREE
FOR
PHYSICIANS.—Section 
203(b)(2)(A) of the Immigration and Nationality Act (8 
U.S.C. 1153(b)(2)(A)) is amended by adding at the end 
the following: ‘‘An alien physician holding a foreign med-
ical degree that has been deemed sufficient for acceptance 
by an accredited United States medical residency or fel-
lowship program is a member of the professions holding 
an advanced degree or its equivalent.’’. 
(d) SHORT-TERM WORK AUTHORIZATION FOR PHY-
SICIANS COMPLETING THEIR RESIDENCIES.— 
(1) IN
GENERAL.—A physician completing 
graduate medical education or training described in 
section 212(j) of the Immigration and Nationality 
Act (8 U.S.C. 1182(j)) as a nonimmigrant described 
in section 101(a)(15)(H)(i) of such Act (8 U.S.C. 
1101(a)(15)(H)(i))— 
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(A) shall have such nonimmigrant status 
automatically extended until October 1 of the 
fiscal year for which a petition for a continu-
ation of such nonimmigrant status has been 
submitted in a timely manner and the employ-
ment start date for the beneficiary of such peti-
tion is October 1 of that fiscal year; and 
(B) shall be authorized to be employed in-
cident to status during the period between the 
filing of such petition and October 1 of such fis-
cal year. 
(2) TERMINATION.—The physician’s status and 
employment authorization shall terminate on the 
date that is 30 days after the date on which a peti-
tion described in paragraph (1)(A) is rejected, de-
nied or revoked. 
(3) AUTOMATIC
EXTENSION.—A physician’s 
status and employment authorization will automati-
cally extend to October 1 of the next fiscal year if 
all of the visas described in section 101(a)(15)(H)(i) 
of such Act that were authorized to be issued for the 
fiscal year have been issued. 
(e) APPLICABILITY OF SECTION 212(e) TO SPOUSES 
AND CHILDREN OF J–1 EXCHANGE VISITORS.—A spouse 
or child of an exchange visitor described in section 
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101(a)(15)(J) of the Immigration and Nationality Act (8 
U.S.C. 1101(a)(15)(J)) shall not be subject to the require-
ments under section 212(e) of such Act (8 U.S.C. 
1182(e)). 
SEC. 7. ANNUAL CONRAD STATE 30 J-1 VISA WAIVER PRO-
GRAM STATISTICAL REPORT. 
The Director of U.S. Citizenship and Immigration 
Services shall submit an annual report to Congress and 
to the Department of Health and Human Services that 
identifies the number of aliens admitted during the most 
recently concluded fiscal year as a result of the Conrad 
State 30 J–1 Visa Waiver Program established under sec-
tions 212(e) and 214(l) of the Immigration and Nation-
ality Act (8 U.S.C. 1182(e) and 1184(l)), broken down 
by State. 
Æ 
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