Conrad 30 Waiver for Clinical Faculty Recruits - Q&A

J-1 physicians that have pursued residency and fellowship training in the U.S. are required to return to their home country for two years at the end of their training before returning to work in the US.  The Conrad 30 waiver program is a federal program (administered by the Maryland Department of Health) to waive this home country return requirement for physicians to work in a Health Professional Shortage Area (HPSA) or a Medically Underserved Area / Population (MUA/P). Recipients of Conrad 30 waivers are required to work full time, with at least 32 hours per week spent in direct patient contact, for three years in the facilities indicated in the application.

There are 30 such waivers available to each state.  Within Maryland, each healthcare facility (address) can only apply for three waivers each year.  Our faculty work at many locations, so it is possible UMB/SOM as a whole, can receive more than 3 waivers per year. 

Any J-1 visa holder (typically just out of training) who is interested in working as a clinician in an HPSA or MUA/P.

Any position where specific criteria are met and can be appropriately documented is potentially eligible for a Conrad 30 waiver. The Conrad 30 application process is extensive and requires documentation verifying the HPSA and MUA/P status of the sites, proven difficulty in filling the position, evidence of need for the physician’s clinical expertise for the patients served at the facility, and a commitment to employing the physician for 3 years at the specified sites.

Multiple sites within UMMS are currently coded as HPSAs or MUA/Ps including:

• UMMC (Downtown and Midtown)
• UM Charles Regional Center
• UM Rehab & Ortho Institute
• UM Shore Regional Health (all locations EXCEPT Easton)
• UM Upper Chesapeake Health (Aberdeen only)

There are other HPSA and MUA/Ps in Maryland, which you can find at: https://bhw.hrsa.gov

UMSOM departments can indicate multiple locations where the physician will work. Some of those locations may be outside HPSAs or MUA/Ps. In this case, UMB may consider applying for a FLEX waiver. However, note that only ten out of thirty waivers per year can be FLEX waivers (across the state), so there are lower chances of approval if a FLEX waiver is needed.

To be eligible to apply for a Conrad 30 waiver for an incoming clinical faculty member on a J-1 visa, the Maryland Department of Health (MDH) now requires that the job posting be placed on the Healthcare Jobs in Rural and Underserved Areas | 3RNET website.  It is recommended that you consider placing any difficult to recruit positions for physicians to work at one of the above locations on this website so that you will have the option to sponsor a Conrad 30 waiver for a J-1 visa candidate. Advertising the open position with 3RNet should be done alongside postings in other venues. Otherwise, you should recruit as you normally would to ensure a good faith effort to reach all qualified candidates per the UMSOM Equitable Faculty Search Policy.  As with any other faculty recruitment, submission of a SOM Faculty Recruitment Information Sheet (FRIS) for review by the SOM Recruitment & Retention Committee is required.

To post a position on the 3RNET website, you need to first register your department as an employer on the site.  The registration process will ask you for basic information. Once complete, you will receive an email indicating they are reviewing your application.  Please keep in mind that you do not need to identify the precise locations where each physician will work when you are registering for a department account.  However, it is important to determine in advance that there is a need for a specific clinical specialty at one of the UMMS facilities located in a HPSA or MUA/P to support a Conrad 30 waiver.

Once the department account is approved, you will have to answer some questions about the location.  Here are the responses we recommend UMSOM departments use:

1. Community Type:
   Select Urban-Underserved from drop down menu
   
   
2. Select Community Population Size:
   Select 50,001-and above from drop down menu
   
   
3. Select Service Population Size:
   Select 50,001-and above from drop down menu
   
   
4. Employer Type:
   Select College or University from drop down menu
   
   
5. Employment Type (check all that apply):
   Check all of the following:
   • Allow J-1 Visa
   • Telehealth
   • Faculty/Teaching Opportunity
   • Accepts New Graduates
     
     
6. HPSA Score:
   Enter 19.

No, a SOM Faculty Recruitment Information Sheet (FRIS) must also be submitted for review by the SOM Recruitment & Retention Committee.

UMSOM Conrad 30 applications are managed through UMB’s Office of International Services (OIS).  OIS will send out a notice to departments when the application period is open (see next section for application timeline). The e-mail announcing the application period will indicate what information is required for the initial request.

OIS will work with the SOM Dean’s Office and Faculty Physicians, Inc. (FPI) to evaluate Conrad 30 requests. Shortage departments will be given priority. UMSOM/FPI will coordinate with UMMS for any physicians that will be placed at hospitals other than UMMC.

No. Conrad 30 applications are managed through UMB’s Office of International Services (OIS). Applicants can have only one employer, UMB, and cannot be employed by FPI or University of Maryland Medical Associates (UMMA) (a subsidiary of FPI).

Yes, there are special considerations when preparing an offer letter for a Conrad 30 candidate:

• Conrad 30 candidates cannot be given a non-compete.
  • The non-compete paragraph needs to be removed from the offer letter.
  • Complete the Faculty Physician Employment Contract instead of the P.A. Physician Employment Agreement.
• Since it is UMB who is sponsoring the H1B visa:
  • All salary must be paid through state/UMB sources.
  • Any extra shift or incentive pay also must be managed through UMB
  • MSP External, cannot be selected as a salary source on the salary sheet.
• There is special language included in the offer letter as follows:
  • Full name and address of each location where the candidates will work (identical to the Conrad 30 site application information)
• Offer letters and agreements are reviewed by immigration legal counsel before being finalized

• Late April - Mid May: Priority window announced for UMB to accept internal requests for Conrad 30 waivers. Departments where a clear shortage has been identified (or can be demonstrated) will be given priority, but slots are extremely limited. Placement at non-UMMC sites will be coordinated with UMMS.
• End of May to June:
  • Selected departments notified end of May.
  • Offer packets submitted/reviewed by Office of Academic Administration
  • Offer letters extended
• May - October: Department gathers required documentation for outside counsel review.
• Mid-July: OIS refers cases to outside counsel for offers that have been accepted (acceptance by mid-July at latest). Outside counsel begins work preparing the Conrad 30 application.
• October 1 - December 1: UMB submits Conrad 30 applications to MDH.
• February: Notification of decision for applications filed in October – December filing window. If MDH has not distributed all thirty waivers at this time, they will sometimes notify employers that additional slots are available.
• February - March: department prepares and submits H-1B request to OIS. Complete request due by April 1^st. See OIS website for additional information.
• July: Physicians begin work.