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Health departments' use of international medical graduates in physician shortage areas.

The Conrad "State 20" Program places international medical graduates (IMGs) on J-1 visas in health professional shortage areas (HPSAs). The authors surveyed program administrators from health departments in forty-two participating states. Problems reported include unfair working conditions and compensation for physicians. Federal immigration agencies were reported to be unresponsive and difficult. Employers seem to be more satisfied than physicians with the program. After the exit of the U.S. Department of Agriculture as a sponsor for physician J-1 visa waivers, Congress expanded the Conrad Program, signaling a continued reliance on IMGs to serve in shortage areas.