How Delaware Is Building a Lasting Healthcare Workforce One Relationship at a Time

From filling all 30 Conrad 30 slots to building a lasting legacy, Delaware is turning physician recruitment into long-term community investment through relationships, collaboration and retention.

Not long ago, Delaware was known as a state where it was relatively easy for international physicians to obtain a Conrad 30 J-1 Visa Waiver.

For the first time in state history, Delaware filled all 30 of its Conrad waiver slots. This milestone reflects years of intentional relationship-building, education, and collaboration.

That transformation didn't happen because physician shortages suddenly disappeared. It happened because Delaware changed the way it approached recruitment through the Conrad program.

Under the leadership of Stephanie Nostrom, Delaware's Conrad 30 program shifted from simply administering waiver applications to actively connecting people. Stephanie has worked hard to educate employers, sharing the program could strengthen their physician workforce. At the same time, Stephanie ensured that physician residents and fellows were introduced to opportunities in rural Delaware before they began their job searches. Finally, Stephanie supported immigration attorneys, employers, and partners worked together to remove barriers and make the Conrad process easier to navigate in her state.

For Stephanie, success has never been measured by paperwork or waiver approvals. It's measured by the people behind them.

"In a world that is vastly digital and automated, the best thing I can do is be accessible," Stephanie said.

Her personal approach has helped Delaware create something every state hopes to achieve: not simply recruiting physicians, but supporting them both personally and professionally in the communities they serve.

Two stories, in particular, show what that looks like.

A Community That Invests in Physicians

For Bayhealth Medical Center, which serves central and southern Delaware, the Conrad 30 program has become an integral part of long-term workforce planning.

Like many health systems serving rural and underserved communities, Bayhealth faced persistent vacancies in hard-to-recruit specialties. Vacant positions affected clinical service lines, limited patient access, and placed additional strain on existing providers.

The Conrad 30 J-1 Visa Waiver Program changed that. Rather than viewing international recruitment as a short-term solution, the organization incorporated the Conrad program into its broader strategy for expanding clinical services, improving specialty coverage, and ensuring patients have access to care when they need it.

By incorporating international physician recruitment into long-term workforce planning, Bayhealth has expanded access to an international talent pool, strengthened specialty coverage, reduced recruitment timelines, and increased access to care throughout the communities it serves.

But leaders at Bayhealth believe the real key isn't simply recruiting physicians, it's creating an environment where physicians want to stay. Their effort demonstrates what happens when an organization invests not only in recruiting physicians, but in helping them thrive.

A collaborative culture, strong leadership support, dedicated immigration assistance, and intentional partnerships have resulted in remarkable physician retention beyond their initial service commitments.

For Bayhealth, international recruitment isn't a temporary fix, it’s a long-term investment in healthier communities. 

It's about the employer willing to invest in that physician's future. And it's about the state leaders who understand that recruiting a physician is only the beginning. Creating the conditions for them—and their families—to build a life in the community is what transforms a temporary solution into a permanent one.

That is the story unfolding across rural Delaware.

For Bayhealth, international physician recruitment isn't simply another hiring strategy—it's become an essential part of ensuring patients have access to care.

A Physician Who Invested Back

Nearly thirty years ago, Jona Gorra, M.D., FACP, arrived in the United States with the same dream shared by countless international medical graduates: care for patients.

After completing her Internal Medicine training at Columbia University, Dr. Gorra searched for opportunities through the Conrad program. Delaware wasn't originally part of her plan, but when other opportunities fell through, she discovered something unexpected: possibility.

Unable to find the practice opportunity she envisioned, Dr. Gorra created one. With determination, support from her family, and an unwavering commitment to providing quality medical care, she opened her own practice in rural Sussex County.

Her first day? She saw zero patients.

Instead of focusing on the obstacles, she focused on caring for every patient exceptionally well. Patients noticed. And as happens in a small town, word spread. They told their neighbors, families referred friends. The community welcomed her, and over time she became much more than a primary care physician.

She served patients in nursing homes, became medical director for three facilities, cared for hospitalized patients before the era of hospitalists, and built lasting relationships throughout the community.

Now, nearly three decades later, Dr. Gorra owns three rural practices that continue serving patients across Sussex County. Today, many of the physicians practicing alongside her are international medical graduates themselves.

One of her longtime physician partners first joined the practice through the Conrad program and has since become a U.S. citizen while continuing to care for the same community.

Most recently, Dr. Gorra recruited another J-1 physician she connected with through a Conrad presentation Stephanie Nostrom gave at Jefferson Einstein medical school, during which Stephanie mentioned 3RNET. The physician registered through 3RNET and Dr. Gorra was able to take the lead from there! 

What made the difference wasn't simply finding a qualified physician. It was helping an entire family envision a future in Delaware.

When the physician's pharmacist spouse was able to find employment locally, it reinforced what Dr. Gorra has learned through decades of experience, and what any seasoned recruiter knows all too well: recruiting physicians means recruiting families.

"When physicians see that their spouses can thrive, their children can attend great schools, and they can build a life in the community, they're much more likely to stay,” Dr. Gorra said. That philosophy extends into how she leads her practice today. New physicians become partners without the traditional financial burdens often associated with ownership. Dr. Gorra absorbs much of the administrative responsibility herself so physicians can focus on what inspired them to enter medicine in the first place: taking great care of patients, and then going home to spend time with their families. She has created a master class in providing the opportunity for “work-life” balance amongst her team. 

Her approach is rooted in service, mentorship, and sustainability. A perfect recipe for taking a rural community from surviving to thriving. 

Perhaps the most remarkable chapter of Dr. Gorra's story isn't that she stayed. It's that she's now helping others do the same.

The Connector Behind the Scenes

Stories like Bayhealth's and Dr. Gorra's don't happen by accident. Behind many of these successful matches is Delaware's Conrad 30 program, led by professionals who believe relationships matter just as much as regulations.

Rather than simply processing applications, Delaware's program focuses on connecting people. State leaders spend time educating employers about the program, presenting to residents and fellows, introducing physicians directly to recruiters, answering questions personally, and helping employers navigate the immigration process from beginning to end.

That relationship-centered approach helped Delaware achieve a milestone this year by filling all 30 Conrad 30 waiver slots for the first time in state history.

But for those involved, success isn't measured only by filled positions. It's measured by the physician who decides to stay. The practice owner who recruits the next generation. The hospital able to expand patient services. The family that gains a trusted primary care physician. And the rural patient who finally has access to care close to home.

First. Next. Forever.

Every physician recruited through the Conrad 30 program begins with a first opportunity.

Many go on to become the next generation of community leaders, mentors, and employers.

Some, like Dr. Gorra, create opportunities for those who follow behind them.

That is how sustainable rural healthcare is built: one relationship, one community, one physician at a time.