By 2036, the Association of American Medical Colleges predicts a shortage of 86,000 doctors. That means longer wait times for care, stressed-out physicians caring for more than a normal number of patients and more health care “deserts” where care is not available.
As we detailed in a blog post about the nation’s nursing shortage, immigration can help with the supply of doctors, too.
Foreign medical residents are essential for filling critical employment gaps in the health care system. Currently, approximately one quarter of all doctors practicing in the United States are immigrants. In metropolitan areas such as New York or Boston, that number is closer to one third. According to the Associated Press, more than 6,600 foreign-born international medical residents matched into U.S. programs this year, the highest number on record.
In fact, our health care system is dependent on immigrants. It is estimated more than one million immigrants work in health care in the United States, many caring for elderly or disabled Americans. This includes medical professionals as well as those who help with food service, maintenance and other support services.
Still, the supply is falling short. This is true for all health care, including primary care physicians and doctors practicing in specialties. It is especially acute in geriatric specialties. Facilities such as nursing homes, already facing labor shortages, have seen the need exacerbated by strict immigration policies. In addition to tens of thousands of deportations, the Trump administration instituted a travel ban on foreign nationals from 12 countries and partial restrictions for citizens of seven countries, shutting down a pipeline of workers that serve in support roles, as well as some medical professionals.
In addition, the administration has limited student visas, affecting the number of immigrants who can study to be doctors, and created an atmosphere that could be perceived as unfriendly to immigrants, driving away some who might be interested in working in the United States.
Specifically for doctors, a three-week pause by the Trump administration on processing J-1 visas in May and June led to backed up appointments and a delay in doctors entering the country for training. The government paused so it could enhance vetting procedures, including instituting reviews of social media accounts. These enhancements are likely to exclude some potential physicians from entering and working in the United States at a time when they are needed. The Health Resources and Services Administration revealed earlier this year that 77 million people currently live in health care deserts.
Visa Options for Physicians
Fortunately, employers have several visa options when it comes to filling the void of doctors:
J-1 Visa: The most common option for international medical graduates to engage in residency or fellowship training in the United States. The Educational Commission for Foreign Medical Graduates (ECFMG) sponsors many J-1 visas for clinical training. Applicants must have ECFMG Certification, pass the U.S. Medical Licensing Examination (USMLE) Steps 1 and 2, and secure a position in a U.S. training program. J-1 visa holders typically must return home for two years after completing their training, unless they are able to secure one of limited options for a J-1 waiver.
H-1B Visa: This visa allows foreign physicians to be temporarily employed in the United States if they have a job offer for full-time or part-time employment. Unlike the J-1 visa, the H-1B does not require one to return to their home country after their employment.
O-1 Visa: This visa is for individuals with extraordinary ability in their field. They must demonstrate substantial accomplishments as a physician to qualify.
TN Visa: This visa is for professionals from Canada and Mexico who come to work in the United States, but for physicians, is limited to teaching or research (i.e., non-clinical) positions only.
Health Care Employers Must Be Proactive on Immigration
A silver tsunami is coming. Approximately 11,200 U.S. residents turn 65 every day — about 4.1 million new senior citizens every year. Lifespans are increasing. According to the Centers for Disease Control, 6 out of 10 adults have at least one chronic health condition.
Today’s challenges are tomorrow’s crisis. Immigrants fill critical roles in the U.S. health care system. Given workforce shortage projections, it is time for health care employers to get ahead of the problem. While hiring a foreign worker presents many unique legal challenges, it is essential to remain competitive not only in today’s global marketplace, but in the future. Health systems must make every effort to attract and retain top talent from around the world.
Harris Beach Murtha’s Immigration Law Practice Group represents large hospital systems, university-affiliated hospitals and medical practices throughout the Northeast Corridor and western and upstate New York. The attorneys on our immigration team represent health care employers and possess specialized knowledge in health care-related immigration matters.
Our immigration lawyers focus on strategies – including immigrant visas for permanent U.S. resident status and temporary visas for foreign nationals – to ensure that health care organizations are able to hire, transfer and retain the brightest and best non-U.S. talent.
If you have questions about visa for doctors or other health care workers, please contact attorney Brendan Venter at (518) 701-2773 and bventer@harrisbeachmurtha.com, another member of the Harris Beach Murtha Immigration Practice Group, or the Harris Beach Murtha attorney with whom you most frequently work.
This alert does not purport to be a substitute for advice of counsel on specific matters.
Harris Beach Murtha’s lawyers and consultants practice from offices throughout Connecticut in Bantam, Hartford, New Haven and Stamford; New York state in Albany, Binghamton, Buffalo, Ithaca, New York City, Niagara Falls, Rochester, Saratoga Springs, Syracuse, Long Island and White Plains, as well as in Boston, Massachusetts, and Newark, New Jersey.
