Virus-Linked Doctor Shortage Has Physicians Demanding Visa Fixes

Amid a shortage of thousands of primary care doctors, an outdated system has stymied pathways for immigrant physicians to secure long-term employment in the U.S., House lawmakers will hear from health-care experts Tuesday.

“For many international physicians, the pathway to permanent residency will take decades, spanning one’s career, limiting our career mobility, and jeopardizing the immigrant status of our children,” Raghuveer Kura, a nephrologist and a founder of Physicians for American Healthcare Access, will tell the House Subcommittee on Immigration and Citizenship in written testimony released ahead of the hearing.

Kura and other witnesses will urge lawmakers at the hearing to expand a program that places immigrant physicians in underserved areas, among other steps to incentivize those workers to take jobs the U.S. is struggling to fill. They’ll also urge lawmakers to pass legislation tackling green card backlogs and to provide permanent status for recipients of Deferred Action for Childhood Arrival to help fill health-care jobs.

The Covid-19 pandemic highlighted an ongoing challenge for the American healthcare system—it’s not training enough primary and specialty physicians to meet the needs of the population.

However, thousands of immigrant doctors who train in U.S. residency programs each year face serious barriers to remain in the country and help relieve the shortage. That’s despite lobbying by hospital groups and immigrant advocates throughout the pandemic.

The U.S. immigration system “is suboptimal at best in its ability to attract and retain the most talented physicians in the world to treat and care for Americans,” Kristen Harris, an attorney at Harris Immigration Law LLC, will tell lawmakers.

Serving High-need Areas

Most foreign physicians come to the U.S. through J-1 exchange visas or H-1B “specialty occupation” visas. But there are a limited number of H-1B slots available each year and J-1 visa holders are subject to a two-year requirement that they return to their home countries before they can seek permanent status in the U.S.

Physicians like Kura, who practices in Poplar Bluff, Mo., can get around that requirement by opting for service-based waivers such as the Conrad 30 Waiver Program, which allows doctors to remain in the U.S. if they practice in federally-designated health professional shortage areas or underserved areas.

The program has brought 15,000 physicians to underserved communities in the last 15 years, David J. Skorton, president and CEO of the Association of American Medical Colleges, will say in his written testimony.

Yet waiver limits for the program, currently set at 30 slots for each state, haven’t been raised in decades. The AAMC and immigration advocates are pressing Congress to pass reauthorization legislation (H.R. 3541, S. 1810) that would base the number of available slots in the Conrad program on demand in each state.

Those advocates are also calling for passage of the Healthcare Worker Resilience Act (H.R. 2255, S. 1024), which would recapture unused immigrant visas and designate 25,000 for nurses and 15,000 for physicians. Despite bipartisan support, the bill has failed to move forward in the last two legislative sessions.