{"id":233658,"date":"2025-10-18T10:14:13","date_gmt":"2025-10-18T10:14:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/233658\/"},"modified":"2025-10-18T10:14:13","modified_gmt":"2025-10-18T10:14:13","slug":"how-new-foreign-worker-visa-fees-might-worsen-doctor-shortages-in-rural-america","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/233658\/","title":{"rendered":"How new foreign worker visa fees might worsen doctor shortages in rural America"},"content":{"rendered":"<p>There are <a href=\"https:\/\/www.fsmb.org\/siteassets\/advocacy\/pdf\/jmr-news-release-vol-111-no-2-final.pdf\" rel=\"nofollow noopener\" target=\"_blank\">almost 1.1 million licensed physicians<\/a> in the United States. That may sound like a lot, but the country has <a href=\"https:\/\/doi.org\/10.1136\/ewjm.173.5.348\" rel=\"nofollow noopener\" target=\"_blank\">struggled for decades<\/a> to train <a href=\"https:\/\/theconversation.com\/doctor-shortages-have-hobbled-health-care-for-decades-and-the-trend-could-be-worsening-251222\" rel=\"nofollow noopener\" target=\"_blank\">enough physicians to meet its needs<\/a> \u2013 and, in particular, to provide <a href=\"https:\/\/theconversation.com\/us-health-care-is-rife-with-high-costs-and-deep-inequities-and-thats-no-accident-a-public-health-historian-explains-how-the-system-was-shaped-to-serve-profit-and-politicians-256393\" rel=\"nofollow noopener\" target=\"_blank\">care in rural and underserved communities<\/a>. <\/p>\n<p>Foreign-born physicians have long filled that gap, reducing the overall national shortage and signing up to practice in often overlooked regions and specialties. Today, <a href=\"https:\/\/meridian.allenpress.com\/jmr\/article\/111\/2\/7\/507660\/FSMB-Census-of-Licensed-Physicians-in-the-United\" rel=\"nofollow noopener\" target=\"_blank\">1 in 5 doctors licensed to practice in the U.S.<\/a> were born and trained in another country.<\/p>\n<p>But the ability of physicians from other countries to obtain work in the U.S. may be threatened by the Trump administration\u2019s aims of limiting foreign workers. In September, Trump issued a proclamation requiring employers sponsoring foreign-born workers through a type of work visa called an <a href=\"https:\/\/www.whitehouse.gov\/presidential-actions\/2025\/09\/restriction-on-entry-of-certain-nonimmigrant-workers\/\" rel=\"nofollow noopener\" target=\"_blank\">H-1B to pay a fee of US$100,000<\/a> to the government. The White House has <a href=\"https:\/\/www.beckershospitalreview.com\/quality\/hospital-physician-relationships\/white-house-weighs-exemptions-on-hb-1-visa-fees-for-physicians\" rel=\"nofollow noopener\" target=\"_blank\">signaled doctors may be exempt<\/a> but has not clarified its position.<\/p>\n<p>As a physician and professor who studies <a href=\"https:\/\/olin.washu.edu\/faculty\/patrick-aguilar\" rel=\"nofollow noopener\" target=\"_blank\">the intersection of business and medicine<\/a>, I believe increasing restrictions on H-1B visas for physicians may exacerbate the physician shortage. To grasp why that is, it\u2019s important to understand how foreign-trained doctors became such an integral part of U.S. health care \u2013 and the role they play today. <\/p>\n<p>The roots of today\u2019s physician shortage<\/p>\n<p>The Association of American Medical Colleges, a trade association representing U.S. medical schools, estimates there will be a <a href=\"https:\/\/www.aamc.org\/news\/press-releases\/new-aamc-report-shows-continuing-projected-physician-shortage\" rel=\"nofollow noopener\" target=\"_blank\">deficit of about 86,000 physicians<\/a> in the country by 2036. <\/p>\n<p>The roots of this shortage stretch back more than a century. In 1910, a landmark study called the Flexner Report detailed <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3178858\/\" rel=\"nofollow noopener\" target=\"_blank\">significant inconsistencies in the quality of education<\/a> at American medical schools. The report resulted in the <a href=\"https:\/\/daily.jstor.org\/the-1910-report-that-unintentionally-disadvantaged-minority-doctors\/\" rel=\"nofollow noopener\" target=\"_blank\">closure of over half the country\u2019s medical schools<\/a>, winnowing their numbers down from 148 to 66 over two decades. <\/p>\n<p>As a result, <a href=\"https:\/\/www.nber.org\/papers\/w33937\" rel=\"nofollow noopener\" target=\"_blank\">the number of doctors in the U.S. declined<\/a> until new training programs emerged. Between 1960 and 1980, <a href=\"https:\/\/medicine.hofstra.edu\/pdf\/about\/medicine_doc_macy1009.pdf\" rel=\"nofollow noopener\" target=\"_blank\">40 new medical schools launched<\/a> with the help of federal funding. In 1980, a congressionally mandated assessment deemed the problem solved, but by the early 2000s, a physician shortage emerged once more. In 2006, the American Association of Medical Colleges called for <a href=\"https:\/\/www.aamc.org\/news\/press-releases\/us-medical-school-enrollment-surpasses-expansion-goal\" rel=\"nofollow noopener\" target=\"_blank\">raising medical school enrollment by 30%<\/a>. <\/p>\n<p>            <a href=\"https:\/\/images.theconversation.com\/files\/696603\/original\/file-20251015-66-l6h09h.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\" rel=\"nofollow noopener\" target=\"_blank\"><img decoding=\"async\" alt=\"Doctor looking at x-rays\" class=\"lazyload\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/10\/file-20251015-66-l6h09h.jpg\"  \/><\/a><\/p>\n<p>              Foreign-born doctors have helped the U.S. bridge a physician shortage for decades.<br \/>\n              <a class=\"source\" href=\"https:\/\/www.gettyimages.com\/detail\/photo\/doctor-royalty-free-image\/671053838\" rel=\"nofollow noopener\" target=\"_blank\">stevecoleimages\/E+ via Getty Images<\/a><\/p>\n<p>Growth in medical school enrollment hit that target in the late 2010s, but even so, the U.S. still lacks <a href=\"https:\/\/www.nrmp.org\/about\/news\/2025\/05\/nrmp-releases-2025-main-residency-match-results-and-data-report-providing-in-depth-insight-into-the-largest-residency-match-in-history\/\" rel=\"nofollow noopener\" target=\"_blank\">enough medical graduates<\/a> to fill yearslong training programs, called residencies, that early-career physicians must complete to become fully qualified to practice.     <\/p>\n<p>Especially lacking are <a href=\"https:\/\/doi.org\/10.4300\/JGME-D-24-00591.1\" rel=\"nofollow noopener\" target=\"_blank\">primary care physicians<\/a> \u2013 particularly in <a href=\"https:\/\/www.ruralhealth.us\/blogs\/2025\/06\/rural-physician-burnout-and-staffing-shortage-impact-in-2025\" rel=\"nofollow noopener\" target=\"_blank\">rural areas<\/a>, where there are <a href=\"https:\/\/www.aamc.org\/about-us\/mission-areas\/health-care\/rethinking-rural-health\" rel=\"nofollow noopener\" target=\"_blank\">one-third as many physicians per capita<\/a> as in urban areas. <\/p>\n<p>Opportunities for foreign-born doctors<\/p>\n<p>Even as the U.S. built up medical school enrollment in the 1960s and 1970s, the government joined other countries such as the U.K. and Canada in creating immigration policies that <a href=\"https:\/\/doi.org\/10.1186\/1747-5341-3-24\" rel=\"nofollow noopener\" target=\"_blank\">drew physicians from developing countries<\/a> to practice in underserved areas. Between 1970 and 1980, <a href=\"https:\/\/www.phg.com\/2000\/01\/physician-statistics-summary\/\" rel=\"nofollow noopener\" target=\"_blank\">their numbers grew sharply<\/a>, from 57,000 to 97,000. <\/p>\n<p>Foreign-born and -trained physicians have remained a key pillar of the U.S. medical system. In recent years, the <a href=\"https:\/\/www.intealth.org\/pdfs\/EVSP-Physicians-Country-2024.pdf\" rel=\"nofollow noopener\" target=\"_blank\">majority of those physicians<\/a> have come from India and Pakistan. Citizens of Canada and Middle Eastern countries have added significantly to that count, as well. Most arrive in the U.S. as trainees in residency programs through one of <a href=\"https:\/\/www.practicelink.com\/resource-center\/physician-immigration-visa\/j1-vs-h1b-visa-for-medical-residency\/\" rel=\"nofollow noopener\" target=\"_blank\">two main visa programs<\/a>. <\/p>\n<p>The majority come on J-1 visas, which allow physicians to enter the U.S. for training but require them to return to their home country for at least two years when their training is complete. Those who wish to remain in the U.S. to practice <a href=\"https:\/\/theconversation.com\/america-is-increasingly-dependent-on-foreign-doctors-but-their-path-to-immigration-is-getting-harder-229980\" rel=\"nofollow noopener\" target=\"_blank\">must transition to an H-1B visa<\/a>. <\/p>\n<p>A small percentage of physicians come to the U.S. on H-1Bs from the start.<\/p>\n<p>H-1B visas are employer-sponsored temporary work permits that <a href=\"https:\/\/www.boundless.com\/immigration-resources\/the-h-1b-visa-explained\" rel=\"nofollow noopener\" target=\"_blank\">allow foreign-born, highly skilled workers<\/a> to obtain U.S. employment. Employers directly petition the government on behalf of visa applicants, certifying that a foreign worker will be paid a similar wage to U.S. workers and will not adversely affect the working conditions of Americans. <\/p>\n<p>Several programs sponsor H-1B visas for physicians, though the most common requires a <a href=\"https:\/\/www.uscis.gov\/working-in-the-united-states\/students-and-exchange-visitors\/conrad-30-waiver-program\" rel=\"nofollow noopener\" target=\"_blank\">three-year commitment to work in an underserved<\/a> area after completing their training. <\/p>\n<p>Foreign physicians fill a crucial need<\/p>\n<p>In 2025, foreign-trained medical graduates filled <a href=\"https:\/\/www.nrmp.org\/about\/news\/2025\/05\/nrmp-releases-2025-main-residency-match-results-and-data-report-providing-in-depth-insight-into-the-largest-residency-match-in-history\/\" rel=\"nofollow noopener\" target=\"_blank\">9,700 of the nearly 40,000 training positions<\/a>. Of those, roughly one-third were actually U.S. citizens who attended medical schools in other countries, with the remainder being foreign citizens seeking more training in the U.S. <\/p>\n<p>After residency, these doctors frequently practice in precisely the geographic areas where the <a href=\"https:\/\/bhw.hrsa.gov\/sites\/default\/files\/bureau-health-workforce\/state-of-the-primary-care-workforce-report-2024.pdf\" rel=\"nofollow noopener\" target=\"_blank\">physician shortage is most severe<\/a>. A nationwide survey of international medical graduates found that <a href=\"https:\/\/doi.org\/10.1080\/20009666.2021.1915548\" rel=\"nofollow noopener\" target=\"_blank\">two-thirds practice in regions<\/a> that the federal government has designated as <a href=\"https:\/\/bhw.hrsa.gov\/workforce-shortage-areas\/shortage-designation\" rel=\"nofollow noopener\" target=\"_blank\">lacking sufficient access to health care<\/a>. <\/p>\n<p>These doctors also occupy a disproportionate number of primary care positions. In a sample of 15,000 physicians who accepted new jobs in one year, foreign-born doctors were <a href=\"https:\/\/doi.org\/10.1007\/s11606-024-09123-9\" rel=\"nofollow noopener\" target=\"_blank\">nine times more likely to enter primary care<\/a> specialties. In 2025, <a href=\"https:\/\/www.nrmp.org\/about\/news\/2025\/05\/nrmp-releases-2025-main-residency-match-results-and-data-report-providing-in-depth-insight-into-the-largest-residency-match-in-history\/\" rel=\"nofollow noopener\" target=\"_blank\">33.3% of internal medicine<\/a>, 20.4% of pediatric and 17.6% of family medicine training positions were filled by physicians trained in other countries.<\/p>\n<p>Who will pay?<\/p>\n<p><a href=\"https:\/\/www.fiercehealthcare.com\/providers\/aha-ama-warn-steep-visa-fee-will-exacerbate-clinician-shortages-hit-underserved-areas\" rel=\"nofollow noopener\" target=\"_blank\">Approximately 8,000 foreign-born physicians<\/a> received H-1B visas in 2024. The new requirement of a $100,000 sponsorship fee would hit hardest for hospitals, health systems and clinics in areas of the country most significantly affected by the physician shortage.  <\/p>\n<p>These organizations are already under economic strain due to <a href=\"https:\/\/www.aha.org\/press-releases\/2025-04-30-new-aha-report-hospitals-and-health-systems-squeezed-persistent-economic-challenges\" rel=\"nofollow noopener\" target=\"_blank\">increasing labor costs and Medicare payments<\/a> that have not kept pace with inflation. Dozens of these hospitals have <a href=\"https:\/\/www.kff.org\/health-costs\/10-things-to-know-about-rural-hospitals\/\" rel=\"nofollow noopener\" target=\"_blank\">closed in recent years<\/a>, and many currently do not make enough money to support their operations. <\/p>\n<p>On Sept. 25, 2025, 57 physician organizations cosigned a letter petitioning Homeland Security Secretary Kristi Noem to <a href=\"https:\/\/www.ama-assn.org\/education\/international-medical-education\/waiving-100000-h-1b-fee-imgs-serves-national-interest\" rel=\"nofollow noopener\" target=\"_blank\">waive the new application fee for physicians<\/a>. <\/p>\n<p>Already, however, the new rule may be having a chilling effect. Despite years of annual growth in the number of foreign-born applicants to U.S. physician training programs, 2025 has seen a <a href=\"https:\/\/www.aamc.org\/data-reports\/publication\/eras-statistics\" rel=\"nofollow noopener\" target=\"_blank\">nearly 10% drop<\/a>. If the new H-1B fee is applied to physicians, the number is likely to keep falling.<\/p>\n","protected":false},"excerpt":{"rendered":"There are almost 1.1 million licensed physicians in the United States. That may sound like a lot, but&hellip;\n","protected":false},"author":2,"featured_media":233659,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-233658","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/233658","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=233658"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/233658\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/233659"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=233658"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=233658"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=233658"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}