J-1 visa waiver program under scrutiny

The program letting IMGs work in underserved areas is endorsed, but some doctors have questions and want answers.

By Victoria Stagg Elliott, AMNews staff. Jan. 6, 2003.

New Orleans -- security concerns raised by Sept. 11, 2001, led to a reconsideration of the screening procedures for J-1 visa waivers, which place international medical graduates in underserved areas, but many physicians at the AMA Interim Meeting are wondering if it isn't time to assess the whole program.

"There's a lot of information that we don't have at this point in time about the value of this particular program," said Norman Kahn, MD, an alternate delegate from the American Academy of Family Physicians.

Among the unanswered questions: Are physicians who hold J-1 visa waivers providing the primary care they are supposed to under the terms of their visas and does the program have the muscle to monitor visa recipients and ensure they abide by the rules? Is it appropriate to restrict J-1 physicians who have additional specialty training from using those skills extensively? Are they trapped as indentured servants by employers well aware that a physician who quits would have to leave the United States? Does allowing waiver holders to practice medicine here after they finish training create a "brain drain" in less developed countries? Is this program really the best way to fill the medical needs of U.S. rural and inner city areas?

"If this program is to continue -- and we're not saying it shouldn't -- we really need to look at the program and see if it is appropriate and if it can be monitored," said Stephen House, MD, a delegate from the Organized Medical Staff Section.