PROFESSION

Rural areas say more J-1 visas needed

The Dept. of Health and Human Services approved only four physicians to work in underserved communities in 2005, leaving health advocates on edge.

By Myrle Croasdale, AMNews staff. Jan. 2/9, 2006.

At its peak in 1999, the Dept. of Agriculture pumped 242 international medical graduates into clinics and hospitals in rural communities. The same J-1 visa waiver program, in the hands of the Dept. of Health and Human Services since 2002, placed just four physicians in 2005.

That dramatic drop is a big concern for medically underserved communities that rely on these programs to help recruit doctors, who commit to stay a minimum of three years.

"You can't just cut the program," said L. Gary Hart, PhD, director of the Rural Health Research Center at the University of Washington School of Medicine. "It would leave places in catastrophically bad situations."

With work-force experts anticipating a national physician shortage, shortfalls in underserved areas are likely to deepen.

"The J-1 visa waiver physicians are an essential pipeline for rural places that would find it nearly impossible to find a physician otherwise," said Keith Mueller, PhD, director of the Rural Policy Research Institute's Center for Rural Health Policy Analysis at the University of Nebraska Medical Center.

Other agencies sponsor J-1 visa waivers, but HHS' program is the only one with a national scope. It also has no limits on the number of doctors it can sponsor. For example, state-administered Conrad 30 J-1 programs are capped at 30 physicians per state, per year. Regional groups, such as the Appalachian Regional Commission and the Delta Regional Authority, don't have numerical limits, but are bound by geographical constraints.

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