Editor’s note: Prominent IMG physicians will discuss their journey to becoming a physician and excelling to medical society and organizational leadership positions in an AMA webinar today, Oct. 21, 7 p.m. CDT. Learn more and register now.
Every physician knows what happens when a community doesn't have enough doctors. Patients wait longer for appointments. Chronic conditions go untreated. Hospitals struggle to maintain essential services. And physicians already stretched thin are asked to do even more.
Now imagine making those shortages worse by turning away qualified physicians who are ready and willing to care for patients.
That is the risk we face when policies create unnecessary barriers for international medical graduates (IMGs), about 70% of whom are foreign-born. These physicians are essential to our healthcare system, and at a time of growing workforce shortages, we cannot afford to lose them.
The AMA is fighting to make sure we don't.
We continue to advocate for a physician exemption from the administration's proposal to increase the cost of an H-1B visa petition to an exorbitant $103,000—up from a few thousand dollars. We are pressing Congress to strengthen the Conrad 30 program, which allows foreign-born physicians to remain in the United States after completing their medical residency training if they agree to practice in underserved communities. And we are working to remove barriers to licensure, expand residency opportunities and streamline immigration processes that delay qualified physicians from entering practice.
These efforts are about more than supporting our colleagues. They are about protecting critical access to care for our patients.
Physicians our patients depend on
IMGs make up roughly one-quarter of the U.S. physician workforce and nearly one-third of physicians practicing in family medicine, internal medicine and pediatrics.
They practice in our hospitals, clinics and academic medical centers. They train future physicians. They provide essential care in rural communities and urban neighborhoods where recruiting doctors is already a challenge. Their contributions are woven into the fabric of American medicine. There are also about 17,000 IMGs who are in residency or fellowship training at more than 770 teaching hospitals.
Yet as we celebrate these physicians during AMA IMG Recognition Week, Oct. 19–23, we must confront a troubling contradiction: Our nation depends on IMGs while maintaining policies that can make it unnecessarily difficult for them to train, work and build careers here.
Consider the proposed H-1B visa fee. Although currently blocked by a federal court, the fee would be a considerable obstacle for IMGs in physician residency to find full-time employment. The traditional path for foreign-born physicians is to immigrate here on J-1 visas to complete their medical training and then transition to H-1B status when they find a job. The steep increase in the visa fee would make hiring non-U.S. citizen IMGs next to financially impossible, especially for hospitals and health systems already operating under significant financial pressure and those serving rural and underserved communities. If the job supply drops, foreign-born physicians are less likely to come here.
The AMA has joined dozens of national healthcare organizations in calling for a healthcare exemption. We are also supporting bipartisan legislation, the H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961), to protect access to these essential professionals.
We need physicians at the bedside, not sidelined by policies that make it harder for hospitals to hire them.
Strengthening the physician workforce
The Conrad 30 program offers another important opportunity to expand access to care.
Under this program, states can sponsor waivers for certain J-1 visa physicians who agree to practice in underserved communities for at least three years. It is an important pathway for retaining physicians who have already completed their medical training in the U.S.
The AMA supports reauthorizing and expanding this program, increasing the number of available waivers, and giving more communities the opportunity to recruit physicians who are ready to serve.
We are also working to address visa-processing delays that have prevented some international medical graduates from beginning residency training on schedule. In some cases, physicians have encountered difficulties related to previous visits to the U.S. for observerships, residency interviews, conferences or other educational activities.
These experiences are intended to help physicians prepare for training in American medicine. They should not become obstacles to entering it.
Our advocacy extends to expanding graduate medical education positions, supporting fair and transparent licensure pathways, addressing delays in permanent residency processing and confronting discrimination and other barriers to professional advancement.
None of these issues exist in isolation. Together, they determine whether qualified physicians can enter our workforce, where they can practice and how many patients they can serve.
Recognition must lead to action
AMA IMG Recognition Week is an opportunity to celebrate the extraordinary contributions of physicians who have come from around the world to care for patients here at home.
But our responsibility cannot end with recognition.
We must continue advocating policies that welcome qualified physicians, strengthen our workforce and expand access to care. We must make it possible for physicians who have trained here, served our communities and earned the trust of their patients to continue that work.
At a time when our nation needs more physicians, we should be opening pathways to patient care, not closing them. Our patients deserve nothing less.
