What’s the news: The U.S. State Department responded to an AMA request and agreed to resume processing visa applications at U.S. embassies and consulates to ensure that non-U.S. citizen international medical graduates (IMGs) can enter the country to begin their residency training programs this summer and bolster the health care workforce fighting the COVID-19 pandemic.

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“We encourage medical professionals with an approved U.S. non-immigrant or immigrant visa petition (I-129 or I-140 with a current priority date, or similar) or a certificate of eligibility in an approved exchange visitor program (DS-2019), particularly those working to treat or mitigate the effects of COVID-19, to review the website of their nearest embassy or consulate for procedures to request a visa appointment,” the department’s announcement states.

“For those foreign medical professionals already in the United States: J-1 Alien Physicians (medical residents) may consult with their program sponsor, ECFMG [the Educational Commission for Foreign Medical Graduates], to extend their programs in the United States,” the State Department adds. “Generally, a J-1 program for a foreign medical resident can be extended one year at a time for up to seven years.”

The State Department announced March 20 that routine visa-processing operations were being suspended, and the AMA urged officials to reconsider this action in a March 24 letter to Secretary of State Mike Pompeo and Acting Secretary of Homeland Security Chad F. Wolf.

The AMA worked with ECFMG and its nonprofit foundation, the Foundation for Advancement of International Education and Research (FAIMER), to alert the State Department about how their March 20 decision could impact some 4,200 foreign national physicians who matched with U.S. graduate medical education programs and were scheduled to start residency training on July 1.

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ECFMG|FAIMER serves as the visa sponsor for close to 12,000 foreign national physicians at teaching hospitals across the nation.

While the COVID-19 pandemic has compounded the urgency, the AMA has been advocating for years on physician visa issues. This includes opposing polices that create unnecessary stress for IMG physicians and their families and exacerbate the physician workforce shortage by further limiting the ability of certain non-US citizen IMGs to receive a visa or green card.

Why it’s important: IMGs play a vital part in delivering care across the nation as they often practice at institutions that are on the front line of the COVID-19 pandemic and play a critical role in providing health care in areas of the country with higher rates of poverty and chronic disease.

“That’s why the AMA has asked top officials at the U.S. State Department and the Department of Homeland Security to ensure that IMGs—many of whom are not U.S. citizens but who play critical roles in our nation’s health care safety net—will be allowed to care for patients as the pandemic escalates in the weeks ahead,” wrote AMA President Patrice A. Harris, MD, MA, in Leadership Viewpoints column.

Further delays in visa processing would have unnecessarily compromised the nation’s COVID-19 response, needlessly endangered vulnerable patient populations, and placed even greater pressure on those serving heroically in this effort.

“The immigrant share of the health care workforce is roughly twice that of the national average in New York, New Jersey and California—three of the states hardest hit so far by COVID-19,” Dr. Harris added. “Our health system desperately needs to deploy every physician, nurse and medical provider capable of responding. The stakes are far too high not to take advantage of every available resource we have.”

What’s next: While encouraged by “this positive development” with the State Department, ECFMG|FAIMER President and CEO William W. Pinsky, MD, said there is still much work to do.

“There are still significant obstacles to getting these physicians here, and we can now shift our focus to addressing these other issues,” Dr. Pinsky said in a news release.

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Additionally, the AMA is advocating on behalf of non-citizen IMGs who are severely restricted as to where they can practice under the terms of their H-1B visas—this includes some physicians who now cannot work as a result of being furloughed after the facilities they were working at closed.

“Some IMGs have been unable to work at a time when their services are greatly needed throughout the U.S.,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to Vice President Mike Pence and Kenneth Cuccinelli, the acting director of U.S. Citizenship and Immigration Services.

“Allowing IMG physicians to serve at multiple locations and facilities will provide greater access to health care for millions of Americans,” Dr. Madara added. “We urge the administration to permit IMG physicians currently practicing in the U.S. with an active license and an approved immigrant petition, to apply and quickly receive authorization, to work at multiple locations and facilities with a broader range of medical services for the duration of the COVID-19 pandemic.”

Physicians can stay up to date on the AMA’s COVID-19 advocacy efforts and track the pandemic with the AMA's COVID-19 resource center, which offers a library of the most current resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.

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