Foreign-trained physicians and the physician workforce

I’ve written previously about the shortage of primary care physicians in the US. In principle, one way to address this shortage is to admit more international medical graduates as physicians. But an historic barrier to this solution is the requirement for US residency training. Some states are passing laws allowing international medical graduates if they requirements pass certain USMLE exams, demonstrate English proficiency and working under supervision in an underserved area. 

However, the Trump administration is about to throw up another barrier:

“. . . President Trump’s September 19 H1-B executive order will upend this system. Hospitals that rely heavily on immigrant physicians — especially rural and safety-net institutions already under financial strain — won’t be able to absorb the additional financial burden of visa sponsorship, which is set to jump from roughly $2,000 – $5,000 to $100,000 per immigrant physician.”

One way to resolve this is to waive the $100K visa charge for international medical graduates who agree to practice in the primary care specialties (family medicine, internal medicine, pediatrics, obstetrics and gynecology and geriatrics) for a minimum of ten years. 

There are other, not mutually exclusive ways of solving the primary care physician crisis, including greater use of physician assistants and nurse practitioners, as well as expanding domestic medical school capacity, recruiting diverse domestic talent, reducing the cost of medical education and increasing investment in primary care.

 

https://www.bostonglobe.com/2025/10/14/magazine/immigrant-physicians-healthcare-crisis/

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