The American Medical Association is urging the Trump Administration to expand the physician workforce by opening up visa processing to get physicians from other countries more quickly into the nation's workforce.
The physicians are needed to meet the demand during the COVID-19 pandemic, the AMA said.
In a letter to Secretary of State Mike Pompeo and Acting Secretary of Homeland Security Chad Wolf, the AMA called for opening visa processing at embassies and consulates worldwide for physicians seeking to join U.S. residency programs starting in July, and urged public confirmation that J-1 physicians are permitted to be redeployed to new rotations.
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WHY THIS MATTERS
The U.S. was already facing a serious physician shortage before the coronavirus due to the aging of the population and the impending retirement of many in the workforce.
The United States has long had a lengthy H-1B visa process that has hindered health systems in getting qualified healthcare professionals in a timely manner, according to Robert Webber, co-chair of the Immigration Practice Group for Dorsey & Whitney.
But the H-1B visa process became even more arduous under President Trump, as the Administration focused on enhancing immigration compliance and tougher standards for work visas and green cards, he said.
The issue is with both renewals and new applications, with the result that physicians who want to work in the United States are going to other countries.
"We're definitely seeing more problems in that area over the last couple of years, Webber said.
To get a green card, the wait time is subdivided by the physician's country of birth, he said. A majority of physicians immigrate from India, but with a wait time of over 10 years, many are giving up.
Webber said the issue is not a "Trump Administration thing." The wait times were also long under Presidents Obama and Bush. But there was less anxiety under the former administrations. The reinterpretation of existing law is basically creating a climate of uncertainty, he said.
THE LARGER TREND
In January 2019, the Department of Homeland Security issued a final rule that changed the H-1B cap selection process to favor the employment of foreign workers with a U.S. master's or higher degree.
The AMA was against the rule, saying it could negatively impact the thousands of non-U.S. citizen international medical graduates seeking to obtain an H-1B visa each year who gained their higher education outside of the U.S.
Despite the AMA's concern, the rule went into effect in April.
Currently, one in four physicians in the United States is a foreign medical graduate, according to Webber.
Rural areas in the country have been dependent on physicians from other countries because there are provisions in immigration law that promote foreign physicians going into rural areas.
"That has been a traditional track for people," he said.
WHAT THE AMA WANTS
The AMA strongly urges the Department of Homeland Security to institute a process by which physicians already in the U.S. in valid visa status would receive expedited processing when seeking a change of status through the U.S. Citizenship and Immigration Services either to begin a U.S. residency or assume a position in an underserved area of the U.S.
It wants the Administration to extend the 30-day grace period beyond the end of the nationally declared emergency and allow extended training activities under supervision during this grace period consistent with pandemic response.
And it wants the Administration to issue a public statement confirming that J-1 physicians are permitted to be redeployed to new rotations within the host training institution as needed to respond to the COVID-19 epidemic.
ON THE RECORD
"Residents and fellow physicians are an important part of the healthcare teams serving on the front lines of the COVID-19 crisis," wrote AMA CEO Dr. James L. Madara. "We want to ensure that non-U.S. citizen international medical graduates are not negatively impacted by the COVID-19 pandemic and can either continue, or begin, to serve a vital role in caring for patients."
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