Although the Trump administration has softened its travel bans – lifting the J-1 visa ban last month – its pausing of visas for citizens of certain countries has prevented foreign medical residents from filling critical positions in American hospitals, which already face shortages.
The restrictions have led to a number of international doctors, due to start their medical training, stumbling at the last hurdle – a visa to enter the country.
It is unclear precisely how many residents have been affected, but six medical residents interviewed by AP said that after years of training and work, they are now being prevented from starting their assignments by what should be a routine procedural step.
One example is a doctor in Canada who was matched to the University of Pittsburgh Medical Centre Harrisburg. Her visa was stymied because although she is a permanent resident in Canada, she is a citizen of Afghanistan. “I don’t want to give up,” she said, “but the situation seems so helpless.”
The problem is concerning for US hospitals, particularly those in low-income or rural areas, as they foresee staffing shortages.
Although the halt to interviews for J-1 visas for approved work or study-related programmes was lifted in mid-June, the national non-profit that facilitates the residency match process said while the visa situation is resolving, for some, it is too little too late.
Two residents in India said they are still unable to secure appointments at any US embassies, despite the lifting of the J-1 visa pause. An incoming resident from Egypt has secured a visa appointment for mid-August, but concerned that her programme may not be able to wait for her arrival.
The Association of American Medical Colleges projects a physician shortage in the United States within the next 11 years, so foreign medical residents are essential for filling critical employment gaps in the healthcare system.
This year, there were more than 6 600 foreign-born international medical residents matched into US programmes – the highest on record.
After the matching process was complete, an additional 300 vacancies were filled with international residents.
International medical graduates often take jobs in places where US medical trainees tend not to want to go and work in specialties that American applicants tend to avoid, including internal medicine, according to Donna Lamb, president of the National Resident Matching Programme.
“It’s not just that they’re coming in and they want to work in big, flashy centres on the coast,” Lamb said. “They’re truly providing healthcare for all of America.”
Limbo
Last month, newly-minted MDs were among the thousands of students, trainees, teachers and exchange visitors put in limbo after the government hit the pause button on new visa appointments.
For foreign-born and educated doctors who had not yet bagged an appointment for placement, the timing couldn’t have been worse, reports Forbes. Most medical residencies officially began on 1 July with orientations for the newest MDs (interns) having started in June.
International medical graduates without visas were worried about missing their start date, putting their positions at risk and leaving hospitals in the lurch, since interns provide hands-on medical care under the supervision of more experienced doctors.
According to the American Medical Association, about a quarter of doctors currently in practice in the United States were educated in foreign medical schools, and the nation already faces a growing physician shortage.
But before a foreign-educated doctor can be licensed to practise medicine in America, they must complete a US residency, making these programmes crucial to keeping the needed supply of foreign doctors flowing.
In March, in what’s known as the “main residency match”, 37 677 graduates of medical schools and schools of osteopathy were placed into first year jobs. Of those, 6 653 were foreign-born students who graduated from a non-US medical school per data from the National Resident Matching Programme. (Another 3 108 were US citizen graduates of foreign medical schools.)
These figures don’t include the 2 374 positions that were initially unfilled in the March match; 300 of those jobs later went to foreign-born and educated students.
“Some people are saying, ‘Oh, maybe (foreign doctors) are taking all the spots,” said Sebastian Arruarana, a resident physician at the Brookdale University Hospital and Medical Centre in Brooklyn, New York.
“But no, they’re not taking the spots – there’s a bigger number of positions to be filled than the number of medical students graduating here.”
Most international medical graduates (who aren’t US citizens) go to the United States on J-1 visas, which are reserved for exchange visitors participating in teaching, research and other training.
Many of this year’s incoming interns had already made their visa appointments, but about 5% – or more than 300 doctors – had not, when the US government put all J-1 visa applications on hold, before subsequently lifting the ban.
Big states like New York and Florida, where 1 592 and 698 foreign-born international medical graduates matched this March, respectively, are home to the most foreign medical residents, but represent only 24% and 19% of residents.
Forbes article – Visa Pause Could Leave U.S. With Fewer New Doctors Amid Shortage (Open access)
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