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ACP: International Medical Graduates Integral to U.S. Health Care System

Advocate Masthead

Passage of legislation recently introduced in U.S. Senate will temporarily ease immigration-related restrictions, allow IMGs to assist in the fight against COVID-19

June 5, 2020 (ACP) – International medical graduates (IMGs) play a crucial role in the nation's health care workforce, but they and their families are facing increasing challenges as they seek permission to work in the United States. The American College of Physicians has been involved with advocacy that has helped to successfully change government policy to support and facilitate the contributions of IMGs to U.S. health care.

“These physicians serve an integral role in the delivery of health care in the United States. They provide health care for underserved populations in the United States and are often more willing than their U.S. medical graduate counterparts to practice in remote, rural areas,” said Renee Butkus, ACP director of health policy. “In addition, they add an important element of diversity. Adherence to care improves when patients experience greater comfort and higher levels of patient satisfaction with care from physicians who look like them.”

The role played by these physicians is even more important during the coronavirus pandemic, Butkus said. But at the same time, government action has threatened their service here.

Earlier this year, the U.S. Department of State announced it was closing embassies and not processing visa requests due to the pandemic. The U.S. Citizenship and Immigration Services (USCIS) agency also stopped processing most visas.

In response, ACP issued a letter calling for the State Department and USCIS to make an exception for physicians. In the letter ACP wrote, “We are greatly concerned that the State Department decision to temporarily suspend visa services and the USCIS announcement that it will not accept new requests for premium processing will have serious healthcare repercussions as the U.S. tries to address this growing national health emergency.”

As Butkus explained, “Beyond ensuring that incoming residents could arrive on time, we wanted to make sure that those already here could renew their visas or change their status if necessary. We also wanted to make sure they could be redeployed as needed to help with the pandemic.”

Fortunately, the State Department agreed to make an exception for health care workers and open visa processing for newly arriving medical residents and physicians, a crucial move considering that the National Resident Matching Program has placed 4,222 non-U.S. IMGs into training positions that start on July 1.

“Now more than ever, we need every one of these physicians to join their U.S. training programs on time,” Butkus said. “For categorical internal medicine, 2,116 (25.4 percent of 8,324) matched spots were filled with non-U.S. IMGs. We are aware of internal medicine training programs where more than 50 percent of incoming residents are on H-1B visas, so the impact of a delayed start and possible denials would be devastating to their physician workforce capacity.”

More needs to be done to protect IMGs to keep the health care workforce strong. Therefore, ACP is strongly supporting the bipartisan Healthcare Workforce Resilience Act (S. 3599), which would authorize immigrant visas for health care clinicians, including up to 15,000 physicians who are eligible to practice in the United States or are already in the country on temporary work visas.

In a May 12 letter to congressional leaders, ACP noted, “By recapturing a limited number of unused visas from prior years and allocating them to doctors and nurses, the Healthcare Workforce Resilience Act offers the advantage of not only addressing the physician shortage that existed before the pandemic but recognizing that the shortages are growing more severe as the need for caregivers becomes greater with each passing day. It is an extremely timely response to the risk imposed by COVID-19.”

ACP adds that the bill “is a smart, bipartisan approach to the physician and nursing workforce shortage – both long and short term – that draws on an untapped resource. It would help save countless lives in these unprecedented times.”

ACP is also supporting the Conrad State 30 and Physician Access Reauthorization Act (S. 948), which allows states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. This bill includes a provision to address the current backlog in the system for physicians on J-1 visas who wish to acquire permanent residency status (a green card).

ACP members can help to ensure these laws are passed. “Our best opportunity is for inclusion of the bill in the next stimulus package,” Butkus said. “We have issued a legislative alert so that members can urge the Senate to do just that. Specifically, we want our members to urge them to cosponsor and include S. 948 and S. 3599 in the next bipartisan COVID-19 relief package.”

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Back to the June 5, 2020 issue of ACP Advocate