About a quarter of doctors currently in practice were educated in foreign medical schools and the United States faces a growing physician shortage.
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Newly-minted M.D.s are among the thousands of students, trainees, teachers and exchange visitors put in limbo after the Trump State department hit pause on new visa appointments last week, as it develops a plan to vet visa candidates’ social media. For foreign-born and educated doctors who haven’t snagged an appointment yet, the timing couldn’t be worse—most medical residencies officially begin July 1, with orientations for the newest M.D.s (known as interns or P.G. 1s) starting some time in June. International medical graduates without visas could miss 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 U.S. were educated in foreign medical schools and the nation faces a growing physician shortage. But before a foreign-educated doctor can be licensed to practice medicine in the United States, they must complete a U.S. residency, making these programs 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-U.S. medical school per data from the National Resident Matching Program. (Another 3,108 were U.S. 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,” says Sebastian Arruarana, a resident physician at the Brookdale University Hospital and Medical Center 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 U.S. citizens) come 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 have already made their visa appointments, but about 5%—or more than 300 doctors—have not, estimates Zain Abdin, a Chicago-based physician and founder of the international medical graduate support organization IMG Helping Hands.
Arruarana, who is also a social media influencer focused on international medical graduate issues, has been hearing from some of those doctors stuck in limbo. “We are stuck and we are helpless,” one international medical graduate who matched at a Texas medical center said in a message to Arruarana. The new resident’s orientation program began on June 3, which is on the early side. “I don’t know what to do in this position.”
“I just got matched on May 23 after so many challenges and against all odds,” another messaged Arruarana. “My program just started the J1 visa sponsorship process, so I don’t have an interview slot.” Some residencies start later in the year, explains Abdin, primarily in September. Those residents, on the whole, are more likely to be impacted by this visa hold.
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, according to NRMP data. But they represent only 24% and 19% of residents. Less populous states like North Dakota, Wyoming and Arkansas—all of which supported Trump in the last election—rely more on foreign medical residents, with foreign-born and educated medical graduates making up 38%, 33% and 32% of their incoming residents, respectively, NRMP data shows.
The ongoing appointments pause affects all student visa types, including F-1 visas, primarily issued to foreign undergraduates and graduates at colleges and universities, and M-1 visas, issued most often to foreign students studying at trade schools or in non-academic programs like flight school.
State department correspondence said the scheduling pause would stay in place until further guidance is issued “in the coming days,” Politico reported last week. In the meantime, leadership from the Educational Commission for Foreign Medical Graduates (ECFMG), which essentially serves as a gatekeeper for foreign medical graduates entering the U.S., is attempting to gain an exception for physicians, according to Arruarana, who says he spoke with a staffer there. An email from the ECFMG warned current residents who need to renew their visas not to travel outside the U.S. until the pause is ended. The ECFMG did not return Forbes’ request for comment.
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