Corrected 7:45 p.m. Monday | More than 4,000 foreign medical graduate students are scheduled to begin U.S. residency programs this summer, but experts fear current immigration policies will delay their arrivals — and their ability to help doctors combat the coronavirus pandemic.
Last month, the Trump administration barred most foreign travel to the United States amid the current health crisis. Many of those flights, however, would have included medical teachers and recent medical graduates arriving with J-1 visas as part of a cultural exchange program.
“If all of these international doctors or a large number of them are unable to arrive here and become part of their training program, it will definitely further stress health care systems and people’s access to proper health care,” William W. Pinsky, CEO of the Educational Commission for Foreign Medical Graduates, told CQ Roll Call.
Pinksy’s commission is the sole organization sponsoring foreign medical graduate students who have J-1 non-immigrant visas, which are granted for work- and study-based exchange programs. J-1 visas usually are allocated to interns, teachers and foreign medical graduates who have been accepted into a U.S. residency program.
But J-1 visa holders are not allowed to arrive in the United States more than 30 days before their program begins, which is July 1 for nearly all medical residency programs.
Some immigration attorneys want the Trump administration to ease this restriction to give students ample time to prepare for their program, especially if they need to undergo a 14-day or longer self-quarantine after coming from Italy, China or another nation with high cases of COVID-19, the disease caused by the coronavirus.
“The solution here is to process them earlier and get them here before their July 1” start date, Greg Siskind, an immigration attorney who specializes in visas for foreign physicians, told CQ Roll Call.
He said the State Department “needs to make it very clear that they are prepared to process these people faster than normal,” if that’s something it decides to do.
The State Department has sent mixed messages pertaining to J-1 and other visas that allow medical professionals to come to the U.S. In March, the department temporarily closed all foreign U.S. embassies but later said those embassies would continue to process certain visas.
Then, in a March 26 tweet, the State Department encouraged “medical professionals seeking work in the U.S. on a work or exchange visitor visa (H or J), particularly those working on #COVID19 issues, to contact the nearest U.S. Embassy/ Consulate for a visa appointment.” The State Department walked back its comments the following day to clarify it was not recruiting foreign residents and would only process applications already in the system.
“The Department of State stands ready to work with doctors and other medical professionals who are already accepted into existing U.S. programs and otherwise expected to travel to the United States to work or study,” William Walters, the deputy chief medical officer for operations in the State Department’s Bureau of Medical Services, said at a March 27 news conference.
Neither the State Department nor the Department of Homeland Security has issued guidance on how J-1 visa holders will be affected under current travel restrictions or as the administration continues to adjust policies related to foreign travel. The U.S. health care system already relies heavily on immigrants, who make up about 17 percent of all medical professionals, according to a 2017 Migration Policy Institute study.
Foreign medical professionals also may come to the U.S. under other visas, including the H-1B, which U.S. employers use to temporarily hire foreign nationals in specialty occupations like technology and engineering. The Department of Homeland Security conducts an annual lottery to determine which employers will be able to petition for those visas.
More than 10,000 medical residents already are in the country on J-1 visas and H-1B visas, according to the Association of American Medical Colleges.
But immigration attorneys say medical professionals with H-1B visas face significant barriers to allowing them to help in areas of the country experiencing a shortage of health care workers. Under visa rules, people can only work in locations previously approved by U.S. Citizenship and Immigration Services. If H-1B holders want to relocate, they must get government approval, which can take months.
Immigration groups and attorneys are calling on DHS to provide more flexibility in terms of where foreign doctors can practice medicine so they can go to areas most affected by COVID-19.
“It would go a long way toward us being able to give better advice to our clients, and to give the states what they need in terms of physician mobility — because the states are doing everything that they can to get doctors to come here,” said Elissa Taub, an immigration lawyer based in Memphis, Tenn., who specializes in visas for foreign physicians.
New York has already waived state licensing requirements to allow foreign medical graduates with at least one year of U.S. residency training to contribute to the coronavirus response. No other state, however, has followed suit. New York also was the top destination in the J-1 physician exchange program last year, according to the State Department. Michigan, Florida, Massachusetts and Illinois rounded out the list of states in the top five.
As of Friday, there were at least 245,658 confirmed cases of COVID-19 in the United States, according to Johns Hopkins University researchers keeping tally. In New York, the number of deaths from COVID-19 has surpassed 1,000.
The federal government must take steps to help clear the red tape preventing foreign medical professionals from working in the U.S., said Frank Trinity, AAMC’s chief legal officer, during a call with reporters on Friday.
“If there were ever a time when we needed the administration to take all necessary actions to maintain and reinforce the health care workforce, now is that time,” he said.
Correction: This report was revised to reflect that J-1 visa holders may not arrive more than 30 days before the start of their education or cultural program.