Guest Post by Joe Guzzardi
Last month, the American Medical Association issued a press release that urged U.S. Citizenship and Immigration Services to process more H-1B visas, thereby allowing more nonresident physicians to come to the United States to practice medicine. The AMA claimed that a shortage of nonresident physicians who help fill care gaps in medically underserved regions diminishes overall patient care.
In a letter to USCIS Director Francis Cissna, AMA CEO James L. Madara said that the fixed per country caps which govern H-1B visa issuance keep the agency from processing enough petitions. The AMA, citing data from the Association of American Medical Colleges, concluded that the nation had a physician shortfall of nearly 20,000 in 2016. And since all pleas for more special interest, employment-based visas routinely include doomsday forecasts for future decades, the AMA predicted that by 2030 the shortage will increase to between 42,600 and 121,300.
But ample evidence exists that the AMA doesn’t need to lobby for foreign-born doctors. Thousands of American medical school graduates are eager for the opportunity to practice their life-saving profession.
In 2018, nearly 1,100 U.S. medical school seniors and more than 800 previous U.S. graduates did not match to a residency at a teaching hospital. Without fulfilling a residency, the doctors can’t practice medicine.
The National Resident Matching Program data reveals that from 2011 to 2018, 8,218 U.S. seniors did not matriculate into residency training. During that same period, 27,866 foreign-trained physicians, non-U.S. international medical graduates (IMGs) on H-1B and J-1 visas were selected for residencies. Although an impressive 94 percent of U.S. citizen medical graduates do match, the six percent that don’t translates to hundreds of individuals who have many years and hundreds of thousands of dollars invested in their extended medical education, but can’t find a job.
For those that don’t match immediately post-graduation, they can reapply for a residency slot. But the longer they’re out of medical school without a residency, the more difficult their chances of success are.
Taxpayers subsidize non-U.S. medical school graduates. Federal Medicare funding underwrites residency training positions for about 3,700 non-U.S. IMGs annually. Reducing the number of IMGs who receive residencies would help U.S.-trained physicians get a fair shot at a job. The goal, then, isn’t to eliminate foreign doctors altogether, but rather to put U.S.-educated physicians at the head of the line for coveted residencies.
Cissna’s office is besieged with requests for more employment-based visas – for ag, leisure and tech. In the IMG’s case, however, they can enter on either an H-1B or J-1 visa. But, on a J-1 they must return home or receive a waiver when their residency ends. The H-1B doesn’t require a waiver to remain, and the visa holder can immediately request lawful permanent status upon his residency’s completion, making it a more attractive option.
Luckily for deserving U.S. doctors, the AMA’s request will likely fall on deaf ears. While addressing a National Press Club audience last month, Cissna said that his hope is that Congress will soon pass legislation that prohibits visa holders from displacing American workers.
Until Congress passes such legislation, the AMA should concern itself with qualified, deserving American doctors denied residencies that are given instead to foreign-born physicians.
Nothing to argue with in the article. Though, I presume some of the graduates might obtain a residency slot in another country.
I suspect many of the US med school grads who don’t get residencies are affirmative action admissions. That said, if there was ever a field where we do not require foreigners it would be medicine. Admission to medical school is very competitive and there is no shortage of applicants and as long as that is the case foreign doctors need to practice in their homelands.
6% are most likely the bottom of the barrel. 10% most likely have some kind of addiction or psych issue. I had one physician client who pretended to read a book in the chair, turning the pages occasionally, only thing was she was holding the book upside down. And I have known many physicians who were dim light bulbs. Almost half of my “peers” in the re education/professional enhancement program were MD’s. And were impaired with more than drug alcohol issues; and scary to believe they treated patients.
The H1 Visa program should be done away with entirely. It is just another advantage for cheap employers in a race to the bottom.
Since the early 1900s, the AMA has been conspiring with state and federal legislatures to ACTIVELY reduce the number of people who can practice medicine in all of its forms. It began going after midwives, then minority medical schools, then reducing the number of medical schools overall, then going after doctors who serviced “mutual aid societies” that assisted (for very affordable prices and sometimes fixed, paid salaries) new immigrants to this country and other benevolent associations like Lions, Rotary, and others, and so, so much more.
One should be asking by WHAT RIGHT does the AMA or any state legislature get to decide who can practice medicine, who can perform what “medical” procedures, and why a fully competitive marketplace of independent certification entities should not be allowed to “rate”, “certify” or other, any or all participants in the healthcare marketplace. And why should someone from a foreign country NOT be allowed to contract with someone from their own country who has been practicing medicine there, regardless of their “status” in this country with respect to the AMA or the government???
FREEDOM would take care of this problem 100%, with government only stepping in to address cases of fraud or harm.
I have a better idea. All universities must admit ALL qualified US citizens first. Then green card Americans if any space left. Then, non-US citizens space permitting. Period.