AN INFLUX OF FOREIGN DOCTORS, BUT QUALIFIED AMERICANS SHUTOUT
Last month, the American Medical Association issued a press release that urged U.S. Citizenship and Immigration Services to process more H-1–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-1–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-1–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 doesn’t translate 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 in-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-1–or J-1 visa. But, on a J-1 they must return home or receive a waiver when their residency ends. The H-1–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.
FOOTNOTE: Joe Guzzardi is a Progressives for Immigration Reform analyst who has written about immigration for more than 30 years. Contact him at jguzzardi@pfirdc.org.
Sounds mumbo jumboish, but what I think it boils down to is that the AMA is in favor of non-Americans over Americans as M.D.s . I can’t think of why that would be, but it appears to be the case. Sounds like a problem that’s easy to solve. Review and restrict the H-1 Visa program from displacing Americans in any workforce, if Americans are qualified and willing to work, whether they be Doctors or Computer programs. We are essentially being overrun in this country when we don’t have to be. Time for the AMA to get on Board the America Train. Start working to get our American students into the medical schools and the internships they deserve or face a citizen backlash on their AMA anti-American,questionable practices.
AMA obviously not interested in what is best for American educated Doctors. Must be why every time you see a Doctor anymore you have to strain to understand what the Hell is wrong with you!!!! No hablo Ingles. Bullshit, Dems way of more illegal voters. Tell me I am wrong!!!
This is the problem when people pick and choose what to disclose when writing a story. He fails to disclose that these candidates were found wanting, and that the National Match is a computerized process. He fails to mention that that perhaps American grads did not want to apply to smaller residency spots and therefore, ended up not matching. He did not mention that there is no pay disparity in residency as compared to H-1B tech jobs. He fails to mention that the majority of foreign doctors do their residencies on super-restrictive J-1 visas, not on an H-1B. When you live in an echo chamber, you hear want you want to hear 🤦ðŸ»â€â™‚ï¸
Andy – Yes, the NRMP is a computerized process, but residency training programs don’t select their applicants on the computer, and there are minimal restrictions on their selection process. This notion that NRMP (“a computer”) does the selecting and that the residency-training program is an outside party is false.
The comment that “American grads did not want to apply to smaller residency spots and therefore, (sic) ended up not matching†simply is victim blaming that is a distraction to keep us from addressing the problem.
Doctors without Jobs is working with a doctor who graduated in good standing from a prestigious medical school who has applied to more than 350 different residency training programs in 47 states (Wyoming and Montana do not have residency training programs, and North Dakota had graduation cut-off dates). This dedicated physician knows other American students who paid more than $10,000 in ERAS application fees and applied to every program in the U.S. and did not match.
There is a systemic problem when we are not prioritizing U.S. doctors, particularly in a time of reported doctor shortages! So the notion of blaming American students simply is false.
The pay discrepancy between U.S. doctors and foreign trained physicians (FTPs) is in the tremendous investment for a U.S. medical education. The doctor previously referenced invested more than $250,000 for a medical education in the U.S.A. ($50,000+/year in tuition + $20,000+/year living expenses). FTPs do not have a comparable investment. I again reference the doctor who tells us that when he worked as an extern at Saint Elizabeth’s Hospital, his three fellow externs (who were FTPs) invested less than $500 for their state-subsidized medical education in India, Pakistan and the Philippines.
This significant financial differential in investment for a medical education in the U.S.A. (U.S. students: $250k or more vs. FTPs: $0) makes it extremely difficult for U.S. medical students to pursue alternative careers. They need to work as doctors simply to service their debt.
For example, if an FTP is not selected for a residency training position in the U.S. and decides to pursue an alternative as a high school biology teacher with a salary of $60k per year, an FTP can still live a middle-class life here, without student loan debt.
Alternatively, if a U.S. medical students is not selected for a residency training position, and decides to pursue high-school biology teaching position with a salary of $60k per year, the U.S. medical student is straddled with $250k in student loan debt. In the case of our doctor we have referenced, his original $250k student loan for medical education accrues interest at 6.7%, and now his debt is more than $400k.
This is a debt unserviceable at most jobs, certainly a teacher’s salary. Garnishing 25% of a $60k salary ($15k per year) for the next 25 years would still not discharge the debt.
Under this scenario, to encourage U.S. students to become doctors and then NOT allow them to work as healers is a tremendous malinvestment, injustice to American talent and a break with the Social Contract.
Lastly, regardless of which visa is being used, they are being used to take jobs away from U.S. medical school graduates. The concept of nation states, traditionally, means that the organizing principles are designed around addressing the needs of the citizens of that country first.
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