What if 15,000 physicians could be added to a workforce that was challenged by shortages before COVID-19 and is strained to the breaking point as the pandemic continues?
The Academy told lawmakers they could do exactly that with legislation just introduced in the House and the Senate.
"The ability to recapture 15,000 unused employment-based physician immigrant visas from prior fiscal years would enable our U.S. physicians to have the support they need and our U.S. patients to have the care they deserve," the Academy said in its May 13 correspondence.
Identical letters went to the numerous, bipartisan House(2 page PDF) and Senate(2 page PDF) sponsors of the Healthcare Workforce Resilience Act (H.R. 6788(www.congress.gov) and S. 3599(www.congress.gov)) -- legislation the AAFP called "a good, incremental, step to address an immediate need presented by the COVID-19 pandemic."
The letters were signed by Board Chair John Cullen, M.D., of Valdez, Alaska.
"Nearly 21 million Americans live in areas of the U.S. where foreign-trained physicians account for at least half of all physicians," the Academy wrote. "Over the past 10 years, more than 10,000 international medical graduates, practicing through J-1 visa waivers, have worked in underserved communities. By increasing the number of visas available to IMGs, these vulnerable populations will be better served and the overall health care system will be bolstered."
Research verifies that IMGs are twice as likely to practice primary care(www.ama-assn.org) as U.S. graduates. They also serve a vital role in providing health care in rural and underserved areas.(depts.washington.edu)
Primary care is, in fact, a growth field for IMGs. In this year's National Resident Matching Program Main Residency Match, 25.5% of family medicine residency positions were filled by 1,193 students and graduates of international medical schools -- 78 more than last year.
The AAFP's May 13 correspondence also called for the Conrad 30 J-1 visa waiver program to be reauthorized and expanded -- reiterating a June 2019 letter(paha.us) that the Academy sent legislators as the House considered the Conrad State 30 and Physician Access Act (H.R. 2895).(www.congress.gov)
Resident physicians from other countries who complete their training here on J-1 visa waivers are required to return to their home countries for two years before they can apply for reentry. The Conrad 30 program allows up to 30 physicians in each state to stay in the United States if they agree to practice in underserved areas for three years.
"Many communities, including rural and low-income urban districts, have problems meeting their patient care needs and depend on the physicians in this program to provide health care services," the AAFP said.
(The recently passed House version of the Health and Economic Recovery Omnibus Emergency Solutions Act(docs.house.gov) would permanently authorize the Conrad 30 waiver; in its present form, however, that legislation is unlikely to pass the Senate.)(www.nytimes.com)
The AAFP also recently joined 32 other health and medical groups in a May 4 letter(4 page PDF) calling on congressional leaders and the White House to maintain work authorization during the pandemic for the nearly 30,000 health care professionals enrolled in the Deferred Action for Childhood Arrivals program.
"It is unacceptable that thousands of doctors currently working in the U.S. on temporary visas are stuck in the green card backlog, putting their futures in jeopardy and limiting their ability to contribute to the fight against COVID-19," the AAFP said in the most recent correspondence. Passing the Healthcare Workforce Resilience Act, however, would "strengthen our health care workforce and improve health care access for Americans in the midst of the COVID-19 pandemic and in the future."
Related AAFP News Coverage
Leader Voices Blog: Delaying Visa Approvals Would Harm Medical Training, Patients