Foreign physicians should be exempt from visa policy change, med groups say

Six major medical groups are calling on the Department of Homeland Security to exclude foreign national physicians from a proposed change in immigration policy.

The American Hospital Association, American Medical Association, Association of American Medical Colleges, National Resident Matching Program, Accreditation Council for Graduate Medical Education, and Foundation for Advancement of International Medical Education and Research on Oct. 9 sent a joint letter to Acting Secretary of Homeland Security Chad Wolf requesting that J-1 physicians—those participating in graduate medical education programs or training at schools of medicine in the U.S.—be excluded from a proposed rule that would limit how long foreign nationals can remain in the country.

Under the proposed rule, foreign nationals who are non-immigrant academic students or exchange visitors would only be allowed to stay in the U.S. for a fixed time. Currently, people who fall under those categories can remain in the country for what is known as a “duration of status,” allowing them to stay as long as they meet the terms of their non-immigrant status.

The medical groups say including foreign national physicians in the change would “jeopardize the delivery of patient care” in the U.S.

“This exclusion is necessary in order to avoid very serious negative and unintended consequences for the delivery of healthcare services to patients at teaching hospitals across the United States. This is especially critical at a time when our health care system is already under incredible strain due to the COVID-19 pandemic and facing an alarming long-term physician shortage,” the groups wrote.

More than 12,000 foreign national physicians provide supervised care at nearly 750 teaching hospitals in the U.S., the groups said. And some of the states hardest hit by COVID-19—Florida, Massachusetts, Michigan, New Jersey and New York—have some of the highest concentrations of foreign national physicians.

“The supervised patient care provided by trainees (residents and fellows) is essential to a teaching hospital’s ability to provide accessible continuity of care. As a result, a change to the ‘duration of status’ model has the potential to disrupt the delivery of health care across the country significantly,” the groups said.

The Department of Homeland Security said the proposed rule change is needed because the agency “is concerned about the integrity of the programs and a potential for increased risk to national security.”

Under the proposed rule, those who want to remain in the U.S. longer than their initial fixed time limit will have to apply for an extension of stay with the U.S. Citizenship and Immigration Services or leave the country and apply for admission with Customs and Border Protection.

“This change would provide the department with additional protections and mechanisms to exercise the oversight necessary to vigorously enforce our nation’s immigration laws, protect the integrity of these non-immigrant programs and promptly detect national security concerns,” the proposed rule says.

The medical groups say the change would delay and disrupt the training of foreign national physicians.

The Educational Commission for Foreign Medical Graduates, the only sponsor approved by the U.S. State Department for foreign national physicians covered by the J-1 visa, already requires physicians to apply annually to renew their sponsorship and continue training, the groups said. Before granting an extension, the commission ensures that each physician is compliant with visa requirements, moving forward in training and meeting milestones, the groups said.

Because foreign national physicians already need to reapply annually for their training, they also, under the proposed rule, would have to annually apply for extensions with the federal government.

“Based on current USCIS processing times, thousands of J-1 physicians would very likely be unable to continue their training programs on time. Similarly, annual travel abroad to extend authorized period of stay during residency or fellowship would be problematic due to its likelihood to disrupt training and, in effect, patient care,” the groups said.

The comment period on the Department of Homeland Security’s proposed change ends Oct. 26.

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