Foreign-born or trained physicians in the U.S. have been navigating an increasingly uncertain future as a new wave of visa regulations and immigration policies complicate their practice.
Here are six recent developments shaping the foreign-trained physician workforce in the U.S.:
1. Visa processing delays have sidelined foreign physicians at hospitals and clinics across the nation in the wake of a freeze on automatic extensions of employment authorizations for visas, among other recent policy developments.
In December, the Trump Administration released Proclamation 10998, which implemented a full suspension of entry to the U.S. for nationals from 19 countries, and a partial suspension of entry from 20 countries. Although the travel ban does not apply to visa holders in the U.S., USCIS paused visa renewals and updates for people from those countries. This subjected more than 10,000 physician H-1B visa holders and 17,000 with J-1s, along with thousands of nurses, lab techs and other healthcare workers to the visa pause.
The proclamation, combined with additional enforcement actions detailed in a March 30 release from USCIS, has left thousands of foreign clinicians unable to work. Many of these clinicians work in rural and underserved areas, while nearly 21 million Americans live in areas where foreign-trained physicians account for at least half of all physicians, according to the American Medical Association. USCIS is funded by processing fees, so the agency remains open despite DHS being shut down due to the funding impasse in Congress. The AMA sent a letter in February to the Department of Homeland Security asking that foreign medical degrees be exempt from the visa pause. The letter details the patient impact of the delayed renewals, citing one physician who worked in an underserved area that had to stop seeing patients due to the slow visa process, leaving over 900 patients without proper access to care.
2. The status of H-1B visas has been in flux since September 2025, when President Donald Trump signed an executive order requiring employers to pay a $100,000 fee for each new H-1B visa application — an increase from the roughly $3,500 employers previously paid. The fee took effect Sept. 21.
The policy received significant pushback from health system leaders whose organizations often rely on the H‑1B visa program to sponsor physicians and medical residents to fill critical staffing gaps.
More than 4,000 research centers and hospitals sponsored visas as of June 2025, federal data previously cited by Bloomberg shows. Research has shown disruptions to the program could worsen access to care, particularly in rural and medically underserved areas that disproportionately depend on international medical graduates.
The American Medical Association applauded legislation introduced March 17 to exempt physicians and other healthcare professionals from a $100,000 filing fee on new H-1B visa petitions. The legislation was introduced by Reps. Mike Lawler, R-N.Y., Sanford D. Bishop Jr., D-Ga., Maria Elvira Salazar, R-Fla., and Yvette Clarke, D-N.Y. The AMA also said it previously joined 53 medical societies in urging the Department of Homeland Security to exempt physicians, residents and fellows from the $100,000 H-1B visa application fee.
3. International medical graduates’ match rate fell to a five-year low, with only 56.4% of non-U.S. international medical graduates matched to a post-graduate year 1, or PGY-1, position, representing a 1.6% decrease from 2025 and a five-year low for these applicants, according to the National Resident Matching Program.
Match Day 2026 recorded a 93.5% match rate for all positions and a 93.3% rate for PGY-1 positions, which are both 0.8% lower than 2025 match rates. Overall, 53,373 applicants registered, and 41,482 of 44,344 total residency positions were filled, according to the National Resident Matching Program.
Among the 11,944 active applicants who are not U.S. citizens, their match rate declined to 56.4% — the lowest level observed in five years.[International medical graduates] play an important role in the U.S. physician workforce, and recent federal immigration policy changes have increased attention to visa sponsorship considerations in residency recruitment for foreign-born candidates,” the National Resident Matching Program said in a March 20 news release.
4. Many physicians see their foreign-trained colleagues as a solution to the ongoing physician shortage, according to Medscape’s “Turning to Foreign-Trained Physicians Report 2026” published Feb. 20.
Medscape surveyed 1,037 physicians between July 2 and Aug. 30. Two-thirds say internationally trained physicians are a viable answer to the broader U.S. shortage, and 75% say they could help small communities.
Still, concerns around language barriers, visa hurdles and licensure requirements persist, and physicians remain divided over whether alternative pathways to practice should be expanded.
5. Some politicians want to get rid of H-1B visas entirely. In February, a Republican representative from Florida introduced legislation that would eliminate the federal H-1B visa program, which allows employers to hire highly skilled foreign professionals through temporary work visas. Rep. Greg Steube, R-Fla., introduced the Ending Exploitative Imported Labor Exemptions, or EXILE, Act, Feb. 9. The bill would amend a section of the Immigration and Nationality Act to end the visa program, which critics argue has disadvantaged American citizens. The H-1B program has been in place since 1990.
Hospitals and health systems are among the employers that rely on the visa program, sponsoring physicians and medical residents to fill staffing gaps, particularly in rural and medically underserved areas. Healthcare groups have warned disruptions to the program could worsen access to care, especially in communities where international medical graduates make up a significant share of the physician workforce.
6. Some states are fighting to keep their foreign-born physicians. Eighteen states currently have laws allowing internationally trained physicians to gain full licensure. Another three — California, New York and Washington — grant limited licensure. Three other states have pending bills related to limited licensure and another six state legislatures are considering pathway bills in 2026. The laws aim to combat the nation’s growing physician shortage, which is becoming more urgent as patient acuity rises, more physicians approach retirement age and a wide array of other factors. One strategy to fight the shortage is reducing or eliminating residency requirements for internationally trained medical school graduates to gain employment in the U.S.
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