Hundreds of foreign-trained doctors nearing the end of their U.S. medical training face potential deportation unless delays in a critical federal visa waiver program are resolved promptly, immigration attorneys warn. The Department of Health and Human Services (HHS) operates the waiver program, which permits physicians on J-1 training visas to remain temporarily by committing to work in underserved areas for at least three years.
Traditionally, HHS processed these waiver applications within one to three weeks. However, an extensive backlog of hundreds of pending applications has developed since last fall and winter, with the State Department and U.S. Citizenship and Immigration Services (USCIS) still needing to review many cases. If applications do not reach USCIS by the July 30 deadline, the affected doctors will be required to return to their home countries.
Failure to secure timely waivers also triggers a costly obstacle for hospitals. To readmit these doctors under an H-1B work visa, employers must pay a recently imposed $100,000 fee introduced by a 2020 presidential proclamation. This surcharge significantly strains the budgets of rural and underserved hospitals, many of which serve patients covered by Medicare and Medicaid and cannot afford such costs.
Impact on Healthcare Access
The physicians stuck in the backlog often serve vulnerable populations, including pediatric, psychiatric, family medicine, internal medicine, and obstetrics/gynecology patients. A psychiatrist currently awaiting approval noted that their intended patient group includes trafficking survivors, homeless individuals, and incarcerated persons in New York.
Hospitals relying on J-1 waiver doctors report difficulty finding U.S.-based replacements, meaning that delays in waivers directly translate to longer gaps in care. The halt in processing has alarmed health workforce immigration attorneys and hospital leaders who emphasize that taxpayers fund medical training through Medicare and deserve the resulting workforce benefits.
Government Response and Ongoing Challenges
HHS spokesperson Emily Hilliard stated the Exchange Visitor Program has reviewed all fiscal year 2025 J-1 waiver applications and some for fiscal year 2026, promising “key process improvements” to prevent future delays. Still, officials have not explained the backlog’s causes or provided clear timelines for resolution.
Legal efforts are underway to address visa fee issues, with bipartisan lawmakers proposing exemptions for healthcare workers, although no hearings have occurred. Additionally, at least three lawsuits aim to overturn the $100,000 H-1B fee. Advocacy groups, including the American Medical Association, have called for emergency processing measures to expedite physicians’ ability to begin work this summer.
Some foreign doctors are withdrawing U.S. waiver applications, choosing instead to pursue jobs in other countries such as Canada rather than face uncertainty and separation from families. This attrition risks exacerbating the shortage of physicians in American underserved areas.
Background
The J-1 visa waiver program allows foreign physicians who completed U.S. postgraduate training to stay under an H-1B visa in exchange for working in designated shortage areas. Without the waiver, doctors must return home for two years before applying for other work visas. The program historically ensured a steady pipeline of international medical graduates in critical specialties serving low-income, rural, and underserved patients.
Delays in HHS processing represent a disruption in a system that annually supports hundreds of doctors transitioning from training to practice. The recent federal policy adding a significant H-1B visa fee has compounded challenges for hospitals seeking to retain these physicians.
Sources
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