NCPA - National Center for Policy Analysis


February 20, 2007

Growth in the H1-B visa -- which helps U.S. companies temporarily hire skilled foreign workers for jobs that are difficult to fill domestically -- are inadvertently undercutting the pipeline to the J-1 waiver, a little-known provision that for years has funneled thousands of physicians to parts of the country that needed them the most, says the Wall Street Journal.

Many foreign doctors are securing an H1-B, which unlike the J-1, doesn't require them to first spend three years in an underserved area, often in rural settings.  The decrease has been profound:

  • The number of foreign doctors on a J-1 visa fell by 45 percent to almost 6,000 in 2005-06, compared to nearly 11,000 in 1995-96.
  • About 25 percent of all physicians in practice or in training across the United States are foreign, but in rural areas the percentage is often much higher.
  • For example, in Crosby, N.D., a remote farming community, the town received 150 applications for two physician slots at its 25-bed hospital in 2001.
  • This year, the sole doctor, from the nation of Georgia, is on call around the clock; six recruiting firms and numerous ads in medical journals have failed to draw qualified applicants for the second opening.

Some health officials have started to mobilize to fix the problem.  Connie Berry, a senior health official in Texas, says that one idea is to require all foreign medical graduates to spend time in an underserved area, regardless of which visa they use to enter the United States for training.

Others are advertising.  Anita Monoian, Yakima, Washington's community clinic director, sent brochures about Yakima's outdoors, and also informed young physicians that the town boasted the only Nordstrom department store outside a major city.  Under her watch, the facility has more than doubled in size.

Source: Miriam Jordan, "With a Quirk in Visa Law, Small Towns Lose Doctors," Wall Street Journal, February 19, 2007.

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