In May, the U.S. Congress will begin considering immigration reform legislation that could make it easier for more foreign physicians to enter the country. Most foreign physicians come to the U.S. on either an H-1B worker visa or a J-1 visa. Foreign physicians who enter on a J-1 are required to return to their home country for at least two years after they've completed their education and training. Only after this two-year requirement has been fulfilled can they return to the U.S. to seek permanent resident status (there are some circumstances under which this requirement can be waived, such as if they agree to serve in an underserved area for three years). However, by and large, the H-1B visa is an easier path for foreign physicians to seek permanent resident status.

The current cap for H-1B visas is 65,000 annually. The Senate immigration reform bill seeks to raise this cap to 110,000. Of course, while not all of these would go to foreign physicians, the new legislation seeks to streamline the H-1B process by which doctors can apply to stay in the country legally. However, the bill will also require hospitals or other sponsors to pay a $1,500 per every H-1B medical resident. This could potentially be an impediment, especially if sponsors do not wish to pay the high fee. The other option in such an event is the J-1 visa, whose two-year requirement could be waived if a physician agrees to work in an underserved area.

There are some who are concerned that changes sought in the immigration reform legislation may still not attract enough doctors to fill shortfalls in underserved areas, particularly given the predicted need for more physicians due to the Affordable Care Act (also known as Obamacare). According to the U.S. Department of Health and Human Services (DHHS), there are approximately 5,900 areas in the U.S. that have more than 3,500 people per primary-care physician. These areas are officially designated as shortage areas, and DHHS says it would take 7,550 more primary care physicians to alleviate the shortages.

Another change the immigration reform legislation seeks to make is eliminating per-country caps on how many people can immigrate to the U.S. each year. Presently, the caps apply to physicians as well as other professions, and as such it could take years for physicians in countries with large backlogs to obtain permanent resident status.

In upcoming posts we will discuss the immigration reform legislation in more detail.