The United States continues to face a persistent shortage of healthcare personnel, particularly in rural communities and smaller towns. To address this, the federal government has expanded programs that allow hospitals to recruit doctors and healthcare workers trained abroad and to validate their qualifications.
Where shortages remain
According to the Health Resources and Services Administration (HRSA), more than 86 million Americans live in areas officially designated as Health Professional Shortage Areas, or HPSAs. These shortages affect every state and include both rural counties and urban neighborhoods where access to care is limited.
Causes behind the lack of doctors
The Association of American Medical Colleges (AAMC) reports that uneven physician distribution, rising retirements, and an aging population have made staffing increasingly difficult. The shortage is most evident in family medicine, pediatrics, and certain hospital specialties.
Doctors trained abroad
Physicians educated outside the United States are officially known as International Medical Graduates (IMGs). The American Immigration Council reports that about one-quarter of the doctors practicing in the country hold medical degrees from institutions abroad. Many work in communities where recruiting local professionals has proven difficult.
Requirements to practice medicine
Practicing medicine in the United States requires certification from the Educational Commission for Foreign Medical Graduates (ECFMG), passing the United States Medical Licensing Examination (USMLE), and obtaining a license from a state medical board. These processes are mandatory, even for American citizens who studied overseas.
Visas available for healthcare workers
The main visa categories used by foreign physicians are the J1, designed for residency and medical training programs, the H1B, issued to highly skilled employees hired by U.S. institutions, and the EB2NIW, a permanent residency option available to those serving the public interest, particularly in medically underserved regions.
Retention programs and legal framework
None of these visas eliminate licensing requirements, but the government prioritizes health-related applications, helping hospitals in shortage areas fill vacancies more quickly. Hospitals can also sponsor candidates directly, expediting their paperwork through federal review.
One example is the Conrad 30 Waiver program, established in 1994. It allows international doctors completing U.S. residencies to remain in the country if they commit to serving three years in designated shortage areas. The program operates under federal law in collaboration with state governments, which identify eligible communities.
Institutional support and oversight
Organizations such as the American Medical Association (AMA) and the American Hospital Association (AHA) emphasize the relevance of internationally trained physicians to maintaining hospital operations.
A report by the American Immigration Council in 2024 noted that many healthcare facilities across the country still depend on foreign professionals to provide essential medical care following the increased demand seen during the COVID-19 pandemic.
Every stage of licensing, certification, and visa issuance is public and regulated by federal and state agencies. No program currently exempts foreign professionals from diploma validation or mandatory examinations.
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Sources: Info Money | Economia em Pauta
