Prevalence of US-trained International Medical Graduates (IMG) physicians awaiting permanent residency: a quantitative analysis

Nagarajan, Kiran Koushik; Bali, Atul; Malayala, Srikrishna V; Adhikari, Ramesh

doi:10.1080/20009666.2020.1816274

Cited by 21 publications

(16 citation statements)

References 3 publications

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“…The top few countries that these graduates hail from are India, Canada, Pakistan and Nigeria [ 16 ]. Some of these applicants have the longest wait times, up to 150 years before they become eligible to adjust their status to that of a permanent resident due to their country of birth [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Care Struggles of US Trained International Medical Graduate Pediatricians in COVID-19 Pandemic

Vasireddy¹,

Malayala

Atluri

et al. 2021

J Clin Med Res

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Background Pediatrician shortage and healthcare access has been a serious issue especially in medically underserved and rural areas aplenty in the USA and has further worsened during the coronavirus disease 2019 (COVID-19) pandemic. Many US trained international medical graduates (IMGs) on a visa status serve these areas to fill in the physician gap. These physicians are usually on a visa and the majority of them have approved immigration petitions. During this pandemic, the sudden changes in immigration policies in addition to the longstanding administrative backlog and processing times had posed new challenges to the pediatricians and the communities served by them. The objective of this study was to determine the demographics, level of training and practice, immigration status, the clinical role they played in the communities they served and the various professional and personal setbacks they faced during the pandemic. Methods A survey was created and data were collected using data collection platform “Survey Monkey”. Screening questions were designed to include only IMG pediatricians on a visa status. Results A total of 267 IMG pediatricians qualified for the survey on a nationwide basis. Of the physicians that participated in the survey, 58.4% were working in either medically underserved or physician shortage areas, 36% of the total physicians were working in a rural setting, 10.6% of the pediatricians had to be quarantined due to exposure to COVID-19, 0.8% were infected with COVID-19 themselves, and 81.3% of the pediatricians had faced hindrance in being able to work at a COVID-19 hotspot due to work site restrictions because of their visa status. Conclusion IMG pediatricians play a valuable role in taking care of the children in medically underserved areas. The challenges surrounding the immigration backlog are contributing to significant hardships for these pediatricians and their families and are causing a hindrance to healthcare access to the children in medically underserved communities during the pandemic especially limiting the pediatricians’ scope and geographic radius of the practice, thus not allowing them to practice to the full extent of their license.

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Section: Discussionmentioning

confidence: 99%

Pediatric Care Struggles of US Trained International Medical Graduate Pediatricians in COVID-19 Pandemic

Vasireddy¹,

Malayala

Atluri

et al. 2021

J Clin Med Res

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“…However, due to the limited annual quota of green cards, which are allocated based on the country of birth of the applicant, the wait times can vary widely among applicants. Due to the sheer number of applicants from countries like India and China, expectedly higher from the two most populous countries in the world, these applicants have the longest wait times before they become eligible to adjust their status to that of a permanent resident [ 10 ]. More so than any other state, this immigration backlog might hamper the healthcare needs of Kentucky as it is heavily dependent on the IMGs delivering frontline and primary healthcare.…”

Section: Discussionmentioning

confidence: 99%

“…One such significant reason was the "immigration backlog." With the immigration being restricted to only 7% of individuals from each country, physicians of large population countries (like India and China) are stuck in an immigration backlog, causing years and sometimes decades of wait time to obtain a permanent residency [10].…”

Section: Introductionmentioning

confidence: 99%

“…However, many policies surrounding the US-trained and licensed IMG physicians posed significant challenges to the physicians at their personal and professional fronts and limited their ability to fight the pandemic efficiently. One such significant reason was the “immigration backlog.” With the immigration being restricted to only 7% of individuals from each country, physicians of large population countries (like India and China) are stuck in an immigration backlog, causing years and sometimes decades of wait time to obtain a permanent residency [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Access in Medically Underserved Areas During the COVID-19 Era: An International Medical Graduate Perspective From a Rural State

Malayala¹,

Vasireddy²,

Kadali³

et al. 2020

Cureus

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Background Physician shortage and healthcare access are serious issues in rural states like Kentucky and further worsened during the coronavirus disease 2019 (COVID-19) pandemic. International Medical Graduates (IMGs) serve the underserved communities of Kentucky to fill in the physician gap. However, uncertainties surrounding immigration policies added significant challenges to physicians and the rural communities served by them during the pandemic. Methods A survey was created using the data collection platform “SurveyMonkey” and sent to IMG physicians practicing on a visa to understand their role and their immigration-related challenges. Only the physicians practicing in Kentucky were included in this study. Results It was found that 84% practice in primary care specialties like internal medicine, pediatrics, or family medicine, 92.9% practice in Medically Underserved Areas or Health Professional Shortage Areas, and 71.4% practice in rural settings. Also, 61.5% practice in a “frontline” COVID-19 specialty and 92.3% were involved in direct care of COVID-19 infected or suspected patients. Of the physicians, 88.5% were in an “immigration backlog”; 92.6% of them were the primary visa holders of their families and 88.9% expressed concern that their families face hardship if they have a disability during the pandemic. It was reported by 92.3% of them that visa-related restrictions limited them from providing additional coverage in these places. Conclusions Lack of physician access is a critical issue facing many rural states in America like Kentucky, and IMG physicians play a valuable role in taking care of this underserved population and fighting the COVID-19 pandemic. The challenges surrounding the immigration backlog are contributing to significant hardships and remain a hurdle to expand healthcare access to the rural and medically underserved communities.

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“…The IMG physicians who work in the underserved areas through the Conrad 30 program are processed and approved for immigrant visas also more commonly known as “green cards.” Over the years due to the administrative backlog of processing these applications these physicians have been stuck on a H1 visa status restrained in their scope of practice due to limitations the visa laws pose. 7 The waiting time for the physicians based on their country of birth could be as long as 150 years. 8 This limbo has raised a lot of uncertainties and anxieties in the IMGs practicing in the state and the country.…”

Section: Methodsmentioning

confidence: 99%

Primary Care Shortage in Medically Underserved and Health Provider Shortage Areas: Lessons from Delaware, USA

Malayala

Vasireddy²,

Atluri

et al. 2021

J Prim Care Community Health

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Objective: To examine the reasons contributing to the physician shortage in the country’s medically underserved areas using the state of Delaware as a focus state. Method: A literature review regarding the shortage of physicians with data compilation from Delaware Department of Public Health (DPH) and Delaware Health and Social services (DHSS) was performed. A review of the “Conrad 30 J1 VISA waiver program,” the most important and primary supplier of physicians to underserved areas of the state was performed. A survey interviewing the physicians recruited through this program to identify any challenges faced by them was designed and conducted. Results: The number of primary care physicians providing direct patient care in Delaware in 2018 had declined about 6% from 2013. The average wait time to see a PCP was 8.2 days in 1998 as compared to 23.5 days in 2018. Forty-six percent of physicians serving in HPSAs in Delaware are IMGs recruited through the J1 VISA waiver program. Eighty percent of these IMGs are actively considering leaving the United States due to anxieties around physician immigration policies, mainly “Immigration backlog.” Conclusion: The existing programs to recruit physicians to underserved areas seem to be inadequate. The state and the hospital systems should be able to utilize the J1 program to its full potential and focus on retaining these physicians after their assigned services. As the challenges of IMGs continue to worsen every day; the medical societies, hospitals, the state and federal government should advocate for policies that resolve these challenges.

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Prevalence of US-trained International Medical Graduates (IMG) physicians awaiting permanent residency: a quantitative analysis

Cited by 21 publications

References 3 publications

Pediatric Care Struggles of US Trained International Medical Graduate Pediatricians in COVID-19 Pandemic

Pediatric Care Struggles of US Trained International Medical Graduate Pediatricians in COVID-19 Pandemic

Healthcare Access in Medically Underserved Areas During the COVID-19 Era: An International Medical Graduate Perspective From a Rural State

Primary Care Shortage in Medically Underserved and Health Provider Shortage Areas: Lessons from Delaware, USA

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