Visa changes cut supply of rural doctors

When it needs a large influx of specialized hires, the technology industry has the H-1B visa program, which allows companies to temporarily hire skilled foreign workers for difficult-to-fill U.S. positions. While the H-1B waiver program continues to steam along, a related program known as the J-1 waiver is losing popularity, causing rural areas typically served by foreign doctors to lose their medical support. The number of foreign doctors here on a J-1 fell 45 percent to about 6,000 in 2005-06, compared with almost 11,000 ten years before.

In the past, doctors from countries like India and Pakistan came in on the J-1, which gives doctors eligibility for a green card if they spend three years in a rural or underserved area. Lately, however, such doctors are bypassing the J-1 and going straight for an H-1B, which allows them to skip the rural practice time and go straight to big, cutting-edge urban centers. These doctors say that going rural doesn't do enough to hone their skills, and isolates them from facilities with the latest technology. What's more, teaching hospitals are agreeing to pay the $1,000 or more it costs to obtain an H1-B, as it allows these foreign physicians to stay in the U.S. after training, as well as letting them apply immediately for a green card.

Without a large number of J-1 physicians in place, many rural U.S. residents are traveling long distances to see doctors. Attempts to lure other physicians are often unsuccessful. And in the mean time, it appears that there's little rural areas can do to turn around this trend, other than creative marketing of their sometimes idyllic communities. It remains to be seen whether that can offset the lure of the big city.

Find out more about the J-1 visa issue:
- read this piece in the Wall Street Journal (sub. req.)

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