In the middle of the ongoing debate over immigration, worries continue about the impact on the healthcare industry, which depends on foreign doctors and medical students.
Now there's new evidence that fewer international doctors are seeking work in the U.S., although it's not clear whether the Trump administration's less welcoming immigration polices are to blame.
National healthcare recruiting company The Medicus Firm said it placed the lowest percentage of internationally trained physicians in 2017 in at least seven years. The percentage of internationally trained physicians placed by Medicus dropped to 24%, down seven points from nearly 32% in 2016, according to the report.
“The reason behind this trend is unclear, especially since the physician workforce demographics have not changed as such,” according to the report, which is based on the company’s 2017 placements at more than 250 hospitals and healthcare employers in 42 states.
The report also found that 6.3% of providers placed in 2017 were on either a J1 or H1-B visa, which is how most foreign-born medical graduates and medical students come to the U.S. Those visitors’ visas were subject to a travel ban imposed by President Donald Trump last year.
That travel ban and stricter immigration policies have raised fears from the medical community of the detrimental impact on the healthcare system, especially since foreign doctors and medical students often provide care in rural and underserved areas.
A federal appeals court ruled (PDF) against the latest version of Trump’s travel ban last Thursday, saying it “continues to exhibit a primarily religious anti-Muslim objective.” The revised ban placed varying levels of restrictions on foreign nationals from eight countries: Chad, Iran, Libya, North Korea, Syria, Venezuela, Somalia and Yemen.
The 2017 drop was the largest since 2014, when placements of internationally trained physicians dropped from 39% to 31%, according to Medicus. Despite the fluctuation, even at the lower 2017 rate, the overall percentage of internationally trained doctors is still relatively in line with the proportion of internationally trained physicians in the workforce, the report said.
The report also showed a decline prior to the controversy over immigration policies. In 2012 more than 42% of placements were made up of international medical graduates, which dropped to 39% in 2013, 31% in 2014 and almost 29% in 2015, before increasing to almost 32% in 2016 and then taking the dip in 2017.
Internationally trained physicians make up about 25% of the physician workforce, according to trade groups, including The Association of American Medical Colleges (AAMC). That figure includes all physicians who graduated from a medical school outside of the U.S., whether they are American-born or foreign-born.
“International medical graduates are a vital component of the physician workforce in the U.S., particularly in light of projected physician shortages through 2025,” the report stated.
No resolution on DACA
Another immigration issue that has raised worries among healthcare organizations is the fate of healthcare workers and students protected by the Deferred Action for Childhood Arrivals (DACA) program. Four separate votes on four different immigration plans aimed at making DACA permanent failed in the Senate last week.
The AAMC called Congress’ failure to act to protect the so-called ‘Dreamers’ disheartening and called on Congress and the administration to come together in bipartisan action to provide stability to those with DACA status.
“As college students look toward medical school, and medical students prepare for their residency training, unless Congress acts, those with DACA status could be prevented from completing the necessary requirements to fulfill their lifelong goal of pursuing medicine or science," AAMC’s president and CEO Darrell G. Kirch said in an announcement.
"At the same time, patients in underserved communities could be denied the care they deserve since Dreamers are more likely to practice in those areas,” he addded
Without legislators' intervention, recipients will lose their protected status on March 5; the Trump administration provided a six-month grace period after announcing plans to end DACA last September.