They’ve gotten through medical school. They’ve applied to residency programs, and been offered a job at a US hospital.

But for some of the 3,814 non-US citizens who graduated from foreign schools and who won coveted residencies in the US, it’s unclear whether they’ll be able to start work on time in the summer.

That’s because a program that allows employers to fast-track H-1B visa applications for their employees has been suspended as of Monday. US immigration officials announced the change just a month ago — and Match Day, when new residents learn where they will be placed was March 17 — leaving some hospitals rushing to figure out who needed this kind of visa and to apply before “premium processing” would no longer be an option.


“They are battling against the clock,” said Claire Ayer of her staff in the Partners HealthCare Office for International Professionals and Students, which handles visa applications for the international staff and students of its Boston-area hospitals, including Massachusetts General and Brigham and Women’s. She said they have been working evenings, weekends, and early mornings to get “premium processing” for as many international residents as possible before Monday.

The faster turnaround costs $1,225 per applicant, but it makes a difference. With “premium processing,” a visa application is answered in 15 days. Without it, the evaluation can take more than six months — and the government does not allow you to apply for an H-1B visa more than six months in advance.

The change comes on the heels of President Trump’s executive orders imposing a temporary travel ban on people from a handful of majority Muslim countries, actions that have been put on hold by federal judges. Some medical students with Iranian citizenship who had been hoping to do their residency training in the United States “have changed their destination to Canada or European countries as coming to the US seems almost impossible from now on,” said Dr. Sanaz Attaripour, a neurology resident at Drexel University, who founded a Facebook group for Iranians applying for American residencies.

Overall this year, slightly fewer foreign medical school graduates applied to US residency programs.

“I’ve been doing immigration for a long time, and I’ve never seen a more inhospitable environment,” said Ayer.

The irony is that the US Citizenship and Immigration Services says it is suspending “premium processing” for the exact reason that people like it so much: the long wait times of the normal H-1B process. The suspension, the agency suggested, would allow its staff to process those applications that have been left by the wayside as “premium processing” cases get first dibs, creating a backlog.

But some say the move’s timing was either tone-deaf or punitive.

“It’s the busiest time for hiring,” said Brian Groves, director of the International Students and Scholars Office at the University of California, San Francisco. “Reasonably, if they wanted to work on the backlog, the time to do it would be at a slow period, not when going into the busiest time.”

Not all international medical residents come to the United States on an H-1B visa. Most get a J-1, which offers “cultural or educational exchange opportunities.” But some either aren’t eligible for a J-1, or don’t want that type of visa because it requires that you return to your home country at the end of your training for two years. And the only way to get around the mandatory trip back home is to work in an underserved community — which, in turn, requires that you get an H-1B.

“There’s likely going to be many rural clinics that are going to have staffing problems,” said Groves.

A CIS spokesperson told STAT that the agency can still expedite an application if it is an emergency situation, if a delay will cause severe financial loss, or if the application involves a nonprofit and the request will further American “cultural and social interests,” among other criteria.

Immigration officials would like to see all wait times reduced — according to CIS, H-1B visas take, for example, more than eight months to process in California, and more than 11 in Vermont — but some worry about the consequences of the suspension.

Even international medical students who have come to American medical schools could be affected. They often use an extension on their student visa for their first year of residency before transitioning to an H-1B for their second. And if residents at any stage aren’t able to start work when they are supposed to, that could potentially cause staffing problems in hospitals.

“How are you going to cover their patients?” Ayer asked.

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  • there are US med school graduates and US citizens who graduated from foreign medical schools who can’t get a residency at all. it is about time to put america first!

    those hosipitals should hire US citizens first. yes, there are many talented people from all over the world, but if we give them jobs, then what can us citizens do?

    • lol , the thing is that it doesnt make sense to put their citizen first its about talent and knwoledge , as US is most sort after for majority of students from all over world US students needs to work more hard to get that position in residency ….

  • Dear Eric Boodman,
    This article is clearly biased and you are certainly misinformed (clearly its politicized with the intention to create bad publicity for the current administration). The reality for foreign medical grads is that 80-90% of them get offered a J1 Visa though ECFMG and not the H1B Visa. Which means that out of the 3,814 IMGs that will start residency in the summer over 3,500 will have no problem starting on time and the majority of hospitals are “not rushing to get visas on time”. The reason for why residents prefers H1B Visas is because they can transitioned to a Greencard and stay in the US easier, compared to the J1 which forces you to work 3 years in and underserved community to get a waiver, helping those with the biggest disadvantages. So all of the poor residents you described are basically trying to cheat the system and escaping the good laws we have in this country to improve health care, its easy you wanna stay, help and will open the door for the American dream.
    For the words of Ms. Ayer, I have the following to say, if you really want all those doctors to start on time, simply offer them the J1 Visa. And as far as middle east doctors, from any nationality including Iranian, there hasn’t been a single case of ECFMG not sponsoring a visa discriminating due to the country of origin.
    Before you go online and publish information, you should do a little more research.

    • For many doctors trained outside the US, coming to learn and work in the US is a big thing in itself. To accomplish this dream they do make many sacrifices, which at times are overlooked. There are places in the world, with better quality of life but best and brightest students in the world chose the US because they have seen people come and live their dream here in the US… things that have changed over the month have left a dent in the dreams of many.
      There are reasons behind why programs offer H1b while they could easily have gone for J1. They are usually the programs in comparatively underserved areas or have other features which make them less appealing. When the applicants make their rank order list, if they rank an H1b sponsoring program, that’s a conscious decision, they know what they are getting and what they are losing. But a change in policy that is implemented after the rank order lists were submitted, no longer values the purpose of making that order list. It has left the residents to blame nothing else but bad luck !!
      But as any other time in life, we should be ready to start from where we are, with what we have ! and we gonna do that and shine bright 🙂

  • The vast majority of international residents went to college and medical school in the US, but still need visas, since there is no path to a green card from student visas. And most ask for H-1Bs, since that way they can most easily apply for permanent residency. Unlike universities, which apply for 3-year H-1B visas for their employees, many hospitals refuse to do this, instead requiring a new application to be filed every single year. This leaves residents in an annual limbo of uncertainty about whether they’ll be able to continue to work, and with long periods of time where they are unable to travel outside the country. If hospitals just stopped being so cheap and lazy and filed for multi-year visas upfront, or just sponsored residents for green cards immediately, this problem could be avoided.

    • In my state the typical foreign medical resident had done college and med school in their home country. The US lacks the medical school capacity to train the numbers needed. The hospitals that hire the residents are having more and more trouble funding the resident slots in the first place. They certainly can’t afford to hire people to deal with visa issues. If the foreign medical wants a position in the US they are going to need to work for it. If not they can stay away. A physician shortage is needed to convince the US government to start funding medical schools and residency programs for Americans.

    • Yeah, and you can request that I come over and wash your car for you too. You never know, I might be feeling generous.

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