Travel, Visa Changes: Concern for Rural Healthcare

Troy Brown, RN

Disclosures

May 25, 2017

International medical graduates and foreign-born healthcare workers are dealing with ever-evolving travel and visa requirements outlined in executive orders issued by President Trump. These changes have created uncertainty for some foreign students and may potentially limit access to healthcare in rural areas, where millions rely on foreign-born healthcare workers.[1]

Medical students typically learn where they will complete their residency on Match Day, which occurs on the third Friday of March. Medical residencies and fellowships begin 3 months later, usually on July 1. This year, however, that schedule may be upended for some new physicians.

"Uncertainty is the word that hits the nail on the head," Matthew Shick, JD, director, Government Relations and Regulatory Affairs, Association of American Medical Colleges, Washington, DC, told Medscape.

"We have about 5000 residents who matched this year [who are internationally educated] who will require some sort of visa to enter residency training within the United States," said Shick. "While a lot of press has focused on the six affected countries of the travel ban, the executive order also calls for a number of enhanced screening measures, some cancellation of programs that allow for waivers of interviews for certain individuals, and generally just created an air of uncertainty and perhaps some processing delays. It's really unclear, within the short time frame of March 17 to July 1, whether the agencies will be able to process all those to have them start on time."

The impact of these new processes may well extend beyond incoming residents, limiting access to care for millions of people in rural areas who rely on them.[1]

The Role of Internationally Educated Health Professionals in Rural Areas

The Association of American Medical Colleges projects a total physician shortfall of between 40,800 and 104,900 physicians by 2030.[2] That shortage likely will affect rural areas most, which already struggle to attract enough physicians, causing a reliance on foreign-born and foreign-educated doctors and nurses to provide healthcare services to almost 57 million people.[3]

"Our organization does rely on foreign medical graduates trained in the United States to fill vacancies in federally designated medically underserved areas," Christa Henderson, human resources officer/physician recruitment, Avera Health, Sioux Falls, South Dakota, told Medscape. "We have around 50 medical professionals in our health system who are in the process [of obtaining] needed visas. We value our international medical graduates, and they are an important part of our workforce and the delivery of healthcare services to the medically underserved population," Henderson said.

The travel restrictions "could be furthering a constriction of the flow of international physicians to the United States, and we at [the National Rural Health Association] would be very concerned about anything that would...take tools away from rural communities to solve their workforce issues. We know that rural communities have a tremendous problem already, and we don't need to make their jobs harder," Brock Slabach, senior vice president for member services, National Rural Health Association, told Medscape.

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