 "H-1B visa fee: Immigrant physicians vital to America, says Harvard scholar")
Foreign-trained doctors who make up almost one quarter of the United States’ medical workforce may be pushed out of underserved areas after the sharp rise in H-1B visa fees, a historian of science has warned. Until recently, hospitals spent about $5,000 to sponsor a physician’s visa. Under President Donald Trump’s September proclamation, that cost has jumped to $100,000 per doctor.
Eram Alam, associate professor and author of The Care of Foreigners: How Immigrant Physicians Changed US Healthcare, said the jump is too steep for many institutions. “This is a massive increase,” she said, adding that smaller hospitals simply cannot absorb the new cost.
Hospitals serving rural America are seen as the most exposed. Many rely almost entirely on foreign-trained physicians who take up roles that American doctors often leave aside in favour of higher-paying or more prestigious work. The American Medical Association has asked the administration to exempt physicians from the higher fees, noting the crucial role they play in caring for millions.
Why immigrant doctors are central to US healthcare
Immigrant doctors are deeply rooted in primary care and other less lucrative specialties. Today, between 200,000 and 300,000 foreign-born physicians practise across the United States, with many coming from India, Pakistan, the Philippines and, increasingly, Nigeria. In some rural hospitals, immigrant doctors make up the entire medical staff.
Alam said these doctors have long accepted positions in challenging settings because they were asked to fill gaps in the system. She noted that early immigrant physicians often worked in social and cultural isolation. Over time, South Asian doctors in particular have taken on leadership roles in hospitals and become visible figures in public life, including in the media.
How shortages at home collide with shortages abroad
The United States benefits from these skilled workers, but their home countries face the loss of medical talent. Alam said many physicians are trained using local taxpayer money, which adds to the strain on health systems abroad and deepens the global shortage. She said the United States needs to train enough of its own doctors so that it can support medical systems worldwide instead of depending on immigration to fill domestic gaps.
Trump’s recent tone on foreign talent
Despite the fee hike, Trump has in recent days appeared more open to bringing in skilled workers for sensitive fields. Speaking to Fox News host Laura Ingraham, he was asked whether his administration planned to deprioritise the H-1B route. “You do have to bring in talent,” he said.
When Ingraham replied, “We have plenty of talent,” Trump responded, “No, you don’t,” adding, “You don’t have certain talents…”