May 19, 2020

Re: Maintaining the Nation’s Physician Workforce during the Covid-19 Pandemic

Dear Speaker Pelosi, Minority Leader McCarthy, Majority Leader McConnell, and Minority Leader Schumer:

On behalf of the Council of Medical Specialty Societies (CMSS), thank you for your leadership in addressing the health concerns and economic hardships experienced by all Americans as a result of the COVID-19 pandemic.

With more than 800,000 physicians across 45 specialties, CMSS recommends additional efforts to maintain the nation’s health workforce by retaining physicians and scientists currently in the United States and by expediting entrance of physicians into the country. A robust health workforce is crucial to ensure that patients can receive the critical care they need during these difficult times.

The U.S. health care system relies heavily on international medical graduates who are citizens of other nations (non-US IMGs), who represent more than 25% of the physician workforce in our country.[1] These physicians are training or practicing here legally on a visa or other protected status. Nearly 21,000,000 Americans live in an area where at least one-half of the physicians are foreign-trained.[2] These highly qualified physicians are an important segment of the nation’s health care in U.S. teaching hospitals and in medically underserved areas—especially now during the COVID-19 pandemic. The nation will face numerous challenges in the coming months. The Centers for Disease Control and Prevention predicted “a second wave of the novel coronavirus will be far more dire because it is likely to coincide with the start of flu season.”[3]

CMSS appreciates the fact that the Helping Emergency Responders Overcome Emergency Situations (HEROES) Act of 2020 includes provisions to support non-US IMGs working on the frontlines to address the COVID-19 crisis. The HEROES Act of 2020 seeks to expedite the processing of:

  • Temporary work visas and immigrant visas for health care workers looking to work in the U.S. amid the pandemic
  • Green cards for physicians in the US engaged in or will engage in the practice of medicine or medical research involving the diagnosis, treatment or prevention of COVID-19

Furthermore, the HEROES Act of 2020 sets to temporarily extend visa expirations for those whose status may be set to expire during the COVID-19 pandemic. Clearly, the sponsors of the legislation understand CMSS’s and its members concerns that the nation properly support non-US IMGs as they provide critical contributions on the frontlines of the COVID-19 crisis.

CMSS also appreciates actions taken by the Department of State and the U.S. Citizenship and Immigration Services (USCIS) to maintain the nation’s health care workforce, including resuming visa processing at embassies and consulates worldwide for physicians and medical residents as emergency and mission critical visa services and  allowing “flexibility for some physicians to work in hospitals other than the one designated as their main employer.” [4],[5] IMGs serve as important members of healthcare teams at teaching hospitals across the country. The combined efforts of the Department of State and USCIS are critical to ensuring that these medical residents are able to join their programs which begin on July 1.

CMSS recognizes and thanks the Administration and the Department of State for their flexibility and recognition of the importance of physicians in light of the recent Executive Proclamation Suspending Entry of Immigrants Who Present Risk to the U.S. Labor Market During the Economic Recovery Following the COVID-19 Outbreak.[6]

However, more must be done to ensure that the nation has an adequate health care workforce in order to successfully address the current public health emergency. Therefore, CMSS urges Congress to encourage the U.S. Department of State and USCIS to:

  • Assure that visa policies will continue to identify physicians as important for national security in terms of health.
  • Continue and prioritize visa processing for physicians and medical residents
  • Expedite USCIS adjudications of extensions and changes of status for physicians and medical residents practicing or otherwise lawfully present in the United States.

While certain visa programs are eligible for renewal, it is not a guaranteed process. CMSS recommends automatically extending visas and other protected status for physicians and medical residents already in the United States through the COVID-19 public health emergency to bolster the health care workforce feeling the burden of addressing the pandemic and guarantee greater access to quality health care for all Americans.

CMSS also recommends exempting physicians on H-1B visas seeking permanent resident status from the annual per-country limitation for employment-based immigrants. Many graduate students from international medical schools are ineligible for permanent resident positions after completing fellowship training due to the restriction that no country have citizens that comprise of more than 7% of total yearly green cards available worldwide for family and employment-based categories.[7]

Again, thank you. CMSS and the specialty society signatories below sincerely appreciate the swift congressional action to combat COVID-19. To provide optimal healthcare for Americans during this pandemic, CMSS urges you to consider the actions identified in this letter to maintain the health care workforce during this crisis.

If you have any questions, or if CMSS can offer any further information or assistance, please contact Dr. Helen Burstin, Executive Vice President and Chief Executive Officer of the Council of Medical Specialty Societies, at hburstin@cmss.org.

Thank you,

Council of Medical Specialty Societies

 

American Academy of Family Physicians

American Academy of Hospice and Palliative Medicine

American Academy of Neurology

American Academy of Pediatrics

American Academy of Physical Medicine & Rehabilitation

American Association of Clinical Endocrinologists

American College of Emergency Physicians

American College of Obstetricians and Gynecologists

American College of Physicians

American College of Preventive Medicine

American College of Rheumatology

American College of Surgeons

American Epilepsy Society

American Gastroenterological Association

American Geriatrics Society

American Psychiatric Association

American Society for Clinical Pathology

American Society for Radiation Oncology

American Society for Reproductive Medicine

American Society of Hematology

American Society of Nephrology

American Thoracic Society

American Urological Association

Infectious Diseases Society of America

North American Spine Society

Society for Vascular Surgery

Society of Critical Care Medicine

Society of Hospital Medicine

The Society of Nuclear Medicine and Molecular Imaging

 

 

[1] https://www.bU.S. inessinsider.com/foreign-doctors-roadblocks-to-helping-with-U.S. -coronavirU.S. -pandemic-2020-4?utm_source=sfmc&utm_medium=email&utm_campaign=cfasnews&utm_content=newsletter

[2] https://www.americanimmigrationcouncil.org/research/foreign-trained-doctors-are-critical-serving-many-us-communities

[3] https://www.washingtonpost.com/health/2020/04/21/coronavirus-secondwave-cdcdirector/

[4] https://www.bU.S. inessinsider.com/foreign-doctors-roadblocks-to-helping-with-U.S. -coronavirU.S. -pandemic-2020-4?utm_source=sfmc&utm_medium=email&utm_campaign=cfasnews&utm_content=newsletter

[5] https://travel.state.gov/content/travel/en/News/visas-news/update-on-h-and-j-visas-for-medical-professionals.html

[6] https://www.whitehouse.gov/presidential-actions/proclamation-suspending-entry-immigrants-present-risk-u-s-labor-market-economic-recovery-following-covid-19-outbreak/

[7] https://www.americanprogress.org/issues/immigration/reports/2019/07/29/472619/immigrant-doctors-can-help-lower-physician-shortages-rural-america/