Advocacy in action: Clearing IMGs’ route to practice

International medical graduate (IMG) physicians play a critical role in the delivery of health care services. Having a disruption to the flow of IMGs who practice medicine in the U.S. would negatively impact the care provided in the U.S. and adversely affect the lives of patients.

The care IMGs provide is desperately needed as the U.S. faces a projected shortage of between 37,800 and 124,000 physicians within 12 years, according to The Complexities of Physician Supply and Demand: Projections From 2019 to 2034 (PDF), a report released by the Association of American Medical Colleges. 

There are almost 325,000 IMG physicians practicing in the U.S., which accounts for around 25% of the physician workforce. Here are some other key IMG facts that you should know:  

• The number of IMGs practicing in the U.S. has grown by nearly 18% since 2010. That figure is bigger than the 15% rise in U.S. medical graduates over that same time period. 
• More than 45,000 IMGs practice internal medicine, making it the most populated specialty among these individuals. 
• The 2019 State Physician Workforce Data Report found that nationally, almost 25 percent of active physicians providing care in the U.S. are IMGs. Likewise, more than 20 million people live in areas of the U.S. where foreign-trained physicians account for at least half of all physicians. 

Led by the policy work of the AMA International Medical Graduates Section (AMA-IMGS), the AMA strongly advocates on vital issues such as: 

• Expansion of the Conrad State 30 and Physician Access Reauthorization Act waiver program to more than 30 slots per state. 
• Immigration and green-card delays. 
• Duration of status.  
• Wage protections. 
• Recapturing unused employment-based physician immigrant visas. 
• Streamlining administrative visa requirements.  
• Discrimination in state licensure and practice.  
• Racial and ethnic disparities. 
• Graduate medical education (GME) funding for more residency positions. 

Among other measures, the AMA supports this congressional legislation: 

The “Healthcare Workforce Resilience Act” (PDF), which would recapture 15,000 unused employment-based physician immigrant visas and 25,000 unused employment-based professional nurse immigrant visas from prior fiscal years as a way to bolster the U.S. health workforce and ensure U.S. patients retain access to care. 

The “Conrad State 30 and Physician Access Reauthorization Act” (PDF), which would reauthorize the Conrad 30 waiver policy for an additional three years. The Conrad 30 program allows resident physicians working in the U.S. on J-1 visas to remain in the U.S. without having to return to their home country if they agree to practice in an underserved area. 

The “Physician Shortage GME Cap Flex Act” (PDF) would provide teaching hospitals with an additional five years to set their Medicare GME cap if they establish residency training programs in primary care or specialties that are facing shortages.  

“The AMA is committed to ensuring that there is proper access to physicians for all patients and that physicians are well supported in their role as leaders of the health care team,” says an AMA statement submitted to a U.S. Senate hearing held earlier this year on the immigrant health care workforce. “If immigration barriers for physicians are reduced, it will help to increase the number of physicians in the U.S., which will lead to healthier communities and ultimately a healthier country as access to much-needed medical care increases.” 

The AMA has:

• Sent several letters to the Biden administration and other federal entities to expedite visa processing and reduce the barriers and hindrances for IMGs practicing medicine in the U.S. 
• Advocated that the Conrad 30 program should be extended beyond September 2022 in the Consolidated Appropriations Act of 2022—signed into law in March. 
• Submitted a statement (PDF) to the U.S. Senate Subcommittee on Immigration, Citizenship and Border Safety for the hearing, “Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce.” 
• Submitted a statement (PDF) to the U.S. House Judiciary Subcommittee on Immigration and Citizenship for the hearing, “Is there a Doctor in the House? The Role of Immigrant Physicians in the US Healthcare System.” 

The AMA is:

• Providing resources regarding subsidies, visa processing and delays, visas affecting families, unlicensed physicians in the U.S., current physicians practicing medicine and licensing examinations. 

• Recently adopted AMA policy on international medical graduates.
• The IMG toolkit offers practical advice on types of visas, practicing medicine in the U.S., finding a residency, state medical licensure and more.
• Issue brief on bipartisan graduate medical education and physician workforce legislation (PDF)

Visit AMA Advocacy in Action to learn more about the advocacy priorities the AMA is actively working on.

The AMA works to generate support for policies critical to the nation’s health care system—and we can’t do it without your help. Learn more about ways to get involved with AMA advocacy.