Pandemic brought challenges for IMGs, and AMA responded

International medical graduates (IMGs) make up about a quarter of the nation’s physician workforce. The AMA’s IMG Recognition Week is a time to take special note of the tremendous contributions that IMGs make to U.S. medicine, its physician workforce and to patient care.

During the pandemic, advocating for IMG physicians and the patients they serve has been a priority for the AMA. Here’s a look at some of the key issues that have impacted the IMG physicians.

1. Protecting foreign medical students in online-only programs

   1. A Trump administration plan that could have led to the deportation of hundreds of IMGs enrolled in schools that were temporarily moving to online-only learning was unfair to the students and an ill-advised action for a nation in the middle of a pandemic and facing a looming physician shortage, the AMA explained in its advocacy.
   2. In July, the AMA urged the administration to withdraw modifications to the Student and Exchange Visitor Program (SEVP) for foreign students with nonimmigrant visas, so medical students could remain in the country while enrolled in fall classes that have been moved online as a result of the COVID-19 public health emergency.
   3. Days after an AMA letter on the subject, the Trump administration reversed course on the matter.
   4. "The AMA is pleased that the administration has reconsidered what would have been a setback for U.S. public and rural health. International medical students can now focus on their studies—rather than their immigration status—as they prepare to enter the health field and help fight this pandemic," said Susan R. Bailey, MD, the AMA’s president.

2. Fighting for IMGs to bolster the COVID response

   1. The AMA told the Trump administration that allowing IMGs and their families into the U.S. on J-1 and H-1B visas is in the country’s best interest. That position was in response to a proclamation suspending the entry of foreign individuals into the U.S. until 2021.
   2. “The U.S. health care workforce relies upon health professionals and scientists from other countries to provide high-quality and accessible patient care,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to U.S. Secretary of State Mike Pompeo and acting Secretary of Homeland Security Chad Wolf.
   3. “During this pandemic, it is more critical than ever to ensure that the U.S. has a fair and efficient immigration system that strengthens the American health care system and advances the nation’s health security,” Dr. Madara added.
   4. The AMA contended that the suspension may exacerbate delays in visa processing that resulted from the COVID-19 related worldwide closure of U.S. consulates and could cause IMGs to arrive at their training hospitals months late.

3. Visa extensions for foreign IMGs in the U.S.

   1. In April, the AMA advocated for the U.S. Citizenship and Immigration Services (USCIS) to temporarily extend visas automatically for one year and expedite approvals of extensions and changes of status for non-U.S. citizen IMGs practicing, or otherwise lawfully present, in the country.

      The AMA cited an urgent need to take the actions because of the extraordinary circumstances created by the pandemic, requiring the services of every available physician. Furthermore, administrative tasks that are inordinately burdensome under normal conditions were even more difficult to complete in a timely manner during the public health emergency.
   2. “The heightened demands currently placed upon physicians and their employers coupled with the difficulties their attorneys are facing in properly filing the necessary and often lengthy paperwork—and which cannot always be achieved completely online—makes renewal or request for a status change virtually impossible to accomplish during this time—especially with USCIS closing most of its facilities and stay-at-home and shelter-in-place orders in effect,” Dr. Madara wrote in a letter to Kenneth Cuccinelli, the USCIS acting director.

The AMA’s pandemic-related advocacy efforts have been summarized in an IMG COVID-19 FAQ. Also included in the guide is information on visa processing, license examinations, and family visa matters.

Physicians can stay up to date on all of the AMA’s COVID-19 advocacy efforts and track the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most current resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.