The American Medical Association (AMA) and 53 leading medical societies urged the Department of Homeland Security (DHS) to exempt physicians from the newly announced $100,000 H-1B visa application fee.
In their letter (PDF), the groups called on DHS to issue guidance clarifying that physicians, residents, and fellows are essential to maintaining a strong health care workforce and should be categorically exempt from the fee. The AMA is eager to collaborate with the administration to ensure that patients don’t lose access to care.
“The U.S. health care workforce relies upon physicians from other countries to provide high-quality and accessible patient care,” physician organizations said in the letter. “Accordingly, we must ensure that the U.S. has a fair and efficient immigration system that strengthens U.S. health care and advances the nation’s health security. [We] urge the Administration to categorically consider H-1B physicians’ entry into the U.S. to be in the national interest of the country, and waive the new application fee, so that H-1B physicians can continue to be a pipeline that provides health care to U.S. patients.”
International medical graduates (IMGs) account for about one in four practicing physicians in the U.S. and have long played a vital role in filling gaps in care. In 2021, about 64 percent of foreign-trained physicians were practicing in Medically Underserved Areas or Health Professional Shortages Areas, with almost 46 percent of these physicians practicing in rural areas. With the U.S. facing a projected shortage of up to 86,000 doctors by 2036, the groups warned that the new fee would worsen access to care and increase wait times for patients.
The full text of the letter is below:
Dear Secretary Noem:
The undersigned physician organizations representing national medical societies write to strongly urge you to issue clarifying guidance that determines that H-1B physicians’ entry into the U.S. is in the national interest of the country thereby exempting them from the Proclamation entitled, “Restriction on Entry of Certain Nonimmigrant Workers.”
This Proclamation implements a $100,000 fee, to be paid by the prospective employer, upon initial application for an H-1B visa beginning on September 21, 2025. However, section 1(c) of the Proclamation states that the restriction will not apply to an H-1B worker, or an industry, “if the Secretary of Homeland Security determines, in the Secretary’s discretion, that the hiring of such aliens to be employed as H-1B specialty occupation workers is in the national interest and does not pose a threat to the security or welfare of the United States.” Therefore, as you establish standards to define categories of H-1B workers covered by this exception, we urge you to clarify that all physicians, including medical residents, fellows, researchers, and those working in non-clinical settings, are critical to our national interest and exempt from the Proclamation.
Maintaining a robust health care workforce in the U.S. that can address the health needs of all our U.S. patients is in the best interest of the health of our nation. However, with a projected shortfall of nearly 86,000 physicians by 2036, there is a growing need for a larger physician workforce that the U.S. cannot fill on its own, in part because the U.S. does not have enough people in the younger generation to care for our aging country. Accordingly, H-1B physicians play a critical role in filling this void, especially in areas of the U.S. with high-need populations.
In 2024, 23 percent of licensed physicians in the U.S. were foreign-trained. These H-1B physicians provide vitally needed health care to U.S. patients, especially in areas of the country with higher rates of poverty and chronic disease. For example, in 2021, about 64 percent of foreign-trained physicians were practicing in Medically Underserved Areas or Health Professional Shortage Areas, with almost 46 percent of these physicians practicing in rural areas. Additionally, between 2001 and 2024 almost 23,000 H-1B physicians worked in underserved communities. Moreover, nearly 21 million Americans live in areas of the U.S. where foreign-trained physicians account for at least half of all physicians aligning with the fact that states with a higher percentage of H-1B physicians are often those with lower physician density. As such, it is important to support and expand pathways for these physicians to be able to enter the U.S. and care for our U.S. patients.
The U.S. health care workforce relies upon physicians from other countries to provide high-quality and accessible patient care. Accordingly, we must ensure that the U.S. has a fair and efficient immigration system that strengthens U.S. health care and advances the nation’s health security. Therefore, the signatories below urge the Administration to categorically consider H-1B physicians’ entry into the U.S. to be in the national interest of the country, and waive the new application fee, so that H-1B physicians can continue to be a pipeline that provides health care to U.S. patients. We sincerely appreciate your attention to this critical matter.
About the American Medical Association
The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.
