Travel and visa restrictions put in place by the Trump administration are threatening the start of thousands of foreign medical residents across the United States, raising serious concerns about hospital staffing ahead of the July 1 residency launch date.
Many of these residents work in safety-net hospitals, often serving patients in low-income or underserved communities. These hospitals rely heavily on international medical graduates, who typically begin their training programs on July 1 after completing orientation in late June.
“If international medical graduates can’t start on time, the effects will be severe,” said Kimberly Pierce Burke, executive director of the Alliance of Independent Academic Medical Centers. “Senior residents leave in June. Without the new class, there’s no one to step in and continue care.”
On May 27, the Trump administration paused visa interviews for foreign nationals applying for J-1 visas — the primary visa used by medical residents coming from overseas. Though the State Department lifted the pause this week, the backlog and new screening rules could still delay thousands of applicants.
The updated process now includes deeper social media checks, aimed at identifying potential security threats. Meanwhile, travel bans affecting 19 countries — with possible expansion to 36 more — further complicate the situation for applicants from affected regions.
Some international doctors may apply for a “national interest exception,” but the process remains unclear, and time is running short.
The U.S. healthcare system depends on foreign medical talent. One in five practicing physicians in the U.S. was born and educated abroad. For residency programs, about one in six doctors comes from another country. In 2024, over 15,500 foreign-trained doctors were placed in 770 hospitals through the Educational Commission for Foreign Medical Graduates.
These residents often work long hours—up to 80 per week—at relatively low pay, but they are essential to hospital operations, especially in fields like internal medicine, family medicine, and pediatrics, which see fewer U.S. graduates entering.
“They are the first doctors patients see in the morning,” said Dr. Douglas DeLong, a physician and former residency program director. “They are the backbone of hospital care.”
At Brooklyn’s Brookdale Hospital, international doctors make up nearly 90% of the 55 internal medicine residency spots. Dr. Christos Paras, who oversees the program, said two incoming residents have already been blocked from entering the U.S. due to visa issues.
“We have doctors from every continent,” said Dr. Paras. “We don’t know yet how bad it will get.”
Dr. Conrad Fischer, director of the internal medicine program at Brookdale, warned that while a few missed residents can be replaced, “next year we’re not talking about two or three—we’re talking about thousands. If restrictions continue, it will gut the program.”
Not all programs can quickly fill gaps. Hospitals that use the national residency match system must first apply for waivers before replacing matched candidates. Others, which hire residents directly, may have more flexibility but still face challenges.
Rural hospitals, already struggling to attract U.S.-trained doctors, depend even more on international graduates. These foreign residents are not displacing U.S. medical school grads—in fact, this year’s 40,000 residency spots far outnumbered the 28,000 U.S. graduates.
Hospitals must maintain proper staffing ratios or risk losing accreditation and funding. If residents don’t arrive on time, care quality and financial stability could both suffer.
“These foreign doctors are well-trained, highly motivated, and deeply committed,” Dr. DeLong said. “They are not just filling gaps—they are the future of American medicine.”
