Bureaucratic Delays Threaten to Deport Hundreds of Doctors Destined for Underserved US Communities
Hundreds of foreign-born doctors nearing the end of their medical training in the United States are facing imminent deportation due to severe bureaucratic delays within the federal government. If their visa waiver applications are not rapidly processed, highly vulnerable and underserved communities across the country will be stripped of vital healthcare providers.
The crisis centers on the J-1 visa waiver program, managed by the Department of Health and Human Services (HHS). This program allows non-citizen physicians to remain in the US while transitioning to temporary worker status. In exchange for the waiver, these doctors legally commit to working in medically underserved, rural, or low-income urban areas for at least three years.
“It will be the patients that suffer the most,” shared a psychiatrist currently caught in the backlog, who spoke on the condition of anonymity due to fears of government reprisal. “In about three months, there’s going to be hundreds of places that are not going to have a physician that should have.”
The Bureaucratic Bottleneck: Why Are Applications Stalled?
In previous years, immigration attorneys state that the HHS Exchange Visitor Program successfully reviewed and processed waiver applications within one to three weeks. Currently, a massive backlog of applications has been languishing since the fall and winter.
To remain in the country, the HHS must first review the applications, forward recommendations to the State Department, and finally secure approval from US Citizenship and Immigration Services (USCIS) before a strict July 30th deadline. According to four immigration attorneys interviewed by KFF Health News, time is rapidly running out.
HHS spokesperson Emily Hilliard declined to answer questions regarding the exact number of pending applications or the root cause of the sudden delays. She stated the department is “implementing key process improvements to prevent future delays” and is “working diligently” to evaluate the remaining applications ahead of the July 30 deadline.
“Why would HHS want to take a program that is working—a program that places hundreds of US-trained international physicians in highly underserved parts of the country every year—and slow-walk it into non-existence?” questioned Jennifer Minear, a Virginia-based health workforce immigration lawyer. “How does that serve the public health? It is baffling.”
The $100,000 H-1B “Deal Killer”
If the July 30 deadline passes without approval, these doctors must legally return to their home countries. To bring them back to work in the US, their prospective employers would be forced to pay a massive new $100,000 fee associated with the H-1B work visa—a fee implemented under a September proclamation by President Donald Trump aimed at the tech industry.
For the small, rural, and safety-net hospitals that rely on J-1 waiver physicians, this fee is impossible to pay.
“A lot of hospitals who hire J-1 waiver physicians are in underserved areas, and so they treat Medicare and Medicaid patients,” the anonymous psychiatrist explained. “By definition, for the most part, they’re not rich hospitals.”
Barry Walker, an attorney specializing in health workforce immigration, bluntly called the H-1B fee a “deal killer, especially for the small, rural hospitals.” While employers can technically request fee exemptions, attorneys have yet to hear of a single hospital or clinic successfully receiving one.
A Threat to the US Healthcare System
The United States healthcare system heavily depends on foreign-born professionals to fill critical staffing gaps. According to 2025 licensing data, nearly a quarter of all physicians operating in the US attended medical school outside the United States or Canada.
The HHS clinical care program specifically targets doctors working in high-need specialties, including pediatrics, psychiatry, family and internal medicine, and obstetrics and gynecology. Furthermore, because postgraduate medical education is largely funded by Medicare, US taxpayers ultimately foot the bill to train these foreign doctors. As attorney Charles Wintersteen noted, if the doctors are deported, “the taxpayers who pay for that training will not get the benefit of it.”
As the US government stalls, other nations are capitalizing on the bureaucratic chaos. Canadian hospitals are reportedly actively recruiting foreign physicians currently training in the US, offering them a stable alternative to the uncertain American visa process.
For the psychiatrist trapped in limbo—whose intended patient demographic includes trafficking survivors, the homeless, and prison inmates—the frustration may ultimately drive them away permanently. “This entire process has been so incredibly painful and just soul-crushing,” they said. “I would rather go to a country that would appreciate my motivation to work with patients.”
