Radiologists fear new $100,000 visa fee could exacerbate specialty’s staffing shortages
Radiologists are expressing concern that a newly introduced $100,000 visa fee could exacerbate staffing shortages in the specialty.
The Trump administration first announced this change via a presidential proclamation, with the added charge taking effect on Sept. 21. Its order applies to the H-1B visa program, created to bring temp workers into the country to perform “additive, high-skilled functions.”
Officials have expressed concern the program has been “deliberately exploited to replace, rather than supplement, American Workers with lower-paid, lower-skilled labor.” They hope the new fee will curb certain individuals’ access to the U.S., according to the proclamation.
Radiology researchers recently sought to analyze how this update might impact the specialty, sharing their findings Monday in JACR.
“International medical graduates (IMGs) constitute an important component of the U.S. health force, and many use the H-1B visa to enter the country and contribute to the healthcare delivery system,” lead author Ajay Malhotra, MD, a radiology researcher with the Yale School of Medicine, and co-authors detailed Oct. 13. “However, the number of physicians on H1-B visas contributing to the radiologist workforce is not well known.”
To address this, Malhotra and colleagues analyzed publicly available H-1B disclosure data from the U.S. Department of Labor. The sample included 479,005 petitions for all occupations received between October 2019 and June of this year. Among them, there were 482 petitions related to radiology, 434 of which were officially certified.
About 26% (or 113) of the certified positions were classified as radiology trainees while the other 74% (321) were other rads working outside of schooling. Among the trainees, 91% (103) were sponsored by university programs, the authors found. Employers were primarily universities or other academic institutions (68%), with the rest working at other non-teaching institutions (32%). Meanwhile, among other non-trainees, about 60% (193) were sponsored by teaching institutions while the other 40% worked outside academia.
“Physicians working in radiology contribute a small proportion of all non-immigrants working under the H-1B program. However, there is a substantial number working as trainees as well as non-trainees and contributing to the radiologist workforce,” Malhotra and co-authors reported. “This is especially important given the radiologist shortages and at a time when the growth in imaging studies is outstripping the supply and capacity of radiologists.”
Researchers cited a 2021 American Medical Association report, estimating that about 10.8% of all practicing radiologists in the U.S. are international medical graduates. Most H-1B visa rads work in large American academic centers, with the top 10 sponsors accounting for the largest proportion.
The analysis comes after medical societies including the American College of Radiology, which publishes this journal, recently urged the administration to excuse radiologists and other physicians from paying the new fee. As currently written, the executive order gives Department of Homeland Security Secretary Kristi Noem the authority to exempt individuals from the fee, if their occupation “is in the national interest and does not pose a threat to the security or welfare of the United States.”
“Some of the biggest medical bodies have highlighted the risk of the proposed changes to access to care for patients and challenges to training programs, leading to consideration for possible exemption from proposed visa changes to healthcare workers,” Malhotra and colleagues concluded. “It will be important for the administration to consider the critical need for radiologists favorably, given the shortages and overall impact on healthcare delivery,” they added later.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.