H-1B Delays: AMA Raises Concerns

The American Medical Association (AMA), the largest association of physicians in the United States, wrote a public letter to the director of the U.S. Customs and Immigration Service (USCIS) expressing concerns about the prolonged waiting period for H-1B visas. The USCIS move towards increased investigation of prevailing wages in the last few months created an enormous backlog of H-1B visa applications. With unyielding start dates for U.S. Graduate Medical Education (GME) programs, many teaching hospitals may experience shortages of medical residents due to the continued backlog.

Effect on the Medical Community

Although the increase to waiting periods spurred by the Trump Administration is nothing new, the impact of increased waiting periods have begun to emerge. Among some of the most impacted employers are teaching hospitals, many of which depend on medical residents for everyday functioning. Each year on or before the first of July, the GME training programs (that permit medical residents to work and learn within a teach hospital) begin. In the letter, the CEO of the AMA, James L. Madara, MD, reminds Director Cissna that delays to H-1B processing for international medical residents significantly impacts critical medical programs. Noting that these “teaching hospitals rely on these medical residents to provide care to many of our nation’s most vulnerable patients.” Supporting this claim, the letter notes that international medical graduates tend to work in some of the more underprivileged areas in the country.

Processing Complaint

 Although Dr. Madara presents a compelling argument for the benefits of international medical residents, the letter focuses on one primary complaint: prevailing wage processing. In order to file the H-1B, the employer has to first obtain prevailing wages from the Department of Labor (DOL). Although DOL provides wage information for many occupations, including physicians, it does not for medical residents. H-1B visa applicants pursuing medical residencies, deprived of information from the DOL, has in the past instead utilized the Association of American Medical Colleges (AAMC) Survey of Resident/ Fellow Stipends and Benefits Report to determine the prevailing wage for similarly situated non-international medical residents. However, these applicants have either been met with requests for additional evidence or outright denied their H-1B visa. In the letter, Dr. Madara notes that the DOL had previously accepted the use of AAMC data for the purpose of determining prevailing wages.