APA Joins in Call For Prioritizing Visas for IMGs

Like many psychiatrists, Kamalika Roy, M.D., has still been seeing patients in person during the COVID-19 pandemic. She volunteered to conduct admission evaluations for new patients, because, as she explained, if doctors don’t continue to provide care, many patients will not get the help they need.

Yet as Roy, an assistant professor of psychiatry at the Oregon Health and Science University, works alongside her fellow psychiatrists during the pandemic, she faces a crisis of her own: By the end of the academic year, she may be forced to leave the United States.

Roy is an international medical graduate (IMG) whose residency and fellowship took place in the United States. She has an H-1B visa, but due to the ongoing pandemic, a host of issues have derailed the process of renewing her visa, which expires on July 14.

The pandemic has highlighted long-standing problems within the U.S. immigration system. “It’s a constant source of negative emotions because you know you have to fight year after year, without any end to it,” she said.

When Roy completed her fellowship training in the United States, she applied for and was granted a J-1 Waiver, which requires she work in a federally designated underserved community. She has done so in Oregon for the past three years, and as a faculty member she also teaches and supervises medical students, residents, and fellows.

Roy’s H-1B visa means her life in the United States is predicated on her working full time. It must be renewed every three years, which is a complicated process that requires various approvals from different authorities. For example, Roy’s employer must prove that it is not paying her an unfair salary compared with other doctors. But, as many physicians’ salaries have been cut due to the pandemic, Roy said she’s unsure if her current salary will meet the U.S. Department of Labor (DOL) wage requirement, as the prevailing wage set by DOL may not reflect postpandemic salaries yet.

“It’s such a complex process, and now I’m stuck waiting because if the DOL does not approve my application, then there will be no way to renew my H-1B visa,” Roy said. “During this pandemic, everything has slowed down to such an extent that it’s impossible to get through this process quickly.

“I have family here,” she continued. “I have a house here. I’ve worked in this underserved area for three years, I have been in this country for 11 years, and I even have an approved petition for permanent residency.”

Despite that approved petition, however, Roy and thousands of other physicians of Indian origin are expected to have to remain in the the United States on H-1B visas for decades before they are granted permanent status. Permanent residency, or green cards, are allotted by country of origin, and there is a disproportionate backlog of green card applications for skilled workers from India.

If Roy’s H-1B visa is not approved in time, she will have a 60-day grace period to find another job or leave the country. “Finding another job in 60 days, as a doctor, is impossible,” she said.

She said some of her colleagues in similar situations are already planning to leave and practice in a more welcoming country. She’s considering doing so as well, because she feels she has no other options.

“We are sick and tired of this,” she said. “At some point, you have to tell yourself that this is enough, and you did enough fighting. There is no point pushing an illogical system, and there is no point losing your life over it. This could be a life-ruining situation.”

In mid-May, APA sent out a call to action urging members to write their members of Congress in support of the Healthcare Workforce Resiliency Act (HR 6788/. 3599). The legislation would recapture up to 15,000 unused employment-based visas for use by international physicians and their families to stay in the United States and continue to treat patients. Information on the legislation and how to send a letter of support is posted here.