Hundreds of Foreign Doctors Face Deportation Due to Visa Processing Delays

A Healthcare Crisis in the Making

Across America, hundreds of foreign-born physicians who have dedicated years to training in U.S. hospitals and clinics now face an agonizing uncertainty. These doctors, who are on the verge of completing their medical training, could be forced to leave the country they’ve come to call home due to massive delays in processing their visa waiver applications. The backlog, which began accumulating last fall and winter, threatens not only the careers of these dedicated healthcare professionals but also the wellbeing of thousands of vulnerable patients in underserved communities who desperately need their care. Immigration attorneys are sounding the alarm that without rapid action from the federal government, a healthcare disaster is looming. The situation is particularly heartbreaking for doctors like a European-trained psychiatrist who spoke to KFF Health News on condition of anonymity, fearing government retaliation. “It will be the patients that suffer the most because in about three months, there’s going to be hundreds of places that are not going to have a physician that should have,” the doctor explained, capturing the human cost of bureaucratic dysfunction.

Understanding the J-1 Visa Waiver Program and Its Current Crisis

The J-1 visa waiver program, administered by the Department of Health and Human Services, serves a critical function in America’s healthcare system. It allows foreign physicians who aren’t U.S. citizens to remain in the country after completing their medical training, transitioning from their educational visa to temporary worker status. In exchange for this privilege, these doctors commit to working for at least three years in areas designated as medically underserved—often rural communities or low-income urban neighborhoods where recruiting American-trained physicians has proven nearly impossible. This arrangement has been a win-win: foreign doctors gain valuable experience and a pathway to potentially staying in America, while underserved communities receive desperately needed medical care. Historically, the program has functioned smoothly, with the HHS Exchange Visitor Program reviewing waiver applications within one to three weeks. However, this year has been dramatically different. Immigration attorneys report that hundreds of applications have been caught in an unexplained backlog, with some applications sitting untouched since last fall. The psychiatrist mentioned earlier applied through this program with hopes of treating New York’s most vulnerable populations—trafficking survivors, homeless individuals, and incarcerated people in need of mental health services. But months after applying, their future remains completely uncertain, as does that of hundreds of colleagues in similar situations.

The July 30 Deadline: A Cliff Approaching Fast

The situation has become increasingly urgent as a critical deadline approaches. Immigration attorneys warn that if these physicians’ applications don’t advance to U.S. Citizenship and Immigration Services by July 30, they will likely be forced to return to their home countries. The processing chain requires three separate government agencies to act: first HHS reviews the waiver application, then the State Department examines HHS’s recommendation, and finally USCIS must grant approval. Under normal circumstances, this multi-agency process allows sufficient time for doctors to transition smoothly from their training programs, which typically end on June 30, to their new positions starting July 1. This year, however, the delays at HHS have created a domino effect that threatens to derail the entire system. Charles Wintersteen, a Chicago-based attorney specializing in health workforce immigration, described the situation starkly: “That’s the cliff that this train is headed for.” When asked about the delays, HHS spokesperson Emily Hilliard provided only vague reassurances, stating that the department has reviewed all fiscal year 2025 clinical J-1 waiver applications and some from fiscal 2026, while “implementing key process improvements to prevent future delays.” However, she declined to explain what caused the backlog in the first place or provide specific numbers about how many applications remain pending. For the doctors caught in this limbo, such non-answers offer little comfort as they watch the calendar count down toward a deadline that could upend their entire lives.

The $100,000 Problem: When Immigration Policy Meets Healthcare Reality

Complicating matters exponentially is a new policy introduced by President Donald Trump last September that created a $100,000 fee for H-1B work visas. While Trump’s proclamation targeted the tech industry’s use of these visas, the fee applies to workers in all fields, including healthcare professionals. This creates a nearly impossible situation for the foreign doctors facing deportation: even if they’re forced to return to their home countries, their American employers could theoretically bring them back—but only if they can afford to pay the staggering six-figure fee. For most hospitals and clinics that participate in the J-1 waiver program, this cost is simply prohibitive. These facilities are, by definition, located in underserved areas where they primarily treat Medicare and Medicaid patients. “A lot of hospitals who hire J-1 waiver physicians are in underserved areas, and so they treat Medicare and Medicaid patients,” the psychiatrist explained. “By definition, for the most part, they’re not rich hospitals.” Barry Walker, an immigration attorney in Tupelo, Mississippi, put it even more bluntly: the H-1B fee is “just a deal killer, especially for the small, rural hospitals.” Immigration attorneys report that as of mid-February, employers had paid the fee for only 85 workers across all industries—a tiny fraction of those affected. Attorneys note that employers might consider paying the fee for physicians in lucrative specialties like cardiology or orthopedics, where they could potentially recover the cost, but they’re extremely unlikely to do so for psychiatrists, pediatricians, or family medicine doctors, let alone for foreign nurses, lab technicians, and other healthcare professionals who form the backbone of many medical facilities.

The Wider Impact: America’s Dependence on Foreign Healthcare Workers

This crisis highlights America’s profound dependence on foreign-born healthcare professionals, particularly in communities that native-born providers often overlook. Nearly a quarter of all physicians practicing in the United States attended medical school outside the U.S. or Canada, according to 2025 licensing data. These international medical graduates fill critical gaps in the American healthcare system, especially in specialties and locations where recruitment challenges are most acute. The J-1 waiver program through HHS, though smaller than other pathways, plays an outsized role in addressing these shortages. Last year, the program received 750 waiver applications, all for physicians working in pediatrics, psychiatry, family medicine, internal medicine, or obstetrics and gynecology—precisely the specialties where shortages are most severe. The current delays represent not just a bureaucratic failure but a betrayal of the social contract underlying the program. As attorney Charles Wintersteen pointed out, postgraduate medical education positions are largely funded through Medicare, meaning American taxpayers have invested in training these physicians. “The taxpayers who pay for that training will not get the benefit of it,” he explained, if these doctors are forced to leave before they can serve in underserved communities. Virginia-based immigration lawyer Jennifer Minear expressed the frustration many feel: “Why would HHS want to take a program that is working—a program that places hundreds of U.S. trained international physicians in highly underserved parts of the country every year—and slow-walk it into non-existence? How does that serve the public health? It is baffling.”

Fighting Back: Efforts to Save Doctors and Patients

As the July 30 deadline approaches, physicians, hospital leaders, lawmakers, and immigration experts are mobilizing on two fronts: pressuring HHS to clear the J-1 waiver backlog and fighting to eliminate or limit the $100,000 H-1B fee. The American Medical Association’s CEO, John Whyte, has called on the Exchange Visitor Program to use “emergency batch processing” for physicians with contracts to begin this summer. Efrén Manjarrez, president of the Society of Hospital Medicine, echoed this urgency in his own letter: “Every day this backlog persists is a day that hospitalized patients in these communities face greater risk.” Meanwhile, the Trump administration has so far ignored letters from hospitals, medical societies, and rural health organizations requesting an exception to the H-1B fee for physicians or all healthcare workers. In March, a bipartisan group of lawmakers introduced legislation that would create such a healthcare exemption, though it has not yet received a hearing. At least three separate lawsuits—from the U.S. Chamber of Commerce, twenty states, and a coalition including a nursing recruiter and a union representing medical graduates—are challenging the fee in court. For the psychiatrist whose story opened this article, the wait has become unbearable. They’ve watched as Canadian hospitals, recognizing America’s dysfunction, have begun actively recruiting foreign physicians completing U.S. training programs. One of their friends accepted such an offer and withdrew their HHS waiver application to head north. If forced to leave, the psychiatrist would be separated from their partner and unemployed for months while obtaining licensure in their home country. Even if their employer somehow found the money for the H-1B fee, they’re no longer certain they’d return. “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.” It’s a sentiment that should alarm anyone concerned about America’s healthcare future—when we drive away dedicated physicians eager to serve our most vulnerable populations, everyone loses.