From 2016, Rishab Gupta worked to set up a life for himself in the United States, completing his medical residency in New York before moving to Boston with his wife Vandita for a neuropsychiatry fellowship last year. But when Gupta flew home to India to care for his dying mother amid the country’s devastating wave of Covid earlier this month, he knew he was leaving that life behind.
“I didn’t have any choice. I knew it was a risk, but I just had to,” he said from his home town, Ludhiana. “She fought bravely, but unfortunately that could not save her.” As he grieves, Gupta is now indefinitely separated from Vandita, who stayed in Boston.
The pandemic’s surge in India led Joe Biden in April to impose a ban on most travel from the country, which has seen more than 10m new cases and at least 100,000 deaths due to the coronavirus. Biden’s travel restrictions have left many like Gupta in a bind, largely because of the tenuous visas that they rely on to practice medicine in the US.
Gupta’s J-1 visa, issued to many foreign doctors, isn’t exempted from the travel ban, and even if he were to apply for an exemption, his visa needs to be revalidated at the embassy first. With consular services rolled back due to the pandemic, appointments are scarce. But foreign medical workers like Gupta and their advocates say they wouldn’t be in this situation if they had more permanent and flexible visas.
The role played by foreign doctors has never been more apparent than over the past year, when so many have put themselves at risk while fighting on the frontlines. Over a third of the 3,600-plus US healthcare workers who have died from Covid were immigrants, and many of them served in safety net hospitals and clinics.
The battles immigrant physicians face, however, started years before the pandemic. J-1 and H1-B visa holders are often tied to their employers and unable to switch jobs easily, let alone move locations within the country while they experience decades-long waits for green cards, which offer more flexibility.
Meanwhile, these doctors are crucial for the functioning of the US health system: according to the Association of American Medical Colleges, the US will have a shortage of up to 139,000 physicians by 2033. And though thousands of foreign doctors come to the US for medical training each year, many aren’t able to stay in the country long-term because of immigration rules.
But there is renewed hope that proposed legislation before Congress will help address the issue, and secure much-needed doctors for America’s healthcare system.
The Healthcare Workforce Resilience Act (S.1024), which has 13 bipartisan co-sponsors in the Senate, would provide green cards – or permanent residency – to 40,000 foreign medical professionals. With permanent residents exempt from the India travel ban, the value of having one is particularly stark right now.
But beyond the human impact permanent residency would have on foreign doctors’ lives, advocatessay it’s crucial for addressing gaps in the health system.
“They’re going to go to one of our competitor countries like Australia, the UK or Canada that love American training,” said Greg Siskind, an immigration lawyer who advocates for foreign physicians as a member of the International Medical Graduate Taskforce.
Such migration can be a waste of US tax dollars – medical residents’ salaries are subsidized by Medicare, regardless of nationality.
“When these doctors are pushed out of the country … it essentially becomes the US subsidizing doctors in countries perfectly capable of affording to train doctors themselves,” said Siskind, who is also concerned the travel ban will prevent about 2,000 trainees from starting residency programs this summer.
Physician shortages are especially acute in rural America. As a result, despite the prevalence of anti-immigration sentiment among many Republican lawmakers, S.1024 has significant support from Republican senators who represent large rural and medically underserved areas.
Awareness of the role foreign physicians play in rural communities isn’t new. Raghuveer Kura, a nephrologist who has lived in Poplar Bluff, Missouri, for the past 10 years says that when he was stuck in Canada over a visa issue in 2019, he only got back in after enlisting government support.
“It’s up to you to decide how you want to get me back … If I don’t reach Poplar Bluff in the next three days, people will die because there’s nobody to do their dialysis.” Kura, who is the founder of Physicians for American Healthcare Access, said he told government officials.
In Missouri, Kura believes the fact that S.1024 is co-sponsored by a senior Republican like Senator Roy Blunt, is a sign of the growing extent to which contributions of foreign doctors are being acknowledged. Still, he recognizes there are still pockets of resistance to the legislation.
“Josh Hawley and others don’t get it,” said Kura, referring to Missouri’s junior senator. “They think we’re snatching jobs. Nobody is snatching jobs. We’re providing a service. If these international physicians are not here, who’s going to take care of those people? We’re trying to help.”
Siskind believes S.1024 should be passed for both moral and practical reasons, and that it could be the first immigration bill to become law under Biden.
“It’s in our self-interest to pass this bill as Americans, and it’s actually in the interest of people who really deserve the relief as well … it’s win-win,” he said. “We’ve invested in these doctors for decades in some cases, and they’re providing services to the populations that are in more need than anyone.”
Though Kura’s green card means he isn’t limited by the travel ban, he still worries he’d get stranded if he went to India right now if he contracted Covid. It’s a concern born out of responsibility to the community he serves, and underlines how dire America’s doctor shortage is.
“Within a span of 10 days there would be nothing which can be done [in Poplar Bluff] because I have 90 dialysis patients. I have to take care of the hospital all alone.”