The Trump administration’s tougher immigration posture is no longer just a policy debate in Washington. It is becoming an operational problem for hospitals and health systems that rely on international physicians to staff residency programs, specialty services and hard-to-fill roles in underserved communities. Visa freezes, renewal slowdowns and added H-1B costs are already disrupting physician schedules, delaying starts and forcing some doctors out of work while their cases sit in limbo.
That matters because international medical graduates are not a niche part of the workforce. The AMA says roughly one-fourth of the nation’s physician workforce are IMGs, and AAMC says about 25% of practicing U.S. physicians fall into that category as the country still faces a projected physician shortfall of up to 86,000 by 2036. In other words, immigration friction lands on top of an already thin labor market.
The immediate pressure point for health systems is the cost and uncertainty surrounding H-1B visas. AAMC reported in January that a Greater New York Hospital Association survey found 25% of responding hospitals had already paused, deferred or limited recruitment of physicians needing H-1B visas; those hospitals employed 1,100 H-1B medical residents and 800 H-1B attending physicians. The AMA has warned that the $100,000 filing fee for new H-1B petitions threatens access to physician-led care, especially in rural and underserved communities.
The slowdown is not theoretical. This winter U.S. Citizenship and Immigration Services began freezing processing of some immigration benefits for people already in the United States from 39 countries, affecting work authorization renewals, green card processing and naturalization. Doctors told Axios that the delays forced unpaid absences, rescheduled patients and longer waits for care, with one physician estimating a work suspension left more than 900 patients without sufficient care.
Congress has noticed. On March 17, 2026, lawmakers introduced H.R. 7961, the H-1Bs for Physicians and the Healthcare Workforce Act, which would exempt physicians and other health care workers from the new $100,000 H-1B fee. The bill has support from hospital and physician groups, but it is still only proposed legislation, not relief hospitals can count on today.
For hospital and health system leaders, the lesson is simple: this is now a workforce continuity issue. Leaders should map current exposure by specialty, residency cohort and geography; identify physicians at risk of delayed starts or renewals; build contingency staffing plans for July onboarding and other key transition points; and increase advocacy with lawmakers and DHS for explicit physician exemptions and faster adjudication. The organizations that treat this as a core operations risk, not a distant immigration issue, will be in the best position to protect access and avoid sudden care disruptions.