Hasiba Karimi was supposed to be seeing patients at a Harrisburg, Pennsylvania hospital in just a few weeks. She is one of 144 foreign-born international medical school graduates who were slated to start their first year of residency (known as an internship) in Pennsylvania this year, and are part of a solution to the critical shortage of doctors in the United States.
But she won’t be stateside anytime soon. That’s because Karimi, who lives in Canada and got her medical education in Turkey, was born in Afghanistan. She was scheduled for an H-1B visa appointment on June 9, the same day President Donald Trump’s executive order barring individuals from 19 specific countries from entering the United States took effect. While the order outlines some exceptions—including for diplomatic visas; athletes, coaches and relatives traveling for competitions; and for ethnic and religious minorities “facing persecution in Iran”—it does not carve out an exception for doctors. So now Karimi, who spent years building her experience and resume to win this internship, can only wait and hope.
“One in four pediatric residents in the USA are international medical school graduates, and they are filling those spots in the most underserved communities that American graduates are not even applying to,” says Sebastian Arruarana, a resident physician at the Brookdale University Hospital and Medical Center in Brooklyn, New York, and an advocate for international medical graduates. “If this is not solved, who will take care of our children?”
Every summer thousands of foreign-born doctors that have graduated from international medical schools come to the U.S. for residency programs. This past March, 6,653 foreign citizens, educated at foreign medical schools, matched to internships at American hospitals, according to data from the National Residency Matching Program (NRMP). Another 300 later matched to internship spots that went unfilled in the March match. Before foreign graduates can practice medicine in the United States, they must complete a U.S. residency, making these programs crucial to the needed supply of foreign doctors.
The ban on individuals from Afghanistan, Burma, Chad, the Republic of the Congo, Equatorial Guinea, Eritrea, Haiti, Iran, Libya, Somalia, Sudan, and Yemen, with partial restrictions on entry for people from Burundi, Cuba, Laos, Sierra Leone, Togo, Turkmenistan, and Venezuela, adds a new barrier for incoming medical residents on top of a pause on the scheduling of new appointments for J-1 visas, which most doctor-trainees use to come to the United States. (That pause was aimed at giving the State Department time to develop a policy on vetting applicants’ social media.)
It’s so far unclear exactly how many medical residents will be impacted by the country-specific bans. “We identified a small number of IMGs who reported residence or affiliation with one of the 13 countries identified as part of the travel ban, but even some of those individuals could already be in the United States, making it difficult to determine if they will be able to enter their residency training next month,” says Donna Lamb, president and CEO of the NRMP. Residents from the targeted countries that are already in the United States will be able to stay, but they may not be able to leave and come back. Residencies last between three and seven years, depending on the medical specialty.
“My visa was approved but is still under processing and not issued yet,” a Yemeni doctor living in Saudi Arabia told Arruarana. “The ban just happened—I really don’t [want to lose] my dream. I’m the first in my family to become a doctor and was able to study medicine on a scholarship in Saudi Arabia.”
Among the doctors waiting for a visa appointment is Artur Polechshuk, who was born in Kazakhstan and studied pediatric medicine at the Saint Petersburg State Pediatric Medical University in Russia. He and his fiancee had both matched at residency programs in West Virginia, and neither of them will be able to make it for their June 24 start date. “Of the nine doctors in the first year positions [at the hospital], only two are U.S.-born medical doctors. The other seven are international medical school graduates,” says Polechshuk. “And half of us can’t come to the country because we are blocked.” (According to NRMP data, this year, 27% of the incoming interns in West Virginia are foreign-born graduates of international medical schools.)
Suraj Kunhi Purayil has already spent time in U.S. hospitals. Born and now living in India, he completed medical school in the Caribbean and completed his third and fourth year clinical clerkships at a hospital in Michigan. He’s supposed to start a residency at an Ohio hospital on July 1, but his J-1 visa was rejected because the immigration officers assumed Kunhi Purayil intended to immigrate to the U.S. He said he’s not sure exactly why they came to that conclusion, but figures that the time he’s already spent in the U.S., which helped his chances at snagging a residency spot, could be working against him on his visa application. “They mostly wanted to know why we traveled to the U.S … so I explained to them it’s part of my med school curriculum where I have to go do 74 weeks of clinical clerkship in the U.S,” Kunhi Purayil says. “I think that might not have been a satisfactory answer.” (Many of the students at Caribbean medical schools are U.S. citizens who couldn’t snag one of the limited spots at U.S. medical schools and clerkships at U.S. hospitals is one of their selling points.)
The NRMP is asking residency programs to extend their start dates or defer acceptances for foreign graduates who can’t get visas to the next academic year. The NRMP and the Educational Commission for Foreign Medical Graduates, which sponsors visas for international medical graduates, are urging the State Department to grant exceptions to the travel ban for doctors. The State Department did not respond to Forbes’ request for comment on whether doctors will be exempted.
The hospital has been supportive, Polechshuk says of his program. “They told us that they’ll wait for us as long as possible and that they’re staying with us. And they’re really very shocked. It’s very hard for them also.”
