September 25, 2025
The Honorable Kristi Noem
Secretary
U.S. Department of Homeland Security
2707 Martin L. King Avenue, SE Washington, DC 20528
Dear Secretary Noem:
The undersigned physician organizations representing national medical societies write to strongly urge you to issue clarifying guidance that determines that H-1B physicians entry into the U.S. is in the national interest of the country thereby exempting them from the Proclamation entitled, “Restriction on Entry of Certain Nonimmigrant Workers.”
This Proclamation implements a $100,000 fee, to be paid by the prospective employer, upon initial application for an H-1B visa beginning on September 21, 2025. However, section 1(c) of the Proclamation states that the restriction will not apply to an H-1B worker, or an industry, “if the Secretary of Homeland Security determines, in the Secretary’s discretion, that the hiring of such aliens to be employed as H-1B specialty occupation workers is in the national interest and does not pose a threat to the security or welfare of the United States.” Therefore, as you establish standards to define categories of H-1B workers covered by this exception, we urge you to clarify that all physicians, including medical residents, fellows, researchers, and those working in non-clinical settings, are critical to our national interest and exempt from the Proclamation.
Maintaining a robust health care workforce in the U.S. that can address the health needs of all our U.S. patients is in the best interest of the health of our nation. However, with a projected shortfall of nearly 86,000 physicians by 2036, there is a growing need for a larger physician workforce that the U.S. cannot fill on its own, in part because the U.S. does not have enough people in the younger generation to care for our aging country. Accordingly, H-1B physicians play a critical role in filling this void, especially in areas of the U.S. with high-need populations.
In 2024, 23 percent of licensed physicians in the U.S. were foreign-trained. These H-1B physicians provide vitally needed health care to U.S. patients, especially in areas of the country with higher rates of poverty and chronic disease. For example, in 2021, about 64 percent of foreign-trained physicians were practicing in Medically Underserved Areas or Health Professional Shortage Areas, with almost 46 percent of these physicians practicing in rural areas. Additionally, between 2001 and 2024 almost 23,000 H-1B physicians worked in underserved communities. Moreover, nearly 21 million Americans live in areas of the U.S. where foreign-trained physicians account for at least half of all physicians aligning with the fact that states with a higher percentage of H-1B physicians are often those with lower physician density. As such, it is important to support and expand pathways for these physicians to be able to enter the U.S. and care for our U.S. patients.
The U.S. health care workforce relies upon physicians from other countries to provide high-quality and accessible patient care. Accordingly, we must ensure that the U.S. has a fair and efficient immigration system that strengthens U.S. health care and advances the nation’s health security. Therefore, the signatories below urge the Administration to categorically consider H-1B physicians entry into the U.S. to be in the national interest of the country, and waive the new application fee, so that H-1B physicians can continue to be a pipeline that provides health care to U.S. patients. We sincerely appreciate your attention to this critical matter.
Sincerely,
American Medical Association
American Academy of Allergy, Asthma & Immunology
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngic Allergy
American Academy of Otolaryngology – Head and Neck Surgery
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation
American Academy of Sleep Medicine
American Association of Child and Adolescent Psychiatry
American Clinical Neurophysiology Society
American College of Allergy, Asthma, and Immunology
American College of Cardiology
American College of Emergency Physicians
American College of Gastroenterology
American College of Obstetricians and Gynecologists
American College of Physicians
American College of Preventive Medicine
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Gastroenterological Association
American Psychiatric Association
American Society for Clinical Pathology
American Society for Gastrointestinal Endoscopy
American Society for Metabolic and Bariatric Surgery
American Society for Radiation Oncology
American Society for Surgery of the Hand Professional Organization
American Society of Anesthesiologists
American Society of Cataract & Refractive Surgery
American Society of Colon & Rectal Surgeons
American Society of Echocardiography
American Society of Hematology
American Society of Nephrology
American Society of Nuclear Cardiology
American Society of Plastic Surgeons
American Society of Retina Specialists
Association of American Medical Colleges
College of American Pathologists
Endocrine Society
Heart Rhythm Society
Infectious Diseases Society of America
Medical Group Management Association
North American Spine Society
Renal Physicians Association
Society for Cardiovascular Angiography and Interventions
Society for Cardiovascular Computed Tomography
Society for Vascular Surgery
Society of American Gastrointestinal and Endoscopic Surgeons
Society of Hospital Medicine
Society of Interventional Radiology
Society of Thoracic Surgeons