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SHM Joins Multi-Stakeholder Letter on Employment Based Visa Restrictions

July 08, 2020

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The Honorable Mike Pompeo
U.S. Department of State
600 19th Street NW
Washington, DC 20006

The Honorable Chad Wolf
Acting Secretary
U.S. Department of Homeland Security
2707 Martin Luther King Jr Ave SE Washington, DC 20528

Dear Secretary Pompeo and Acting Secretary Wolf:

The undersigned medical professional organizations write to you with an urgent request that impacts access to care for our nation’s patients. We strongly urge you to issue clarifying guidance pertaining to the Proclamation Suspending Entry of Aliens Who Present a Risk to the U.S. Labor Market Following the Coronavirus Outbreak by directing Consular Affairs to advise embassies and consulates that H-1B physicians and their dependent family members’ entry into the U.S. is in the national interest of the country, so that these physicians can enter the U.S. in a timely manner and begin providing valuable medical services to U.S. patients and ease the burden on the U.S. physician workforce.

Section 3(b)(iv) of the June 22, 2020, proclamation contains a carve out for “any alien whose entry would be in the national interest…” Moreover, in response to the proclamation, the Department of State issued a statement that “[m]ission-critical immigrant visa categories include applicants who may be eligible for an exception under these presidential proclamations, such as…certain medical professionals.” Every physician is mission critical, especially now when we are seeing COVID-19 cases spike across the country and China has identified a new strain of H1N1 that has “all the essential hallmarks of a candidate pandemic virus…” Therefore, as you establish standards to define categories of immigrants covered by this section, we urge you to clarify that all health care professionals, such as medical residents and fellows, biomedical researchers, and those working in non-clinical settings—not only those who are involved in COVID-19 research and practice—are critical to our national interest, and therefore exempt from the proclamation.

Maintaining a robust health care workforce in the US, that is capable of addressing the health needs of the citizenry, is heavily reliant on international medical graduates (IMGs) who are citizens of other nations. Prior to the COVID-19 pandemic, the U.S. was already facing a serious shortage of physicians largely due to the growth and aging of the general population and the impending retirement of many physicians. IMGs represent more than 25 percent of the physician workforce in our country and nearly 21 million people live in areas of the U.S. where foreign-trained physicians account for at least half of all physicians. As such, non-U.S. citizen IMGs play a critical role in providing health care, especially in areas of the country with higher rates of poverty and chronic disease. Accordingly, the entry of every IMG is in the national interest of the U.S. especially during the pandemic, when physicians are needed in every specialty now more than ever.

We also urge the Administration to protect the spouses and dependent children of H-1B physicians by exempting their H-4 family members from the current immigration ban. The spouses and children of our physicians, who are entering the U.S. to provide critical health care to patients across the U.S., should not be separated from one another, especially during a global pandemic. H-1B physicians can remain in the U.S. for 3 years or more. This means that parent IMGs who are able to enter the U.S. to help treat COVID-19 patients, per the carve out, may be forced to make the impossible decision of leaving behind young children for years or coming to train in the U.S. To force mothers and fathers to choose whether to be separated from their children and spouses, or take a position treating some of America's sickest patients, in some of our most underserved areas, is unfair. Moreover, physicians and their family members should not fear traveling internationally and should be able to easily reenter the U.S. on their existing valid visas. If these vital changes are not made, it could deter IMGs from coming to the U.S. which would cause us to surpass our projected shortfall of nearly 139,000 physicians by 2033, leaving innumerable U.S. patients without a physician.

It is critical not to endanger patient care and our research enterprise by closing our borders to skilled health and science professionals during this pandemic and beyond. We must ensure that the U.S. has a fair and efficient immigration system that strengthens American health care and advances the nation's health security. As such, all physicians are mission critical and it is in our nation's interest to allow them and their families into the U.S. Thus, the signatories below urge the Administration to consider H-1B physicians and their families' entry into the U.S. to be in the national interest of the country so that families can remain together and IMG physicians can immediately begin to provide health care to U.S. patients. We sincerely appreciate your attention to this critical matter.

American Medical Association
American Academy of Allergy, Asthma & Immunology
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation
American College of Allergy, Asthma and Immunology
American College of Emergency Physicians
American College of Gastroenterology
American College of Obstetricians and Gynecologists
American College of Physicians
American College of Radiology
American College of Rheumatology
American Gastroenterological Association
American Psychiatric Association
American Society for Clinical Pathology
American Society for Dermatologic Surgery Association
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society of Anesthesiologists
American Society of Hematology
American Society of Nuclear Cardiology
American Society of Retina Specialists
Association for Clinical Oncology
Association of American Medical Colleges
College of American Pathologists
Endocrine Society
Heart Rhythm Society
Medical Group Management Association
Renal Physicians Association
Society for Cardiovascular Angiography and Interventions
Society of Hospital Medicine
Society of Interventional Radiology
The Society of Thoracic Surgeons