Nearly one in four physicians practicing in the United States is foreign-born, a group that plays a significant role in the nation’s health care workforce. Many immigrant physicians work on the front lines in rural and underserved urban areas where U.S.-trained doctors are scarce.
That dynamic is explored by Harvard professor Dr. Eram Alam, author of "The Care of Foreigners: How Immigrant Physicians Changed U.S. Healthcare." Alam argues that America’s reliance on immigrant physicians was cemented by the 1965 Hart-Celler Act, which opened immigration pathways for skilled professionals during a physician shortage in the Vietnam War era.
In Southern Oregon, doctors Som Ghosh and Mujahid Rizvi have practiced medicine in Medford for more than 20 years. In light of the issues Alam explores, Ghosh and Rizvi discuss their own experiences working as immigrant physicians in the United States.
Despite their essential role, entering the U.S. medical system often requires navigating a long process of exams, visas and bureaucratic hurdles designed to standardize international training within the U.S. framework.
For many physicians, maintaining legal status requires ongoing administrative work.
Rizvi, an oncologist, recalls the logistical strain.
“Each step had its challenges,” he said. “You kind of have to go through the process of going to a U.S. embassy. Sometimes you have to fly to Canada to get your passport stamped.”
Even with an established career, systemic bottlenecks can remain. Ghosh, a specialist in critical care and pulmonary disease, said the immigration pathway can be particularly difficult for some nationalities.
“Especially for physicians of Indian origin, it still is a challenge because the wait times are exceedingly long,” Ghosh said, citing visa backlogs created in the early 2000s.
Alam notes that demand for visas from other sectors — particularly technology workers from India — has contributed to the competition immigrant physicians face.
Why immigrant physicians choose to practice in the United States
For many immigrant doctors, the United States offers the opportunity to practice medicine with resources that may be scarce in other countries.
“The level of opportunity in the United States is unmatched anywhere else in the world,” he said.
Ghosh said practicing in the U.S. also allows physicians to focus on patient care.
“I like that part about practicing medicine in America where you do what is right, you do what is needed,” he said, “without having to worry about financial constraints.”
As the United States continues to face physician shortages, immigrant doctors remain a key part of the health care system.
In her book, Alam argues their work has helped normalize the presence of foreign-born physicians in American medicine.
Ghosh said representation will remain important as the workforce evolves.
“Representation, I think, is key,” he said. “The health care workforce needs to represent the greater population."
Guests
- Dr. Som Ghosh, critical care and pulmonary disease
- Dr. Mujahid Rizvi, hematology and oncology
