Critical Visa Delays Risk Leaving Hundreds of Foreign Doctors Unable to Serve Underserved Communities

Hundreds of foreign doctors who are nearing the end of their medical training in the U.S. may be forced to leave the country unless the federal government expedites their visa waiver applications, which have been delayed since last fall and winter, immigration attorneys warn.

The J-1 visa waiver program, administered by the Department of Health and Human Services (HHS), permits non-U.S. citizen physicians to transition from their training visas to temporary worker status. In return, these doctors commit to practicing in underserved areas for at least three years.

“It will be the patients that suffer the most because in about three months, there’s going to be hundreds of places that are not going to have a physician that should have.”

The unidentified psychiatrist, who spoke to KFF Health News on condition of anonymity due to fears of government retaliation, is among hundreds of doctors who applied in 2024 for a J-1 waiver through the HHS Exchange Visitor Program. If approved, the psychiatrist—who trained in Europe before completing a residency and fellowship in the U.S.—would serve vulnerable patients in New York.

In recent years, HHS typically processed waiver applications in one to three weeks, according to two immigration attorneys. However, the program now faces a backlog of hundreds of pending applications, which must still be reviewed by the State Department and approved by U.S. Citizenship and Immigration Services (USCIS), four attorneys told KFF Health News.

Attorneys warn that if applications aren’t advanced to USCIS by July 30, the doctors will likely have to return to their home countries. Reentering the U.S. would require employers to pay a new $100,000 fee for an H-1B work visa—a cost many rural and underserved hospitals cannot afford.

“That’s the cliff that this train is headed for,” said Charles Wintersteen, a Chicago-based attorney specializing in health workforce immigration.

HHS spokesperson Emily Hilliard did not disclose the number of pending applications or explain the cause of the delays. However, she stated that the Exchange Visitor Program has reviewed all fiscal year 2025 clinical J-1 waiver applications, as well as some from fiscal 2026. The department is “implementing key process improvements to prevent future delays” and “working diligently” to evaluate remaining applications before the July 30 deadline, she added.

The psychiatrist in limbo noted that employers hiring J-1 waiver physicians must demonstrate they were unable to fill positions with American workers. If these doctors cannot arrive on time—or at all—patients will face even longer waits for care, they said.

Wintersteen emphasized that postgraduate medical education positions are largely funded through Medicare, warning that “the taxpayers who pay for that training will not get the benefit of it.”