International medical school graduates can be a boon to rural hospitals that have trouble attracting physicians. But there are a limited number of H-1B visas—visas for people whose jobs require a minimum of a bachelor's degree—issued every year, and there are often aren't enough of them to go around, especially since that limit applies to all industries, not just healthcare.
But this year will likely mark the first time in several years that there will be enough H-1B visas for the entire year. And because the application period began April 1, now is the time for hospitals to be recruiting international medical school graduates.
"This year, my prediction is they will last all year long, so I think it's a great opportunity for employers in the U.S. who want to hire international medical graduates," Los Angeles-based immigration attorney Carl Shusterman said in an interview. "The U.S. has really used these foreign medical graduates as the device for serving people in these [rural] areas where they could not get American doctors to go and serve."
One physician executive who's experienced this first hand is Brian Bossard, MD, FACP, FHM, who is the CEO, founder, and director of Inpatient Physician Associates, LLP, a Lincoln, Nebraska-based hospital medicine group which also has programs serving two very rural areas.
"There was a provider shortage," he said in an interview. "In hospital medicine in particular, there's been a real need for H-1B visas to fill that void."
Bossard says he's hired close to 10 H-1B visa physicians as attending hospital medicine physicians. He says that one of biggest advantages for hiring these physicians is the fact that they're willing to work in rural areas.
"There's a greater willingness for them to reach out to the rural areas and provide care there," Bossard says. "No question, smaller communities around the country have a harder time recruiting U.S. graduate physicians."
That only adds to the rural physician shortage. Citing statistics from Rural Healthy People 2010, the National Rural Health Association says that only about 10% of physicians practice in rural America, despite the fact that these areas are home to nearly 25% of the population.
According to Shusterman, the lowered demand for H-1B visas can be blamed on a soured economy and the fact that companies in other industries, such as technology, aren't hiring as much.
"The last couple of years, all of a sudden, the demand really went down," he says. "When the economy goes bad, then these companies don't hire a lot of people for H-1B visas."
He says since this year's application period has just begun and residency programs are winding down, now is the perfect time for hospital executives to recruit international medical graduate candidates.
"They should be selecting people right now out of residencies and fellowship programs," he says.
Bossard says there are, of course, advantages to hiring U.S. graduates, who don't come with the legal processing and attorney fees associated with hiring H-1B physicians. But when U.S. grads aren't an option, H-1B doctors can be lifesavers.
"There are some strings attached to the visa candidates," Bossard says. "But for me I wouldn't have been able to maintain my business without their help. They've been a huge asset for me, and as a result, a huge asset for the hospital systems that we work with."
Alexandra Wilson Pecci is an editor for HealthLeaders.
