Changes to the H-1B visa program, which grants workers from other countries temporary visas to work with specific employers in the US — a program the Trump administration has said it may alter — could significantly affect healthcare services, researchers warn in a recent issue of JAMA. 

The researchers estimated that 1.4% of all medical providers in the country in 2015 were H-1B applicants.

“Some hospitals have come to rely on large numbers of international medical graduates and H-1B visa holders to provide medical services,” noted Peter Kahn, MPH, a fourth-year student at Albert Einstein College of Medicine in Bronx, New York, and Tova Gardin, MPP, a researcher at Harvard Medical School in Boston.

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Kahn and Gardin used US Department of Labor Office of Foreign Labor Certification (OFLC) data on H-1B visa program applications for physicians, residents and/or fellows, which they categorized by state and sponsoring employer. They also used data from the Association of American Medical Colleges (AAMC) to calculate the proportion of active patient-care physicians in each state in 2015.

They found that 10,491 H-1B physician visa applications were certified for use by 2156 hospitals or patient groups, and that 1.4% of all active patient-care physicians were H-1B applicants.

The highest number of H-1B applicants were in New York (13.98%), followed by Michigan (9%) and Illinois (7.87%). North Dakota had the highest proportion of physicians with H-1B visas applications in relation to the state total physician workforce (4.7%).

“Certain states and employers relied heavily on the H-1B program, whereas others seldom, if at all, used it,” Kahn and Gardin noted.

The top four hospitals sponsoring H-1B visa applicants were William Beaumont Hospital (4.5%), Bronx-Lebanon Hospital Center (2.03%), Cleveland Clinic (1.72%), and Presence Saint Francis Hospital (1.43%), Kahn and Gardin found.

Kahn and Gardin pointed out several limitations of their analysis, including a lack of individual-level data for H-1B visa approvals made by the US Citizenship and Immigration Services, and also a lack of overall 2016 H-1B approval data.

“As such, this study potentially overestimates the number of physicians who will eventually enter the United States with an H-1B visa,” they said.


Kahn PA, Gardin TM. “Distribution of Physicians With H-1B Visas by State and Sponsoring Employer.” JAMA. 2017;317(21): 2235-2237. doi:10.1001/jama.2017.4877