US Visa Fees: Indian Doctors Face Hurdles, Rural Care Faces Shortage

WASHINGTON, DC -A heated congressional hearing on America’s growing physician shortage has opened a new fault line that could directly affect Indian medical graduates seeking careers in the United States.

At the center of the debate is a proposed “$100,000 supplemental fee for new H-1b visas”, a sharp increase over current employer-paid processing costs. Lawmakers on February 24 questioned whether such a move would discourage rural hospitals from hiring foreign-trained doctors at a time when workforce gaps are widening.

The issue surfaced during a Ways and Means health subcommittee hearing focused on expanding graduate medical education (GME) and strengthening healthcare delivery in rural America.

India was not mentioned directly during the hearing. However, Indian nationals have historically formed one of the largest groups of international medical graduates in the United States, particularly in internal medicine, family medicine and other primary care specialties.

Many international medical graduates, especially from India, serve in rural and medically underserved areas under visa arrangements linked to service obligations. Lawmakers noted that a substantial rise in visa costs could make recruitment financially unviable for small community hospitals already operating on tight budgets.

Congressman Adrian Smith warned that the United States faces “a very real problem, a rapidly depleting health care workforce”.

“By 2037, the US will see a shortage of 187,000 physicians. Nearly half of all practicing physicians will retire in the next decade,” he said.

Rural communities are especially affected. “83 million Americans live in an area with too few primary care physicians,” Smith said, noting that only “2 per cent of residencies can be found in rural America”.

While lawmakers from both parties broadly supported expanding Medicare-funded residency slots, immigration policy quickly emerged as a point of contention.

Congresswoman Linda Sanchez raised concerns about the proposed visa fee increase and asked whether it could harm underserved communities that depend heavily on international medical graduates. Dr. Andrew Racine, president of the American Academy of Pediatrics, responded that “anything that’s going to decrease the supply is going to have an impact on our ability to serve the needs of children.”

Several lawmakers acknowledged that foreign-trained physicians play a critical role in residency programs and rural healthcare systems.

Some Republican lawmakers argued that immigration policy should not replace domestic training reforms. Congressman Greg Steube said American medical graduates were losing residency slots to foreign doctors and said he plans to introduce legislation to address the issue.

Beyond immigration, lawmakers debated proposals to expand Medicare-funded residency positions. A bipartisan plan seeks to add 14,000 slots over seven years, with a focus on rural and underserved areas.

Medicare currently spends about $22 billion annually on GME, but caps introduced in 1997 continue to shape how residency positions are allocated nationwide.

For Indian medical students pursuing US licensure and residency — a pathway that involves clearing US licensing examinations and securing accredited training slots — the debate adds a new layer of uncertainty. (IANS)