Policy Statement on Supporting International Medical Graduates as an Integral Part of the Mental Health Workforce
Background
The United States healthcare system continues to struggle with an ongoing shortage of primary and specialty care physicians including psychiatrists, a situation which is projected to worsen in the coming years. For decades, International Medical Graduate (IMG) physicians, especially psychiatrists, have played a crucial role in providing care across the country and often for publicly insured, severely mentally ill, financially disadvantaged, ethno-racially diverse, and rurally located patients.
IMG physicians have been vital in increasing access to healthcare, including mental health services in underserved communities, as well as making significant contributions in research, medical training, and clinical supervision. IMGs often fulfil their medical service obligations in medical specialties experiencing critical workforce shortages, including child and adolescent psychiatry.
IMG psychiatrists and subspeciality psychiatrists represent a significant part of the behavioral healthcare workforce, including 29.6% of the child and adolescent psychiatry workforce. Changes in immigration policies that provide common pathways to residency training and employment for foreign trained physicians, including visa waiver programs, negatively impact the provision of medical and behavioral health care in the underserved communities in which IMG physicians serve.
To ensure timely access to mental healthcare services for US children, adolescents and their families, as supported by the IMG psychiatry workforce, the American Academy of Child and Adolescent Psychiatry (AACAP) recommends:
- State and Federal agencies that regulate immigration maintain and improve robust pathways for IMGs to access the training, resources, and professional development opportunities necessary to provide high-quality child and adolescent psychiatric care.
- Continuing and further expanding the Conrad State 30 J-1 Visa Waiver Program, which enables IMGs to obtain a waiver from the home-country physical presence requirement by fulfilling their service obligations in medically underserved areas while addressing critical shortages in child and adolescent psychiatry services.
- Federal agencies that regulate immigration policy provide exemptions from H-1B visa caps, fees and related proclamations for IMG physicians, particularly those in shortage specialties such as psychiatry and child and adolescent psychiatry.
- Policymakers maintain the current duration of status framework in the J-1 visa waiver program, which provides the flexibility necessary for IMGs to complete residency and fellowship training.