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Boston Globe
a day ago
- Health
- Boston Globe
Trump travel restrictions bar residents needed at US hospitals
'If international medical graduates can't start their medical residencies on time on July 1, the ramifications are so far-reaching that it is really unconscionable,' said Kimberly Pierce Burke, executive director of the Alliance of Independent Academic Medical Centers. Senior residents leave hospitals in June and go on to start their careers, she noted. Hospitals rely on new residents to replenish their ranks. 'If they don't come on July 1, that leaves a hole in the patient care team,' Burke said. 'Who's going to pick up the slack?' Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up On May 27, the Trump administration suspended new interview appointments for foreign nationals applying for J-1 visas. The visas, for participants in cultural or educational exchange programs, are used by most medical residents arriving from overseas. Advertisement On Wednesday, the State Department lifted the pause on visa appointments, according to an official who spoke anonymously to discuss an internal policy change. It was not immediately clear how many, or how quickly, physicians could be granted their visas. The process now includes 'enhanced social media vetting,' intended to ferret out potential security risks, the official said. The administration also has banned or restricted travel to the United States from 19 countries. The restrictions may be extended to an additional 36 countries, including many African nations, if they do not comply with U.S. demands regarding overstayed visas and security concerns. Advertisement The bans and restrictions were motivated by a commitment 'to protecting our nation and its citizens by upholding the highest standard of national security and public safety through our visa process,' the State Department official said. Foreign doctors from countries covered by the bans and other restrictions could request a 'national interest exception,' according to the State Department. It was not immediately clear how that process would unfold. The American medical system relies heavily on physicians from other countries. One in five U.S. physicians was born and educated overseas, according to the Association of American Medical Colleges. New doctors from other countries account for 1 in 6 medical residents and specializing fellows at U.S. teaching hospitals. In 2024, the Educational Commission for Foreign Medical Graduates sponsored more than 15,500 doctors from more than 150 countries to fill residency or fellowship training spots at 770 hospitals. Related : Residents are new medical school graduates who complete their training by working for several years under the supervision of more experienced doctors, gaining experience and acquiring the skills needed for various specialties. They work up to 80 hours a week on average, earning relatively low salaries. Residents are the foot soldiers of hospitals, critical to their operations, said Dr. Douglas DeLong, a semiretired physician in upstate New York who has worked in academic training programs. 'If you're a patient in a hospital, the resident is the first doctor you see in the morning,' DeLong said. Many foreign medical residents stay and build their careers in the United States. Most go into primary care fields such as internal medicine, family medicine and pediatrics, areas of shortage that American medical graduates tend to avoid. Advertisement Many of the 6,653 noncitizen doctors accepted for residency positions in the United States this year had already secured visa appointments before May 27. Those from banned countries who are already in the country are able to remain. But an estimated 1,000 medical residents were not able to obtain visas allowing them to work in the United States. The vacancies will have disparate effects on hospitals, depending how heavily reliant they are on foreign medical talent. At Brookdale Hospital Medical Center in the Brooklyn borough of New York City, people queued up for emergency care Monday. The lobby thrummed with visitors clutching bouquets of roses, and patients nodded off on benches, waiting to be seen. Like many hospitals in underserved communities, Brookdale relies heavily on international medical graduates who are not U.S. citizens to staff the medical and pediatrics floors and outpatient clinics. 'It's a wait-and-watch situation,' Dr. Christos Paras, who oversees the residency program, said in an interview. 'We just don't know what the impact will be.' 'We have residents from literally all over the world,' he added. 'I am not exaggerating — every continent.' Brookdale's internal medicine residency program relies on foreign medical graduates to staff about 90% of its 55 positions. So far, two noncitizens have been blocked from entering the country, said Dr. Conrad Fischer, director of the program. 'If I am missing two or three people, I can go out and get the spots filled,' Fischer added. 'But next year, we're not talking about missing two or three — we're talking about missing thousands.' Advertisement If the travel restrictions are maintained, 'it would gut the program,' he said. Dr. Christos Paras, who oversees Brookdale's residency program, at the hospital on Monday. Paras said that Brookdale doesn't know "what the impact will be" on Trump's travel ban. NICOLE CRAINE/NYT Hospitals and clinics in rural areas of the country already struggle to recruit graduates of U.S. medical schools to their residency programs. They rely heavily on international graduates. New foreign doctors are not taking residency positions away from American medical school graduates. Just the opposite: This year, there were about 40,000 residency positions offered through the national match system, but only 28,000 graduates of U.S. medical schools. Foreign residents fill a crucial labor shortage. Hospitals are not allowed to overwork residents and may lose their accreditation as medical teaching institutions if they do. An insufficient number of residents could also cost them Medicare funds tied to graduate medical education. The noncitizen international medical graduates who make it to U.S. training programs are 'well-trained, well-qualified and motivated,' DeLong said. 'This is the new generation of physicians for Americans,' he added. 'These are the physicians who will take care of us as we age. They are the future of medicine.' This article originally appeared in .
Miami Herald
12-06-2025
- Health
- Miami Herald
Study: Lesbian, gay, bisexual medical students less likely to graduate
Bisexual, gay and lesbian medical students are more likely to leave school before graduation, a new study says. Bisexual medical students were twice as likely to drop out or be dismissed from medical school, and gay and lesbian students were 47% more likely, according to findings published Tuesday in JAMA Network Open. "Although future studies need to examine the cause of these disparities in attrition, LGB students experience discrimination within medical training environments, which may lead to risk of attrition," wrote the research team led by Dr. Sarwat Chaudhry, associate dean for student research at Yale School of Medicine. For this study, researchers reviewed 2014 to 2017 data from the Association of American Medical Colleges to track more than 45,000 registered medical students. Nearly 1,400 said they were bisexual on a student questionnaire, and more than 1,500 said they were gay or lesbian. In all, 4.2% of bisexual students and 3.7% of gay and lesbian students didn't finish medical school, compared to 2.4% of non-LGB students, the study found. Hispanic queer people were at particularly high risk for leaving medical school, researchers found. Their attrition rates were three-and-a-half times higher than other groups. "Members of both the LGB and Hispanic communities may encounter less supportive attitudes toward homosexuality, often more prevalent among recent immigrants or first-generation households, and traditional cultural values around notions of masculinity, authority, and gender roles, perpetuating rigid expectations around sexuality and gender expression and alienating Hispanic LGB students," the research team wrote. Medical schools also haven't explicitly addressed discrimination against Hispanic students, inadvertently leaving them with less social support, researchers added. They said future studies should examine the ways in which ethnicity and sexuality might combine to create greater problems for some medical students. More information The Medical Student Pride Alliance has more for future queer medical students. Copyright © 2025 HealthDay. All rights reserved. Copyright 2025 UPI News Corporation. All Rights Reserved.
Yahoo
12-06-2025
- Health
- Yahoo
Study: Lesbian, gay, bisexual medical students less likely to graduate
Bisexual, gay and lesbian medical students are more likely to leave school before graduation, a new study says. Bisexual medical students were twice as likely to drop out or be dismissed from medical school, and gay and lesbian students were 47% more likely, according to findings published Tuesday in JAMA Network Open. "Although future studies need to examine the cause of these disparities in attrition, LGB students experience discrimination within medical training environments, which may lead to risk of attrition," wrote the research team led by Dr. Sarwat Chaudhry, associate dean for student research at Yale School of Medicine. For this study, researchers reviewed 2014 to 2017 data from the Association of American Medical Colleges to track more than 45,000 registered medical students. Nearly 1,400 said they were bisexual on a student questionnaire, and more than 1,500 said they were gay or lesbian. In all, 4.2% of bisexual students and 3.7% of gay and lesbian students didn't finish medical school, compared to 2.4% of non-LGB students, the study found. Hispanic queer people were at particularly high risk for leaving medical school, researchers found. Their attrition rates were three-and-a-half times higher than other groups. "Members of both the LGB and Hispanic communities may encounter less supportive attitudes toward homosexuality, often more prevalent among recent immigrants or first-generation households, and traditional cultural values around notions of masculinity, authority, and gender roles, perpetuating rigid expectations around sexuality and gender expression and alienating Hispanic LGB students," the research team wrote. Medical schools also haven't explicitly addressed discrimination against Hispanic students, inadvertently leaving them with less social support, researchers added. They said future studies should examine the ways in which ethnicity and sexuality might combine to create greater problems for some medical students. More information The Medical Student Pride Alliance has more for future queer medical students. Copyright © 2025 HealthDay. All rights reserved.
Yahoo
11-06-2025
- Health
- Yahoo
Research cuts pose ‘existential threat' to academic medicine and put nation's health at risk, new report says
Federal research funding cuts pose an 'existential threat' to academic medicine that will have repercussions for patient care in the US, according to a new report from the Association of American Medical Colleges, highlighting what it calls significant damage already done to the nation. The association, which represents 172 MD-granting US and Canadian medical schools and more than 490 teaching hospitals and health systems, noted in Wednesday's report that proposals in the House GOP tax and spending cuts bill could lead to a loss of health insurance for 11 million people enrolled in Medicaid or Affordable Care Act coverage and jeopardize loans for half of medical students. This is the first time in recent history when all three missions of academic medicine – research, education and patient care – are threatened, said Heather Pierce, the association's senior director for science policy. Typically, she said, when one is under fire, the others can compensate to ensure that health care is not compromised. 'This is the first time that all the missions of academic medicine simultaneously face these threats from our federal partners,' Pierce said. Should this trend continue, Pierce said, the United States will probably face a physician shortage, stagnation in scientific progress and a decline in the quality of medical care. Academic health systems, which include medical schools and teaching hospitals, educate future physicians and investigate complex medical cases, treating the sickest patients. The new report says these institutions are also twice as likely as other hospitals to provide clinical services such as trauma centers, organ transplant centers, birthing rooms and substance use disorder care. The report says patients treated at major teaching hospitals – where future health care professionals receive practical hands-on training – have up to 20% higher odds of survival than those treated at non-teaching hospitals. Funding cuts to these institutions have effects that trickle down to patients nationwide. The report noted that academic health systems conduct the majority of research funded by the US National Institutes of Health, and complex patient care is made possible only through extensive medical research. As of June, more than 1,100 NIH grants have been terminated since the beginning of the second Trump administration, according to the report. These include at least 160 clinical trials to study HIV/AIDS, cancer, mental health conditions, substance abuse and chronic disease. Although not all clinical trials involve life-saving treatments, for some people who have diseases that have no established therapies, trials may be their only option. 'We've made terrific progress in many diseases, but there are many diseases where we have a long way to go to be able to offer a newly developed treatment that we know can improve or lengthen their lives,' Pierce said. 'With those diseases, in many cases, the only way to try to move forward is with what scientists think are the very best potential treatments for those diseases.' Some of the clinical trials were terminated before their conclusion, which is unethical, she said. 'Halting a clinical trial before it ends at any point, even if all of the patients who are in the clinical trial finish their treatment, before data analysis has been done, before the results are released, renders that clinical trial less useful and less ethical,' she said. Patients take on the risk of uncertainty when they join clinical trials, not knowing whether the treatment will be effective. 'If we never know the outcome, all of that time, all those patients launching everything that they did to bring science forward has been wasted. In some cases, it could be years of progress.' The report notes that research funding has made crucial contributions to life-saving care. For example, the NIH funded the development of the first artificial heart valve with the first successful replacement at the NIH Clinical Center in 1960. Today, more than 100,000 heart valve replacements are performed each year. And a study also found that NIH funding contributed to research associated with every new drug approved from 2010 to 2019. Each year, medical schools and teaching hospitals that are members of the Association of American Medical Colleges train about 77,000 residents nationwide, making these institutions the primary producers of primary care and specialty physicians. Medicare offsets a portion of the costs for the majority of trainees, and teaching hospitals fully cover the cost of training for the rest of the residents. The proposed elimination of federal student aid programs and changing eligibility requirements for loan forgiveness would affect nearly half of all medical students, the new report says. Should investment not increase, the association predicts that the nation will face a shortage of up to 86,000 physicians by 2036. As federal partnerships with research institutions continue to falter and immigration restrictions become more strict, the United States is becoming a less attractive place for students to pursue science, Pierce said. The nation has benefited from their longstanding global medical and scientific approach, she said. 'There is information being shared between countries, people being trained all over the world,' Pierce said. 'The United States has always been the place where people want to come, trained to be scientists and trained to be physicians, and we have benefited from that.' Nearly half of US graduate students in STEM fields are from other countries. If the United States is not seen as a place that will collaborate with and welcome international scholars, students and researchers will leave, Pierce said. She emphasizes that what makes US innovation unique is that research comes 'with not the support but the full partnership of the federal government.' A weakening of this partnership will make it 'harder for the United States to stay as the driver of innovation and science progress,' Pierce said. A physician shortage coupled with declining research investment leads to the suffering of patient care, she said. 'When the research stops, progress stops,' Pierce said. 'Scientific progress toward more treatment, towards more cures, towards a better quality of life, is all dependent on this ecosystem [of academic medicine] that is more intertwined than I think anyone realized.'
Boston Globe
09-06-2025
- Health
- Boston Globe
Trump budget's caps on grad school loans could worsen doctor shortage
Four years of medical education costs $286,454 at a public school, on average, and $390,848 at a private one, according to the Association of American Medical Colleges. Medical school graduates leave with an average debt of $212,341, the association found. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up The price of a four-year program in osteopathic medicine is $297,881 at a public school, on average, and $371,403 at a private school, according to the American Association of Colleges of Osteopathic Medicine. The average indebtedness of their graduates is $259,196. Advertisement The proposed loan caps 'will either push students and families into the private loan market, where they take on more risk and have less consumer protection, or simply push people out of higher education altogether,' said Aissa Canchola Bañez, policy director at the Student Borrower Protection Center, a nonprofit advocacy group. Private student loans are also not eligible for Public Service Loan Forgiveness programs, which many students rely on to manage their debt. Students from low-income families may have difficulty qualifying for private loans. Advertisement In a letter to congressional leaders, the American Medical Association asked lawmakers to carve out exceptions in the law for medical education, saying that the current bill would deter good candidates from applying to medical school, discourage physicians from working in underserved areas, and make medical school unaffordable for all but the very wealthy. Critics said it could also drive more doctors away from lower-paying primary care fields, an area of acute need, and into more lucrative specialties. Conservatives have argued for decades that the availability of federal student loans allowed tuition costs to balloon — a proposition rejected by the Association of American Medical Colleges, which instead blames the rising cost of living. Studies examining the relationship between loans and tuition have varied in their conclusions. Sara Robertson, press secretary for Republicans on the House Education and Workforce Committee, said the proposed loan limits 'will drive down the cost of medical school and thus reduce the need for students to borrow in the first place.' She said private lenders would offer students lower interest rates than the government's Grad PLUS program would. The private market, though, has shrunk markedly since the Great Recession, according to Lesley Turner, an associate professor of public policy at the University of Chicago and an author of an unpublished paper that linked loans to rising tuition. In an email, Turner said it wasn't clear that 'the same level of nonfederal funding would be available today.' Because of inflation, she noted, the $150,000 limit for medical students is 'substantially reducing the amount these students can borrow, even compared to the status quo before the Grad PLUS program.' The program was started in 2006. Advertisement Robertson said schools could also help close the gap. 'Nothing in the bill prevents colleges from providing additional financial aid to low-income students pursuing medical school,' she said. That is not an option for schools of osteopathic medicine, most of which are private and not attached to universities with foundations, and which currently enroll almost one-third of the nation's future doctors, said David Bergman, senior vice president of government relations and health affairs for the American Association of Colleges of Osteopathic Medicine. And many academic medical centers, which have lost millions of dollars in research grants abruptly pulled by the Trump administration, are facing severe financial strain. A vast majority of medical students rely on loans, not just those from low-income backgrounds, Bergman noted. Ending federal involvement in administering and subsidizing student loans was one of the goals laid out in Project 2025, the Heritage Foundation's conservative blueprint for overhauling the government. It argued that leaving student loans to private lenders and ending federal loan forgiveness programs would 'allow for market prices and signals to influence educational borrowing.' Trump's policy bill would allow medical residents to defer not only their loan payments but also the interest on those payments, a provision that many medical professionals have supported. But the legislation would prohibit residents from counting those low-paid years of training as public service, limiting their eligibility for a popular loan forgiveness program that encourages young doctors to work in underserved areas. As a result, 'access to much-needed medical care for patients in rural and underserved communities will be diminished,' the American Medical Association's CEO, Dr. James Madara, wrote in the letter to House Speaker Mike Johnson, Republican of Louisiana, and House Democratic leader Representative Hakeem Jeffries of New York. Advertisement The changes will disproportionately affect low-income students with backgrounds that are underrepresented in medicine, who may face more difficulty obtaining private loans, said Dr. Virginia Caine, president of the National Medical Association, which represents Black physicians and which advocates for health equity. In turn, she said, it will limit those students' ability to return to serve in their communities. By 2037, the United States is expected to face a shortage of 187,130 physicians, including 87,150 primary care physicians such as internists and pediatricians who play a pivotal role in the early detection and management of chronic disease, according to the federal Health Resources and Services Administration. (There are currently 933,788 professionally active physicians.) About 75 million Americans live in areas where it is difficult to get access to primary care. The ratio of primary care providers is projected to decline to 76.8 per 100,000 people by 2037, from 81.6 per 100,000 in 2022. This article originally appeared in
