The United States has long been a desired destination for practicing medicine. At an average of $261,000 annually, physician salaries are higher in the U.S. than other developed countries. Doctors in Germany earn about $155,000, France $143,000 compared to $137,000 in Japan. Many less developed countries compensate doctors far less. The U.S. is also recognized as a leader in medical research, making it a desirable destination for academic researchers.
More than one-quarter of applicants for U.S. residency programs are foreign medical graduates. In 2025, 9,761 international medical graduates matched to a residency program in the U.S. out of a pool estimated to be as high as 15,000 who wanted to come. Some of these were U.S. citizens attending school abroad, but most were foreign born and educated abroad. National Public Radio (NPR) reports that the U.S. is a popular place to practice medicine for doctors trained abroad, but that may be about to change:
Immigrants make up about a quarter of all the country’s doctors, and the U.S. health care system depends heavily on them. There are roughly 325,000 physicians — not including nurses or other critical health care workers — living and working in the U.S., who were born and trained elsewhere.
In some rural areas, doctors trained abroad make up an even larger proportion of practicing physicians. Foreign medical graduates are more likely to practice in small towns and rural areas than their U.S. trained counterparts. More from NPR:
In primary care and specialties like oncology, for example, foreign-born doctors account for about half of the workforce.
However, NPR also reports that many foreign-born physicians are increasingly reluctant to practice in America:
Meanwhile, health care is already burdened by retirements and burnout. Many experts say recent immigration and health policies are only making it harder — and less appealing — for foreign-born talent to augment the short-staffed American health system.
Then, in September, Liu was doing rounds with two doctors from Mexico and Costa Rica, when the administration hiked fees nearly 30 fold for H1B visas, which are for highly trained professionals, to $100,000. He watched his colleagues’ tearful reactions to the sudden uncertainty that thrust on their careers, knowing that employers like hospital systems are unlikely to be able to afford to pay for such dramatic increases.
He points to his own recent co-authored research in JAMA estimating that 11,000 doctors, or roughly 1% of the country’s physicians, currently have H1B visas. “That might seem like a small number, but this percentage varied widely across geographies,” he said, and they tend to congregate in the least-resourced areas, reaching up to 40% of physicians in some communities.
Another concern for foreign-trained academic medicine physicians is the perceived reduction in scientific research funding.
For the past six decades, immigrants have contributed heavily to the U.S.’s reputation as the undisputed world leader in health research and practice. In pay and prestige, the U.S. has been unparalleled, helping attract the world’s best talent — at the expense of their home countries.
The U.S. is facing a physician shortage, especially in primary care that is expected to get worse over the next decade. States like Texas are taking steps to make it easier for foreign- trained physicians to practice medicine without repeating time consuming residency programs. However, if facing a $100,000 HB1 visa cost, fewer will apply.
A medical education is a tremendous asset, costing hundreds of thousands of dollars. Some of the costs are personal, in both time and money. Some are public costs, in terms of universities and residency programs. It would be unfortunate if Trump Administration immigration priorities stand in the way of attracting physicians trained abroad. The United States needs all the doctors we can get.
Read more at NPR: The U.S. relies on immigrant physicians. What if they no longer want to come?