Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words

Last updated September 20, 2026.

Read together, the 88 KevinMD posts on immigration and medicine say one thing consistently: the United States depends on immigrant physicians for its rural hospitals and its primary care, and treats them, and immigrant patients, as provisional. International medical graduates matched 9,682 residency positions in 2026 and more than sixty percent go into primary care, often in underserved places; the physicians writing describe visas denied after matching, employment tied to legal status, recommendation letters withheld, and, since 2025, immigrant patients who skip the clinic because agents may be in the hall. ICE or deportation appears in 45 percent of the record before 2017 and 32 percent in 2025 and 2026. Where physicians disagree, on whether the H-1B is a crutch, on English tests for immigrant nurses, and on the J-1 waiver, both sides are on this page under their own names.

This page is a maintained record of what international medical graduates, immigrant physicians, and the physicians who treat immigrant patients have written on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 88 essays and podcast transcripts with IMG, international or foreign medical graduate, immigrant, immigration, visa, J-1, H-1B, DACA, undocumented, refugee, deportation, ICE, travel ban, or Caribbean medical school in the title, published between November 2004 and September 2026 by 72 named contributors, 48 of the posts bylined by physicians, 4 of them podcast episodes with transcripts, and 5 written anonymously, the highest share of any record. Of the 88, 29 were published from 2023 onward and 8 in 2026. Every claim is attributed to a named author with the month it was published, quoted in the author’s own words, and linked to the original.

This record holds two subjects that the physicians writing say are one: the immigrant as doctor and the immigrant as patient. Race in medicine is on the Race and medicine: what physicians say, in their own words record; the residency Match in general is on the Residency: what residents and physicians say, in their own words record; immigrant children are also on the Children’s health: what pediatricians say, in their own words record. Students, a historian, a nurse researcher, and podcast guests are cited at the same weight as physicians and identified as such. Each section opens with a direct answer, then what named authors have said, in the order they said it. Contributors who sell services into this subject, including admissions advising and a Caribbean medical school, are identified where they are cited. This is physician opinion and experience, not immigration advice.

What do international medical graduates say about the Match?

The Match posts on KevinMD begin in 2014 with a surgeon’s warning that only about half of offshore graduates matched, and continue with IMGs describing the pandemic year, a Step 1 that went pass/fail after they had outscored their American peers to compete, a match rate of 58 percent, letters withheld, and a 2026 essay counting 9,682 IMGs matched. Match appears in 18 percent of posts before 2017 and 32 percent since 2025.

Skeptical Scalpel, MD, a retired surgical chairman, wrote in April 2014 of “the impending problem of too many medical school graduates and not enough residency training positions,” in “The residency chances of offshore medical school graduates.” Skeptical Scalpel, MD, a retired surgical chairman, wrote in April 2015 that “If the school does not list residency match statistics, that could be a red flag,” in “IMGs matching into surgery: What are the chances?” Karolina Woroniecka, MD, PhD, an international medical graduate, wrote in July 2020 that “IMG’s have had to score higher on Step 1 than their American medical graduate (AMG) counterparts,” in “Coronavirus takes a toll on IMGs: anxieties over USMLE Step 1 becoming pass/fail.” Samir Desai, MD, a physician who sells residency application advising, wrote in November 2020 that “The reality of the current day residency match is that programs are often inundated with applications,” in “What Caribbean medical students need to know about the residency match.” An anonymous physician, a resident writing anonymously, wrote in June 2024 that “It’s evident that IMGs face added challenges and potential discrimination regarding due process compared to their American counterparts,” in “Resident struggles: How hierarchical health care systems impact IMGs.” Fereshteh Kagar Bafrani, MD, an international medical graduate, wrote in September 2025 that, most painful of all “the recommendation letters I had been promised were withheld, cutting off my ability to apply for residency this year,” in “An IMG’s story of exclusion in U.S. residency.” Chinyelu E. Oraedu, MD, an internist, wrote in June 2026 citing the 2026 Match that “Of the 9,682 IMG applicants who matched this year, 6,733 were non-U.S,” citizens, in “International medical graduates and the hidden curriculum.”

What do physicians say about visas, waivers, and rural medicine?

On visas the physicians on KevinMD agree about the arrangement and disagree about its fairness: the J-1 waiver sends foreign physicians to underserved towns for three years, the H-1B ties employment to status, and a 2025 study found H-1B physicians twice as prevalent in rural counties. A historian traces the bargain to the 1960s. Visa appears in 19 percent of posts in 2017 to 2019 and 32 percent since 2025; rural or underserved in 41 percent since 2025.

Vincent DeGennaro, Jr., MD, MPH, an internist, wrote in March 2017 that “Nearly all foreign physicians are required to work for three years in an underserved area of the U.S,” in “Trump’s travel ban affects doctors too.” Juan J. Delgado-Hurtado, MD, MPH, an international medical graduate, wrote in July 2020 that “IMGs mainly come to the United States on two types of visas,” in “The uncertainty of an international medical graduate during the COVID-19 pandemic.” G. Richard Olds, MD, the president of a Caribbean medical school, wrote in April 2022 that “City dwellers and high-income patients might not feel the impact of the shortage,” but ‘the story is different in rural America’, in “International medical graduates ease the U.S. doctor shortage.” Gregory Tan, a student and the son of a rural neurologist, wrote in May 2022 that his father’s experience showed “the J-1 work exemption is an unsustainable fix for a far greater problem,” in “The J-1 work exemption: a flawed solution to the physician shortage.” George Abraham, an internist and past ACP president, said on The Podcast by KevinMD in July 2024 that “international medical graduates tend to gravitate to rural areas or underserved areas as a form of their visa fulfillment requirements,” in “How international medical graduates shape U.S. health care [PODCAST].” Arthur Lazarus, MD, MBA, a psychiatrist, wrote in June 2025 that “One, a general surgery match from Ethiopia, had his visa denied outright,” in “International doctors blocked by visa delays as U.S. faces physician shortage.” Adam Brandon Bondoc, MD, a physician, wrote in September 2025 that “More than sixty percent of IMGs go on to practice in primary care, often in rural or underserved communities,” in “IMGs are the future of U.S. primary care.” Eram Alam, PhD, a historian, wrote in November 2025 that 1960s policymakers addressed the shortage by “inviting foreign physicians to staff shortage areas in exchange for legal status,” in “How immigrant physicians solved a U.S. crisis.” A physician, writing anonymously, wrote in November 2025 citing a JAMA study that “physicians sponsored under the H-1B visa program are twice as prevalent in these bucolic outposts as in their urban counterparts,” in “The H-1B crutch in rural health care.”

What do physicians say about Caribbean schools, accents, and being foreign?

The being-foreign posts on KevinMD are about stigma with a price attached: Caribbean schools described as schools of opportunity by their defenders and as red flags by a surgeon, discrimination that one anonymous IMG says permeates the system, and, in 2026, a developmental pediatrician asking what a halting accent does to a parent receiving an autism diagnosis. Caribbean appears in 29 percent of posts in 2017 to 2019; language or accent in 18 percent since 2025.

Stacy Meyer, who works in Caribbean medical school admissions, wrote in September 2018 that “Caribbean medical schools are, first and foremost, schools of opportunity,” in “Addressing the ‘ugly truth’ about Caribbean medical schools: Why they’re not all the same.” Jessica K. Willett, MD, an emergency physician, wrote in May 2019 that “The stigma of a Caribbean medical school education is built on rumors,” in “The truth about Caribbean medical schools.” A foreign medical graduate, writing anonymously, wrote in August 2023 that “discrimination permeates the very system itself,” in “Navigating the broken medical system: challenges faced by foreign medical graduates.” Ronald L. Lindsay, MD, a developmental pediatrician, wrote in February 2026 asking what a parent hears in an autism diagnosis from “a physician whose English is halting or heavily accented,” in “When language becomes the barrier: IMGs and autism diagnoses.”

What do physicians say about immigrant and undocumented patients?

Physicians on KevinMD have written about undocumented patients as the uninsured the Affordable Care Act left out since 2011, and about refugees since 2016. Since 2025 the posts are about fear: one in twelve children at risk of losing a loved one to deportation, the rescinded policy that had kept ICE out of hospitals, and a patient whose husband and child were taken and who died alone. Undocumented appears in 32 percent of posts before 2017 and 23 percent since 2025; fear in 36 percent since 2025.

Renée Volny, DO, MBA, a physician, wrote in December 2011 that “the exclusion of undocumented immigrants from the ACA is a roundabout way of crafting anti-immigration policy,” in “Undocumented individuals will become a larger share of the uninsured.” Abraar Karan, MD, a physician, wrote in October 2015 of a patient, that “He is certainly not alone in this fear, and resultant avoidance of contact with the medical system,” in “We need to provide health insurance for undocumented people. Here’s why.” Xandra Rarden, MD, a family physician, wrote in December 2016 that refugee patients bring a form certifying “they are unable to take the test to become a U.S,” citizen, in “How a family physician gets to know her newly arrived refugee patients.” Elisabeth Poorman, MD, an internist, wrote in October 2017 that the mayor sought to reassure 500,000 undocumented Houstonians “they would not be targeted for deportation at emergency shelters,” in “Anti-immigrant policies put people at risk during Harvey. And that’s just the beginning.” Fiorella Castillo, a pediatrician, said on The Podcast by KevinMD in March 2025 that we know “about 1 in 12 children risk losing a loved one to deportation, and this leads to long-term trauma and adversity,” in “Protecting immigrant families: a pediatrician’s call to action [PODCAST].” Carlin Lockwood, a student, wrote in May 2025 that the administration “rescinded a policy that previously protected individuals from ICE arrests in ‘sensitive’ areas,” in “The silent toll of ICE raids on U.S. patient care.” Joshua Vasquez, MD, a physician, wrote in July 2025 that “As lawmakers debate cuts to Medicaid and restrictions on care for undocumented immigrants,” in “Who gets to be well in America: Immigrant health is on the line.” Amanda Perez, MD, an internal medicine resident, wrote in June 2026 that “A couple of months ago, her husband and child were captured by Immigration and Customs Enforcement (ICE) officers,” in “Deportation and addiction: My patient died alone.”

What do physicians say about immigration policy?

The policy posts on KevinMD track three administrations: a bioethicist writing in 2016 about DACA students in his medical school, an internist whose colleague could not visit family under the 2017 travel ban, two essays on rescinding DACA, and, since 2025, physicians describing an executive order that expedites deportations and a social media disclosure rule that can turn a post into a red flag. DACA appears in 10 percent of posts in 2017 to 2019 and 0 percent since 2025.

Mark Kuczewski, PhD, a bioethicist, wrote in July 2016 that DACA students showed “how important a mechanism of bringing undocumented immigrants out of the shadows can be,” in “Can medicine cure what’s wrong with U.S. immigration policy?” Vincent DeGennaro, Jr., MD, MPH, an internist, wrote in March 2017 that a colleague worries “the travel ban is just the first step in what will be a continuous battle,” in “Trump’s travel ban affects doctors too.” Isha M. Di Bartolo, MD, a physician, wrote in August 2017 that, unequivocally “DACA has been shown to raise attainment of higher education, improve employment rates, raise family incomes,” in “The effect of rescinding DACA on immigrant communities.” Arthur Lazarus, MD, MBA, a psychiatrist, wrote in June 2025 that with a social media disclosure mandate “even the most benign online post could become a red flag,” in “International doctors blocked by visa delays as U.S. faces physician shortage.” Joshua Vasquez, MD, a physician, wrote in July 2025 that “These aren’t just policy decisions, they’re declarations about who belongs,” in “Who gets to be well in America: Immigrant health is on the line.”

What do physicians disagree about?

On the H-1B, Anonymous writing anonymously calls it a crutch that lets hospitals sidestep a competitive labor market, and Adam Brandon Bondoc, MD, says the same physicians are the future of primary care. On the J-1 waiver, Gregory Tan calls it an unsustainable fix and Juan J. Delgado-Hurtado, MD, MPH, chose it. On English tests, Lynne Moronski, PhD, MPA, RN, a nurse researcher, wrote in October 2025 that “attempts to weaken or otherwise erode ELP within the current policy debate is perilous, however well-meaning these attempts may be,” in “The debate on English tests for immigrant nurses.” On Caribbean schools, Skeptical Scalpel, MD, says do due diligence and Jessica K. Willett, MD, says the stigma has run its course. The record does not resolve these; it dates them.

What would fix it? What physicians propose.

Asked what would fix it, physicians on KevinMD propose insurance for undocumented people, an immigration policy that stops treating a decade of inaction as a pause, whistleblower protections for IMGs in residency, local training pipelines instead of imported quick fixes, and clinics that partner with the organizations immigrant families already trust.

Abraar Karan, MD, a physician, wrote in October 2015 that a growing contributor to cost is “the systematic exclusion of undocumented patients,” in “We need to provide health insurance for undocumented people. Here’s why.” Mark Kuczewski, PhD, a bioethicist, wrote in July 2016 that “we have been stuck in inaction for more than a decade,” in “Can medicine cure what’s wrong with U.S. immigration policy?” Megha Shankar, MD and Jonathan G. Shaw, MD, physicians, wrote in July 2020 that “Clinicians must recognize how these times of crisis exacerbate existing racial and gender health disparities,” in “Immigrant women are essential: Sociocultural factors clinicians should know during times of crisis.” Gregory Tan, a student, wrote in May 2022 that “significant effort must be made to accommodate the new physician to an unfamiliar work environment,” in “The J-1 work exemption: a flawed solution to the physician shortage.” Fiorella Castillo, a pediatrician, said on The Podcast by KevinMD in March 2025 that “We really need systemic changes to our immigration policy to stabilize what otherwise is a precarious legal status,” in “Protecting immigrant families: a pediatrician’s call to action [PODCAST].” Joshua Vasquez, MD, a physician, wrote in July 2025 that fairness must be more than a sentiment: “It must be paired with access, safety, and dignity,” in “Who gets to be well in America: Immigrant health is on the line.” A physician, writing anonymously, wrote in November 2025 that when hospitals choose the imported quick fix “they forgo investments in scholarships, loan forgiveness, or apprenticeships that could cultivate a self-sustaining cadre of local healers,” in “The H-1B crutch in rural health care.” Vasilii Khammad, MD, PhD, a pediatric resident, wrote in May 2026 that “As a physician, I felt I had no choice but to step forward,” in “International medical graduates need real protections.”

How has the conversation changed since 2004?

The record starts with Kevin Pho’s short commentaries, 6 of them, counted here but not cited. The 2011 to 2016 posts are about undocumented patients and the Affordable Care Act, offshore match rates, and refugees. The record’s first peak is 2017, the travel ban and DACA, and its second is 2020, IMGs in the pandemic. Since 2025 it has its largest year, and its subjects are visas denied after the Match, letters withheld, ICE in the clinic, and the history of the bargain. AI is mentioned in 9 percent of the 2025 and 2026 posts.

Two things did not change. Shortage is named in 9 to 44 percent of posts in every period. And the most frequent byline on this record is Anonymous.

Term 2004 to 2016 (22 posts) 2017 to 2019 (21 posts) 2020 to 2022 (16 posts) 2023 to 2024 (7 posts) 2025 to 2026 (22 posts)
Visa 14 percent 19 percent 44 percent 43 percent 32 percent
Match 18 percent 29 percent 44 percent 29 percent 32 percent
Rural or underserved 27 percent 14 percent 25 percent 43 percent 41 percent
Undocumented 32 percent 19 percent 6 percent 0 percent 23 percent
ICE or deportation 45 percent 29 percent 25 percent 0 percent 32 percent
DACA 5 percent 10 percent 12 percent 0 percent 0 percent
Shortage 9 percent 24 percent 44 percent 14 percent 32 percent
Caribbean 18 percent 29 percent 12 percent 14 percent 5 percent
Language or accent 9 percent 19 percent 19 percent 57 percent 18 percent
Fear 9 percent 38 percent 25 percent 0 percent 36 percent
AI 0 percent 0 percent 0 percent 14 percent 9 percent

Term frequencies are the share of posts in each period whose text contains the term at least once, computed on the September 20, 2026 corpus of 88 posts with one stored expression per term.

The KevinMD immigration and medicine corpus by the numbers

These figures describe the set of KevinMD posts this page draws on. They are counts of what KevinMD has published, not workforce or immigration data.

Measure Value
Posts in the corpus 88
Published 2023 or later 29
Published in 2026 (through September) 8
Named contributors 72
Posts bylined by physicians (MD or DO) 48
Podcast episodes with transcripts 4
Posts bylined by nurses 1
Written anonymously 5
Kevin Pho’s early commentaries, counted but not cited 6
Posts not indexed, counted but not cited 6
Most frequent contributors Skeptical Scalpel, MD (3); Bianca Nfonoyim, MD and Rebecca Whitmire, MD, MPH (1); Samir Desai, MD (1); Madhuri Chengappa, MD (1); Mara Divis, DO, Juliana Morris, MD, EdM. and Eva Raphael, MD, MPH (1)
Title matches excluded 53 with the subject thin in the text; figurative uses of ICE were excluded at the title search

How this page was built and how it is updated

The corpus was assembled from title searches for IMG, international medical graduate, foreign medical graduate, foreign-trained, immigrant, immigration, visa, J-1, H-1B, green card, DACA, undocumented, refugee, deportation, ICE, travel ban, and Caribbean or offshore medical school. Figurative uses were excluded, and posts whose text mentioned the subject fewer than four times were excluded. Term frequencies were computed against the full text of each post. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. 6 posts in the corpus are not indexed; they are counted but not cited. Quotations are taken verbatim from the original posts and were checked against the source text by script. Author credentials are as they appeared in the byline at publication; where the byline gave none, the credential is the one the post itself states. Students, a historian, a nurse researcher, and podcast guests are cited at the same weight as physicians and identified as such. Contributors who sell services into this subject are identified where they are cited: Samir Desai, MD, sells residency application advising; G. Richard Olds, MD, is the president of a Caribbean medical school; Stacy Meyer works in Caribbean medical school admissions. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. No immigration tag exists on KevinMD; the closest archives are the Residency and Medical Training tag and the Health Policy category. Related records: Race and medicine: what physicians say, in their own words, Residency: what residents and physicians say, in their own words, Children’s health: what pediatricians say, in their own words, Primary care: what physicians say, in their own words, and Medical school: what students and physicians say, in their own words.

This page is updated as new essays on immigration and medicine are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/immigration-and-medicine

The 33 KevinMD posts cited on this page, in order of publication