Summary of the White Paper: "Cutting the American Physician Shortage with International Doctors"

The United States faces a critical physician shortage, with projections estimating a deficit of over 100,000 doctors by 2034. This crisis has been exacerbated by physician burnout, an aging population, and a stagnant number of medical training opportunities. As a result, millions of Americans, particularly those in rural and underserved areas, experience long wait times or lack access to primary care and specialist appointments. The Association of American Medical Colleges (AAMC) predicts a shortage of up to 86,000 physicians by 2036, underscoring the urgent need for policy changes to expand the physician workforce.

One of the major barriers to addressing this shortage is the limited number of medical residency slots, which are essential for licensing new doctors. While medical school admissions have increased, residency positions remain capped by federal funding, leaving thousands of medical graduates, both from U.S. and international programs, without a pathway to practice. International Medical Graduates (IMGs), many of whom are highly experienced and already licensed abroad, face additional challenges due to stringent state licensing requirements that mandate repeating their residency in the U.S., even when they have completed comparable training in their home countries. These unnecessary restrictions prevent thousands of qualified physicians from contributing to the healthcare system at a time when they are most needed.

Several policy solutions have been proposed to address the physician shortage.

Expanding telehealth services could alleviate some demand by allowing patients to consult with doctors remotely, especially in underserved areas. Additionally, states could grant more authority to nurse practitioners, physician assistants, and pharmacists to provide routine care, freeing up physicians for more complex cases. However, these measures alone will not be enough to meet the growing healthcare demands of the population. Increasing the number of medical school and residency slots is an essential long-term solution, but it requires significant federal investment and will take years to produce new doctors. In the meantime, alternative pathways for unmatched U.S. medical graduates, such as Assistant Physician programs in states like Missouri, allow these individuals to work under supervision while contributing to patient care.

One of the most immediate and impactful solutions is creating alternative licensure pathways for internationally trained physicians. Some states, including Tennessee and Virginia, have already enacted laws allowing foreign-trained doctors to work under supervision before earning full licensure, bypassing the need for them to repeat their entire residency. Other states, such as Colorado and Washington, are exploring similar policies that enable experienced IMGs to practice in community health settings or university-affiliated programs. A sponsorship model, in which healthcare institutions vet and mentor IMGs before granting them full licensure, has also been proposed as a way to integrate thousands of skilled physicians into the workforce without compromising patient safety.

The physician shortage is a growing national crisis that requires swift legislative action. While increasing medical training opportunities is a necessary long-term goal, removing bureaucratic barriers for qualified international physicians offers an immediate and effective solution. State-led initiatives are crucial in implementing these reforms while federal efforts remain slow-moving. By embracing these changes, the U.S. healthcare system can ensure more patients receive timely care, reduce burnout among existing medical professionals, and improve overall public health outcomes.