'Bureaucratic and monetary hurdles' hinder international medical graduates' pursuit of radiology
Issues with acquiring visas for international medical graduates (IMG) hinder radiology programs’ ability to accommodate students outside of the United States, according to newly published data in Academic Radiology.
According to the new paper, radiology trainee programs must overcome several hurdles in order to offer J-1 and/or H-1B visas to trainees, with more difficulties associated with the latter, which also happen to be more desired by students. As a result, 24% of surveyed program directors (PDs) report not supporting J-1 visas, while nearly 70% do not support offering H-1B visas.
Based on responses provided by 121 U.S. diagnostic radiology PDs, issues with offering visas to graduates can be attributed to the expenses associated with them, a lack of familiarity with the process, regulations from the Educational Commission for Foreign Medical Graduates, and the time-consuming process of filling out and submitting required paperwork.
Corresponding author of the new paper David M. Yousem, MD, MBA, with the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins Medical Institution in Baltimore, and colleagues explained how such difficulties could create bias against IMG students applying for residency programs.
“Even though all applicants for a U.S.-based residency program submit their applications through the Electronic Residency Application Service, their paths forward are vastly different, as the selection process is subject to potential bias against IMGs since it is not a blinded process,” the group wrote, adding that this bias can occur in several ways.
First, PDs might be less likely to choose a candidate who does not have current U.S. citizenship, as the process for acquiring visas is riddled with red tape. There also is the matter of the quota system, which allots a set number of slots for IMG candidates prior to the match, limiting their opportunities to match with a program. And then there are hierarchical two-rank systems in some programs that rank U.S. MDs first, regardless of how their qualifications, transcripts and experience compare to IMG candidates.
However, streamlining the United States Citizenship and Immigration Services (USCIS) processes for obtaining the Employment Authorization Document and green cards for medical graduates could help to eliminate some of these barriers while also benefiting radiology programs, the authors suggested.
This would help programs by:
Putting application expenses on trainees, rather than programs.
Streamlining document review by having necessary forms completed before entering residency.
Screening for quality of candidates through the immigration system.
Putting the candidate on a pathway to citizenship before residency begins, which also would ease their transition into employment after completing their education.
The authors maintain that although IMGs play an “important role in the U.S. healthcare system workforce, medical research, education and diversity,” their ability to contribute continues to be limited due to “bureaucratic and monetary hurdles around visas.”
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.