The United States is expected to face a major shortage of doctors in the coming years. According to projections by the Health Resources and Services Administration (HRSA), the country could be short of physicians by around 81,180 by 2035. This shortage of doctors is already developing in the U.S., with estimates representing gaps of 57,259 during 2025 and nearly 79,080 by 2030 as per National Center for Health Workforce Analysis (NCHWA) projects. This growing problem is being addressed by considering the easier process for obtaining work authorization and medical licenses for International medical graduates (IMGs) across the U.S.
In recent years, many U.S. states have started taking steps to include more IMGs in the healthcare workforce. As of May 2025, the Federation of State Medical Boards (FSMB) reported that approximately 37 states have either implemented or introduced new licensing processes or pathways especially for IMGs. These efforts are developed to help in the reduction of both future and current physician shortages.
Out of these, 12 states have passed laws allowing qualified IMGs to receive full medical licenses even if they have not completed postgraduate training in North America. Furthermore, 22 more states are enacting similar legislation. Some states, such as Washington, California, and New York, have created a special pathway that allows IMGs to obtain limited licenses without needing additional graduate medical education (GME). Additionally, most states already have special provisions that allow highly skilled or distinguished IMGs, like those with strong academic or research backgrounds, to gain licensure through alternative routes.
Despite these positive developments at the state level, federal immigration policies have created challenges for IMGs. On May 27, 2025, the U.S. Department of State temporarily stopped scheduling new visa interviews for J-1 applicants. This included many international physicians seeking training or work in the U.S. However, this suspension was lifted on June 18, and additional restrictions followed. A presidential order blocked entry for J-1 visa applicants from 12 nations, including Sudan, Afghanistan, Burma, Yemen, Haiti, Libya, Equatorial Guinea, the Republic of Congo, Somalia, Eritrea, Chad, and Iran. Whereas partial restrictions were placed on applicants from seven other nations, such as Venezuela, Laos, Togo, Cuba, Turkmenistan, Burundi, and Sierra Leone. These actions have made it harder for some IMGs to enter the U.S. and contribute to the healthcare system.
Another important effort to address the physician shortage is taking place at the national level through legislation. The U.S. Congress has introduced two bills: S.709 and H.R. 1585, which aimed at improving the Conrad 30 program. This program offers each state the opportunity to sponsor up to 30 IMGs per year, who waive their requirement to return to their home country for two years after training, as long as they agree to work for three years in underserved regions.
The proposed updates to the Conrad 30 program are intended to expand and strengthen these pathways, which make it easier for IMGs to practice and stay in the U.S., specifically in terms of areas with the greatest need for healthcare providers.
In conclusion, while the U.S. is facing a serious and growing shortage of physicians, efforts at both the federal and state levels are underway to address this problem. Expanding the opportunities for IMGs to practice medicine across the U.S. could play a major role in improving access to healthcare, particularly in underserved areas. However, immigration policy guidelines will need to align with these goals to ensure long-term success.
Reference: Adashi EY, O’Mahony DP, Cohen IG. The national physician shortfall: Role of international medical graduates. Am J Med. 2026;139(2):135-136. doi:10.1016/j.amjmed.2025.07.037
