The Trump administration has been working to catch up to President Donald Trump’s tweet announcing the planned executive order that will suspend all immigration into the United States. The decision was made in response to “the attack from the Invisible Enemy” and is one of many immigration changes being put in place under the guise of combating the COVID-19 coronavirus crisis.

The executive order is expected to have exemptions for farm workers and medical professionals, however, the next generation of medical professionals’ careers are already at stake due to the J-1 visa program seemingly slipping through the cracks.

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A J-1 visa is a non-immigration visa that is specific to applicants looking to partake in a work-and-study-based exchange visitor program. This is a training visa that allows an applicant to work and study in the US, either in their field or industries like seasonal tourism, before returning to their home country. Per the Department of State (DOS) website, the goal of the Exchange Visitor Program is to “foster global understanding through educational and cultural exchanges.”

Will We Lose People on the Front Line of the Pandemic due to Immigration Issues?

In response to a previous petition from the Education Commision of Foreign Medical Graduates (ECFMG), the DOS approved “J-1 physicians engaging in alternate rotations and clinical assignments during the pandemic as deemed appropriate.”

That move provides hospitals with much needed assistance in combating COVID-19 as residents and fellows will be able to take on some of the workload that is currently overwhelming first responders and hospital staff. The decision will not be able to fulfill its potential if the incoming class of residents and fellows working under J-1 visas are unable to gain entry to the country.

This summer, a projected 4,222 students and professionals are set to complete their residency and fellowship programs in the US using a J-1 visa. Many of these individuals have been matched with their programs for some time.

One Spaniard anesthesiology resident in Chicago whose fellowship is now in jeopardy shared their plea to the DOS with Grit Daily anonymously. The student explained that they had signed their fellowship agreement in March of 2019, but worry that they will lose their place in the program as the Spanish Ministry of Health is closed and cannot provide a Statement of Need (SON). A SON is a simple statement from a foreign Ministry of Health that validates a candidate’s visa application and is a required document when obtaining a J-1 visa.

We spoke with Matthew Basilico, PhD, a student in the MD-PhD program in Economics at Harvard University that matched into the General Surgery Residency at Johns Hopkins Hospital and was set to start in June.

“Preventing foreign medical graduates from starting as resident physicians could have a serious impact on our ability to fight COVID-19 domestically,” says Basilico “These physicians are integral in the care of hospital inpatients and perform many critical duties on ICU teams. Thousands of these physicians will be on the front lines of our response to COVID-19 beginning in June. Furthermore, any policy creating barriers for these physicians will be an unneeded distraction for hospital leaders directing America’s clinical fight against COVID-19,” he says.

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It All Comes Down to a Letter

The ECFMG has been working to resolve the issue surrounding the J-1 visa as it pertains to the medical field by lobbying for exemptions from the DOS. From their efforts, the ECFMG has persuaded the DOS to begin processing J-1 visas again and to relax their requirements so that applicants can electronically submit SONs. These are steps in the right direction, but the move to resume processing visas may be negated by the new executive order and accepting electronic SONs overlooks a key element of the issue. 

One of the biggest challenges being presented to those matched with programs—aside from getting the US government to process their visa—is getting a SON from their home country’s Ministry of Health. What was once a simple task is now extremely complicated due to the fact that Ministry of Health offices in many countries have been effectively shut down to the public. Fighting the COVID-19 pandemic has become the focal point of many foreign governments. Countries that are fully locked down are dedicating their time and resources to fighting the outbreak and do not have the ability to execute routine actions like issuing a SON. 

In an effort to fix this bureaucratic issue, the ECFMG is attempting to petition the DOS to waive the requirement for SONs. Many of the people being affected by the J-1 issues are already in the country and are completing their student visas. Their ability to complete their medical training is being compromised by a small element of the J-1 visa, one that was very routine up until the global COVID-19 outbreak.

“Making the hospitals chase down this paperwork or adjust to having fewer physicians because of this lack of paperwork seems to be the last thing we would want to do right now as a country,” says Dr. Basilico.

The bureaucracy surrounding the J-1 visa could mean less doctors on the medical frontline, resulting in life or death situations for COVID-19 patients across the United States.