Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Healthcare Workforce

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Internationally trained healthcare workers in America have long faced barriers to working in their fields; even those who have practiced for years in their home countries must repeat much of their training in U.S. medical residency programs. But these residency programs are often strongly biased toward American applicants. Despite strong qualifications, international applicants are accepted at roughly half the rate of their American counterparts, according to the National Resident Matching Program. State testing and licensure also costs thousands of dollars and years of missed income and opportunity to serve. We applaud Senator Alex Padilla and the Judiciary Committee for raising awareness of this important issue during the Senate Judiciary Committee Hearing on September 14th, 2022.

Watch the full hearing here.

Read our official statement submitted to Congress below, and learn more about our work with immigrants in the healthcare sector here.


Upwardly Global commends Chair Padilla and the Judiciary Committee for holding a hearing during this critical time for our country’s healthcare system. Upwardly Global is the first and longest-serving organization focused on advancing the meaningful inclusion of immigrants and refugees with international credentials into the U.S. workforce. With offices in four major cities, Upwardly Global works with thousands of job seekers across the country every year to support their full inclusion in the U.S. labor market. Our work with immigrant and refugee medical professionals guides this statement.

In all of the Committee Members’ states, there are communities experiencing lack of access to healthcare due to the shortage of physicians and nurse practitioners. It is projected that by 2033, the United States will be 139,000 physicians short of the needed amount.

There is particularly a need to meet healthcare demands in underserved communities, including immigrant communities and other communities of color. Under COVID-19, hospitalization rates amongst Black and Hispanic communities across the U.S. were at least double the national average, and death amongst the older Black and Hispanic population were two times as high as the non-Hispanic white population.

While the demand for physicians is high, the United States does have the resources to meet this need in the form of work-authorized immigrant and refugee professionals with overseas training and credentials. There are 2.3 million recently arrived, college-educated immigrant and refugee professionals in the U.S. today with degrees in high-demand fields like technology, administration, healthcare, and other skilled professions; 165,000 are internationally trained medical professionals who are unemployed or severely underemployed.

We are underutilizing this talent.

Most of these medical professionals are sidelined due to licensing rules that fail to recognize their expertise and require costly and time-consuming examinations and residencies. Upwardly Global has worked to address these limitations and provide support for medical professional through the following avenues:

1. Encourage establishment of paid internship and returnship programs.
Together with New York-Presbyterian, one of the largest academic medical centers in the country, Upwardly Global has co-designed and launched a paid, mid-career internship program to on-ramp internationally trained immigrants into open roles in the healthcare sector. The model addresses staffing needs with a new, diverse pool of talent; equips our medical system to have a greater, more equitable impact on health access and outcomes in underserved communities; and offers alternative career pathways for immigrants with international credentials and experience.

2. Highlight and encourage improved state licensing laws.
Upwardly Global is also working with legislators, regulators, healthcare providers, and grassroots and national organizations in several states, including Washington and Illinois, to make it easier for immigrants and refugees eager to share their talents and skills. Recently, this has taken the form of urging states to ease restrictions and allow internationally trained medics to serve during the COVID-19 pandemic. Licensing reform should be supported in tandem with critical local actors and hospitals.

3. Fund community-based organizations that support training, relicensing, and connections to employers.
There are Offices of New Americans (ONA) in many cities around the country that should be funded with the mandate to support immigrants and refugees with international healthcare credentials. We are working with ONA in New York State on their Professional Pathways Program in a direct service and capacity-building role — a model program to this end. Critical federal agencies should also direct funding to this group of largely invisiblized immigrants and refugees. We are also currently working with the Office of Refugee Resettlement to support Afghans with international credentials — an example of targeted focus.

Although these initiatives have significantly improved opportunities for immigrant and refugee medical professionals and have helped to ease the burden on the healthcare system in certain states, more work can and needs to be done on the federal level. By taking these critical steps, we can ensure that thousands of immigrant and refugee physicians are able to contribute their skills and talents while simultaneously addressing the physician shortage in underserved communities across the United States.

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