A contentious congressional hearing on America’s worsening physician shortage has raised concerns that proposed visa fee changes could complicate career prospects for Indian medical graduates seeking to work in the United States.

The debate emerged during a House Ways and Means Health Subcommittee hearing focused on expanding graduate medical education (GME) and addressing gaps in rural healthcare delivery. At the centre of the discussion is a proposal to impose a $100,000 supplemental fee for new H-1B visas, a sharp increase over existing employer-paid processing costs.

Physician shortage and rural strain

Congressman Adrian Smith warned lawmakers of a looming crisis. “By 2037, the US will see a shortage of 187,000 physicians. Nearly half of all practicing physicians will retire in the next decade,” he said.

He highlighted the strain on rural America, noting that 83 million Americans live in areas with too few primary care physicians and that only 2 per cent of residency slots are located in rural regions.

As lawmakers explored ways to expand Medicare-supported residency positions, immigration policy surfaced as a flashpoint.

Immigration debate intensifies

Congresswoman Linda Sanchez questioned whether higher visa fees would disproportionately hurt underserved communities that rely heavily on international medical graduates (IMGs). Dr. Andrew Racine, president of the American Academy of Pediatrics, cautioned that any measure reducing physician supply would impact patient care, especially for children.

Indian nationals were not directly referenced during the hearing, but they form one of the largest groups of IMGs in the US healthcare system, particularly in internal medicine, family medicine and primary care specialties. Many serve in rural and medically underserved areas through visa programmes tied to service obligations.

Hospital administrators warned that additional visa-related costs could make recruitment financially unviable for smaller institutions. Jason Shenefield, CEO of Phelps Health in Missouri, said his rural system already faces significant financial losses per resident under existing funding structures.

Divided views on reform

Some Republican lawmakers argued immigration reforms should not substitute for domestic medical training expansion. Congressman Greg Steube contended that American graduates were losing residency opportunities to foreign-trained doctors and signalled plans for corrective legislation.

Meanwhile, bipartisan proposals seek to add 14,000 Medicare-funded residency slots over seven years, prioritising rural and underserved communities. Medicare currently allocates about $22 billion annually toward GME, though caps imposed in 1997 still shape distribution.

For Indian medical aspirants navigating US licensing exams and residency placements, the evolving debate introduces fresh uncertainty, underscoring how American healthcare policy and global medical mobility are increasingly interconnected.