Visa renewals are processing again, but health systems and international physicians still have no clear path forward.
In late April, the U.S. Citizenship and Immigration Services updated its website to indicate physicians were no longer subject to a visa processing hold. The freeze stemmed from a federal policy implemented in December that paused decisions on visa extensions, work permits and green cards for citizens of 39 countries. Although the travel ban did not apply to visa holders in the U.S., USCIS paused visa renewals and updates for people from those countries. This subjected more than 10,000 physician H-1B visa holders and 17,000 with J-1s — along with thousands of nurses, lab techs and other healthcare workers — to the visa pause. Many affected physicians were put on administrative leave by hospitals while awaiting their renewal.
With no clarity on which applications are covered, how quickly they will be processed or whether a formal request process is required, the resumption has left health systems and physicians with unanswered questions on next steps, according to the American Academy of Pediatrics.
Here is what to know about the immediate aftermath of the reversal.
1. The reversal has no implementation guidance. Although many physician associations said they are pleased with visa applications continuing to be processed, they called on the agency to provide clearer guidance on next steps.
“At present, there is no clear practical pathway for physicians or hospitals to act on this update,” American Academy of Pediatrics President Andrew Racine, MD, PhD, said in a May 4 news release. “Bridging the gap between policy language and implementation is critical to secure consistent lifting of the hold, timely adjudication, and prevention of patient-care disruptions. It’s a move in the right direction, but there’s still work to be done.”
A USCIS spokesperson told Becker’s it is processing “certain applications associated with medical physicians” but did not specify which applications were being processed.
“Screening and vetting processes for these applicants continues to exceed what the previous administration implemented, including through expanded background checks, biometric and social media screening, and new risk-based adjudication processes to close security gaps and prevent fraud,” the spokesperson said. “Applications associated with medical physicians will continue processing in the normal course of USCIS adjudications to final decision.”
The agency declined to answer Becker’s questions for further details.
2. The backlog has gotten worse. Previously, J-1 waiver applications were processed in one to three weeks, Politico reported, but now hundreds sit in a queue for processing. Although review is now in motion, it’s unclear how long it will take to clear all the applications.
Some foreign physicians have waited months for an update on their application, even after their hospital paid a $2,965 fee to fast-track their applications so they would receive it in two weeks. Because most medical residencies begin or end in the summer, the limbo made some foreign physicians miss fellowship deadlines, forgo jobs or be sidelined from their current position while awaiting renewal. Foreign-trained physicians are rallying against the delays and dozens of lawsuits have been filed in federal court.
3. The $100,000 H-1B fee is still in effect. Although applications are making moves, there has been no change to the $100,000 H-1B visa fee.
In September, President Donald Trump raised the application fee to $100,000, up from approximately $3,500. National healthcare organizations, such as the American Medical Association and the American Hospital Association, for months have advocated for healthcare-specific exemptions to the $100,000 fee. Four federal lawmakers introduced a bill aimed at exempting physicians and other healthcare workers from the $100,000 H-1B visa application fee. It has been in the House Committee on the Judiciary since March 17.
Sixty-four percent of hospitals using or planning to use the H-1B program told the AHA in November they would pause, defer or limit recruitment because of the fee.
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