Healthcare systems across the United States continue to experience major staffing shortages, affecting hospitals, clinics, long-term care facilities, rural health centers, and emergency departments. Retirements, burnout, training limitations, and uneven distribution of providers are driving a nationwide workforce crisis. Immigration policy now plays an increasingly important role in determining how quickly health employers can recruit and retain talent.
This NPZ update highlights the major factors influencing the healthcare workforce shortage and how current immigration rules impact staffing in critical areas.
1. The Growing Healthcare Workforce Gap
National projections indicate significant shortages across a range of healthcare professions by 2036, including:
- Tens of thousands of missing physicians
- More than 200,000 nursing vacancies
- Severe gaps in primary care, emergency medicine, psychiatry, and rural specialties
These shortages affects patient wait times, access to care, emergency department capacity, and overall health outcomes. Rural communities are especially impacted because they have fewer physicians per resident and face greater recruitment challenges.
2. How Immigration Rules Affect Recruiting Physicians
International medical graduates (IMGs) make up about one-quarter of all U.S. physicians and are critical to underserved communities. Many begin their careers in the United States through the H-1B visa category.
Recent policy developments have made hiring IMGs more difficult, including:
- Significantly higher H-1B-related filing fees
- A capped number of available H-1B visas
- Processing delays that slow staffing decisions
- Competition with other industries for the limited H-1B slots
These challenges are especially hard on hospitals in rural areas and safety-net systems that depend heavily on IMG physicians.
3. Training Capacity: Residency and Fellowship Limitations
Physician shortages are directly affected by the limited number of residency and fellowship training positions in the United States. Although federal legislation has added some new residency slots in recent years, the increases fall far short of projected workforce demands.
Some states have responded by creating state-funded residency programs, expanding training sites in underserved regions, and forming partnerships between hospitals and medical schools to increase home-grown physician supply.
4. Expanding Scope of Practice to Improve Access
To help alleviate shortages, many states have expanded the scope of practice for:
- Nurse practitioners
- Physician assistants
- Other advanced practice providers
A growing number of states now allow nurse practitioners to practice independently, which can increase access to care—especially in rural and medically underserved areas.
5. Loan Repayment Programs and Workforce Incentives
Federal and state governments continue to invest in incentives to attract healthcare workers to shortage areas. These programs include:
- Loan repayment assistance for clinicians working in high-need communities
- Loan forgiveness for those employed in public service roles
- State-specific financial incentives tied to service commitments
- Telemedicine initiatives allowing rural areas to access specialists remotely
While these efforts help, supply still lags behind demand.
6. Nursing Shortages Are Intensifying
Hospitals, home health agencies, and long-term care facilities are facing rising nursing shortages. Contributing factors include:
- Limited nursing school enrollment capacity
- High turnover due to burnout
- A large segment of the nursing workforce nearing retirement
- Recruitment challenges driven by compensation differences between clinical and non-clinical roles
Policymakers are exploring expanded training capacity, retention-focused programs, safety improvements, and streamlined pathways for internationally trained nurses.
7. Immigration Reforms Under Discussion
Beyond changes to the H-1B program, policymakers have proposed several immigration-related solutions to address healthcare gaps, including:
- Exempting certain healthcare workers from visa caps
- Creating a dedicated healthcare immigration category
- Improving the J-1 waiver process for physicians
- Recapturing unused immigrant visas for physicians and nurses
These ideas have gained bipartisan attention, but none have yet been enacted into law.
Conclusion
The U.S. healthcare workforce shortage is a complex issue influenced by training capacity, state regulations, workforce demographics, and immigration policy. As healthcare systems continue to struggle with growing patient needs, smart immigration pathways and policy updates will be essential tools for supporting the nation’s healthcare infrastructure.
NPZ Law Group continues to monitor legislative and regulatory developments that affect healthcare employers, medical professionals, and internationally trained clinicians.
FAQs — Healthcare Workforce & Immigration (2026)
1. Why is the healthcare workforce shortage worsening?
Retirements, burnout, limited training capacity, and uneven distribution of providers across the country contribute to growing shortages.
2. How does immigration affect physician supply?
International medical graduates are essential to the U.S. healthcare system, particularly in underserved areas. Visa fees, caps, and delays directly affect recruitment.
3. Are states expanding scope of practice for NPs and PAs?
Yes. Many states now allow advanced practice providers to deliver care with greater independence to help fill staffing gaps.
4. Will new immigration reforms help healthcare employers?
Proposals under discussion—including visa exemptions and faster pathways for J-1 waivers—could ease shortages, but nothing has been enacted yet.
5. What can healthcare employers do now?
Employers can invest in recruitment programs, partner with training institutions, explore all available immigration options, and use state and federal incentives to attract clinicians.
Contact Information
If you or your family members have any questions about how immigration and nationality laws in the United States may affect you, or if you want to access additional information about immigration and nationality laws in the United States or Canada, please do not hesitate to contact the immigration and nationality lawyers at NPZ Law Group. You can reach us by emailing info@visaserve.com or by calling us at 201-670-0006 extension 104. We also invite you to visit our website at www.visaserve.com for more information.