Foreign Doctors and Dentists in the U.S.: Visa Pathways in 2026

The United States is facing its most acute healthcare professional shortage in decades, and this structural gap has made medical and dental immigration a central element of American public health policy. For physicians and dentists trained outside the U.S., the current moment represents a concrete window of opportunity — provided the chosen immigration route aligns with the professional’s profile, specialty, and intended practice location.

The mechanism is twofold: on one side, the American healthcare system cannot train physicians and dentists fast enough to meet the needs of an aging population; on the other, federal and state programs have been specifically designed to attract foreign professionals to underserved regions. Understanding this ecosystem is the first step for any doctor or dentist considering building a career in the U.S.

The True Scale of the Shortage

The Association of American Medical Colleges (AAMC) projects a shortage of up to 86,000 physicians by 2036, driven by the retirement of a significant portion of the workforce and the longstanding cap on residency slots. The National Center for Health Workforce Analysis, under the Health Resources and Services Administration (HRSA), works with even more severe scenarios: the total deficit could reach 187,000 physicians by 2037, with approximately 87,000 in primary care alone.

In March 2025, HRSA reported that more than 77 million Americans lived in areas classified as Health Professional Shortage Areas (HPSAs) — regions with a severe shortage of primary care physicians. To bridge the current gap, the system would need to incorporate approximately 13,000 additional physicians. The Southeast and Midwest lead the ranking of most affected regions, with entire communities depending on a minimal network of practices.

The dental landscape is equally critical. HRSA counts 59.7 million people living in dental HPSAs, with an estimated shortage of around 10,000 dentists. The American Dental Association projects a shortage of approximately 10,000 dentists by 2030, worsened by the fact that roughly 40% of American dentists are nearing retirement age, with no equivalent replacement among new graduates.

Why the Shortage Exists

Three structural forces fuel the crisis. The first is demographic: American life expectancy has grown, and the population over 65 demands a volume and complexity of care that puts pressure on all specialties, from geriatrics to cardiology. The second is regulatory: the cap on Medicare-funded residency slots, known as the GME Cap and frozen since the 1990s, artificially restricts the training of new physicians even when qualified candidates are available.

The third is professional burnout. A Medscape survey from August 2025 indicated that 63% of American physicians report open positions with no qualified professionals to fill them. The combination of high workloads, administrative pressure, and the legacy of the COVID-19 pandemic led many mid-career physicians to reduce hours or leave practice early. The result is a system losing capacity at the top without replenishing it at the base.

The Weight of Internationally Trained Physicians

In this context, International Medical Graduates (IMGs) have gone from being the exception to becoming the backbone of many regions. Approximately 24.7% of active physicians in the U.S. are graduates of foreign medical schools, according to the AAMC, equivalent to roughly 325,000 professionals — an increase of nearly 18% over the previous decade.

These physicians are strongly concentrated in primary care and rural areas. It is estimated that more than 20% of family physicians practicing in the U.S. trained abroad, frequently in counties where American colleagues do not settle. For the healthcare system, they cover demand that would otherwise go unmet. For the foreign professional, working in an underserved area is both an entry point and, in many cases, an accelerated path to permanent residence.

Conrad 30 and the J-1 Waiver

The Conrad 30 J-1 Visa Waiver program is one of the most important mechanisms in this arrangement. Physicians who complete residency or fellowship in the U.S. on a J-1 visa are generally subject to the two-year home residency requirement before they can apply for new visas or adjust their status. Conrad 30 allows each state to grant up to 30 annual waivers of this requirement, in exchange for a three-year commitment to full-time service in a designated underserved area, typically a HPSA or MUA.

In 2025, the AAMC backed legislation to expand the state cap from 30 to 100 waivers, with the stated goal of significantly increasing the number of foreign physicians serving underserved communities. The bill was still moving through Congress as of April 2026, and any passage will depend on bipartisan support. Even in its current form, the program is the most widely used path for Brazilian and Latin American physicians to transition from J-1 to a long-term work visa in the U.S.

H-1B for Healthcare Professionals

The H-1B visa is the most well-known option for physicians and dentists intending to work in the U.S. in specialized positions. The category requires a bachelor’s degree or higher in a related field, a formal job offer from a U.S. employer, and a Labor Condition Application filed with the Department of Labor.

The H-1B is subject to an annual lottery with a cap of 65,000 regular slots plus 20,000 for holders of U.S. master’s or doctoral degrees. 2025 data showed approximately 5,600 H-1B holders working specifically in healthcare, out of a total universe of 442,000 beneficiaries. University hospitals, nonprofit health systems, and university-affiliated research centers are often exempt from the numerical cap, making these institutions particularly attractive routes for physician-researchers and specialists. Dentists in hospital residency or fellowship programs may also qualify for this exemption.

EB-2 NIW: Green Card Through National Interest

The EB-2 NIW (National Interest Waiver) is the most sophisticated immigration route and, at the same time, the most aligned with the profile of physicians and dentists serving underserved areas. The category allows a Green Card petition without a job offer and without a labor market test (PERM), provided the professional demonstrates that their work serves the national interest of the United States.

The applicable analytical standard is the three-prong test established in Matter of Dhanasar (2016): the proposed work must have substantial merit and national importance, the foreign national must be well-positioned to advance it, and the balance of circumstances must favor waiving the job offer requirement. Physicians working in HPSAs or in critically demanded specialties frequently satisfy all three prongs with strength. Dentists with a public health or research profile also find space in this category.

The process begins with Form I-140 (self-petition), followed by status adjustment via Form I-485 if the professional is already in the U.S., or consular processing abroad. EB-2 priority dates for Brazilian nationals have remained relatively accessible in recent Visa Bulletins, though the picture changes month to month and requires monitoring.

O-1 for Proven Excellence

The O-1 visa serves professionals with demonstrated extraordinary ability. For physicians and dentists, it is a viable route when there is a strong track record of publications in indexed journals, recognized awards, presentations at prestigious conferences, service as a peer reviewer for scientific journals, and coverage in specialized media. The evidentiary standard is high, but the O-1 is not subject to a lottery or numerical cap, making it a relevant alternative for top-tier professionals who were not selected in the H-1B lottery.

What Congress Is Debating for 2026

The Resident Physician Shortage Reduction Act of 2025 proposes adding 14,000 new medical residency slots over seven years, structurally expanding the GME Cap for the first time in decades. If passed, the bill would increase the absorption capacity for IMGs in residency programs, especially in primary care and high-demand specialties such as psychiatry, geriatrics, and emergency medicine.

Other bills moving through the same legislative cycle seek to expand Conrad 30 and create tax incentives for hospitals that host foreign physicians in underserved areas. None of these measures had been enacted into law as of the publication date of this article, but the package signals that Congress recognizes the shortage as a structural, not cyclical, problem.

Planning the Transition

For Brazilian physicians and dentists planning to immigrate, planning begins before arriving in the U.S. For physicians, passing the USMLE Step 1, Step 2 CK, and Step 3 exams, along with ECFMG certification, is a prerequisite for any residency program and for most work visas. For dentists, the path runs through the National Board Dental Examination and, in most states, Advanced Standing programs at American dental schools that culminate in a DDS or DMD recognized by the American Dental Association Commission on Dental Accreditation.

The choice between H-1B, EB-2 NIW, and O-1 is not mutually exclusive: many professionals start on H-1B or J-1, transition to EB-2 NIW as they consolidate work in underserved areas, and in some cases explore the O-1 as a bridge or alternative. The underlying message is that the American system offers multiple doors — and each door requires documentary, technical, and strategic preparation to be crossed safely.

Victoria Harper

Editor-in-Chief

Meet the author

Leading journalism and editorial content at Visto n’ Visa, Victoria helps make immigration topics clear, trustworthy, and easy to understand. Her focus is on delivering useful, human, and relevant content for people exploring new paths abroad.