Foreign Physicians and Dentists in the U.S.: Visas and Opportunities

The United States healthcare system is going through one of the most severe workforce crises in its history, and this gap is opening concrete immigration pathways for physicians and dentists trained abroad. Official projections combine mass retirements, a historic bottleneck in Medicare-funded residency slots, and post-pandemic burnout. The result is a structural scenario in which IMGs (International Medical Graduates) are no longer the exception but a central part of U.S. public health policy.

The Association of American Medical Colleges (AAMC) projects a shortage of up to 86,000 physicians by 2036, while the National Center for Health Workforce Analysis, under the Health Resources and Services Administration (HRSA), estimates a total deficit of 187,130 physicians by 2037, of which 87,150 are in primary care alone. For qualified Brazilian and Latin American professionals, this translates into real demand, specific waiver programs, and visa categories designed to retain clinical talent.

The True Scale of the Shortage

HRSA data updated in 2025 shows that more than 77 million Americans live in primary care Health Professional Shortage Areas (HPSAs) — regions where the physician-to-population ratio falls below the federal threshold. To close the gap, the country would need approximately 13,364 additional physicians in those areas. The most affected regions are concentrated in the Southeast, rural Northeast, and tribal and border communities, where accessing a basic medical appointment may require traveling dozens of miles.

The dental sector follows a similar pattern: 59.7 million people live in dental HPSAs, with an estimated shortage of 10,143 dentists. The American Dental Association (ADA) reinforces the trend by projecting a shortage of 10,000 dentists by 2030, with about 40% of active practitioners nearing retirement. The Midwest and South have the largest disparities, with rural and low-income populations disproportionately affected.

Structural Causes

Three forces explain the picture. The first is population aging combined with the aging of the medical workforce itself — a significant share of American physicians are 65 or older. The second is the cap on Medicare-funded residency slots, known as the GME Cap, frozen since the Balanced Budget Act of 1997. This federal limit restricts how many new physicians can be trained each year, creating a bottleneck at the end of the pipeline even when qualified candidates exist.

The third is professional burnout. Recent Medscape surveys indicate that around 63% of physicians report open positions with no qualified professionals to fill them, while post-pandemic fatigue has accelerated early retirements and reduced working hours. The combined result is growing demand against a supply that grows more slowly.

The Role of Foreign-Trained Physicians

IMGs already account for approximately 24.7% of active physicians in the U.S., according to the AAMC — around 325,000 professionals, with nearly 18% growth since 2010. In family medicine, more than one in five physicians trained outside the country, and the concentration is even higher in rural areas, where U.S.-trained physicians tend not to settle.

This structural role is recognized by the federal government itself through the Conrad 30 J-1 Visa Waiver. The program allows each state to grant up to 30 annual waivers of the home-country return requirement applicable to J-1 physician visa holders, in exchange for a three-year full-time service commitment in areas designated as underserved (HPSAs or MUAs). In 2025, the AAMC supported legislation to raise the state cap to 100 waivers, signaling bipartisan recognition that the current Conrad 30 is insufficient given the scale of demand.

Visa Pathways for Clinical Professionals

H-1B for Physicians

The H-1B is the most common nonimmigrant category for foreign physicians working in salaried positions. The process involves annual electronic pre-registration and lottery selection when demand exceeds the cap of 65,000 regular visas plus 20,000 for holders of a master’s degree or doctorate from a U.S. institution. Fees in 2026 include the electronic registration at $215, the base I-129 at $780, plus the ACWIA, Fraud Prevention and Detection Fee, and Asylum Program Fee, totaling amounts that vary by employer size. Premium processing is $2,805 with a decision within 15 business days. Hospitals and nonprofit healthcare institutions qualifying as university affiliates may be exempt from the annual cap, making the H-1B predictable for physicians hired by academic hospital systems.

EB-2 NIW for Physicians in Underserved Areas

The EB-2 National Interest Waiver has been increasingly used by physicians practicing in HPSAs or engaged in clinically relevant research. This category waives the job offer and labor certification (PERM) requirements when the applicant demonstrates substantial merit, adequate positioning to advance the endeavor, and net benefit to the U.S., per the Matter of Dhanasar precedent. For physicians specifically, there is a well-established pathway via the physician national interest waiver, which requires five cumulative years of full-time practice in a designated area. The I-140 fee is $715 and the I-485 adjustment of status with biometrics is $1,440 in 2026.

O-1 for Extraordinary Ability Profiles

The O-1A serves physicians with extraordinary ability demonstrated through sustained recognition, publications in peer-reviewed journals, critical roles in prestigious organizations, awards, and relevant academic citations. There is no annual cap and the visa can be renewed indefinitely in increments. It is particularly useful for clinical researchers, physicians with a robust scientific output, and professionals with a documented international profile.

J-1 and the Conrad 30 Window

The J-1 is the traditional gateway for medical residency in the U.S., sponsored by the Educational Commission for Foreign Medical Graduates (ECFMG). It carries the two-year home-country return requirement (INA 212(e)), which can be waived through Conrad 30 or federal waivers (Veterans Affairs, Department of Health and Human Services, Appalachian Regional Commission, Delta Regional Authority). The J-1 + Conrad 30 combination is the most common route for foreign physicians who wish to remain in the U.S. after residency without returning to their home country.

Dentists: A Similar Path, with Nuances

For dentists, the starting point is typically credential validation through an Advanced Standing Program at a CODA-accredited U.S. dental school, completing the DDS or DMD in two to three additional years. From there, the H-1B, EB-2 NIW, and O-1 pathways follow logic analogous to that of physicians. Demand in dental HPSAs opens room for national interest arguments, especially in pediatric dentistry and community dentistry in rural areas.

What Is Being Discussed in Congress

The Resident Physician Shortage Reduction Act, currently pending, proposes adding 14,000 new Medicare-funded residency slots over seven years, with explicit prioritization for primary care, psychiatry, and designated underserved areas. If passed, the bill would represent the largest expansion of GME since the 1997 freeze and would increase available slots for IMGs in the national Match.

How Brazilian Professionals Can Position Themselves

The practical process begins long before the visa. For physicians, it involves ECFMG certification, passing USMLE Step 1, Step 2 CK, and Step 3, and participating in the Match to secure a residency position. For dentists, it involves the National Board Dental Examinations and enrollment in an Advanced Standing program. In parallel, it is strategic to build a portfolio to support future EB-2 NIW or O-1 petitions: peer-reviewed publications, conference presentations, letters from independent experts, evidence of public health impact, and, when applicable, documentation of practice in underserved areas.

With more than 77 million Americans without access to a primary care physician and nearly 60 million facing a dental shortage, the window of opportunity for qualified professionals is open — and likely to remain open for more than a decade. The combination of programs such as Conrad 30, EB-2 NIW and O-1 categories, and the possible expansion of GME outlines an immigration ecosystem that, while demanding in its technical requirements, rewards those who prepare in advance and document every step of their career with rigor.

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.