After earning a medical degree, who gets the residency, the citizen or the foreigner?
We tell our children to study hard. Get the education. Earn the degree. Prepare for a profession where they can make a difference. Suppose Johnny does all of that.
He graduates from medical school. He has the degree. But on the usual path toward independent medical practice, there is another essential step: postgraduate clinical training, usually through residency training. And without a residency selection, a student’s medical career is effectively on hold, as residency training is required to obtain a full medical license and practice independently.
So, now Johnny needs a residency. And that brings me back to the question we asked in my last article: When does the system give American applicants First Consideration? The ANSWER – it doesn’t. It rewards Foreign Trained Physicians with VISA preferences to overcome Medicare Reimbursement CAPS on U.S. Doctors.
A controversy involving Rochester General Hospital in New York brought that question into sharp focus. A viral post alleged that 80 of 82 resident physicians were foreign-trained working under H‑1B or J‑1 VISAS, leaving only two positions for Americans.
That is a serious allegation. It also remains unverified. Medical-school rosters do not establish citizenship or VISA status, and the hospital’s published response did not provide that breakdown. Still, the questions deserve answers.
How many American applicants applied? How many were interviewed? How were applicants selected? And what role did VISA sponsorship play?
Before we can answer those questions honestly, we need to understand three things: 1. How residency selection works; 2. How H‑1B and J‑1 differ; and 3. What the numbers actually tell us.
A country concerned about having enough doctors should also be concerned about whether qualified Americans have a fair opportunity to complete their training.
